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Cancer Isn't Just Cancer Cells: The Hidden Cells Helping Tumours Survive

When one thinks about <span><a href="https://www.healthandme.com/health/cancer">cancer</a></span>, the first thing that comes to mind is a mass of irregular cells growing wildly. But what is a tumour? It is much more than mere cancer cells surrounded by an extensive network of blood vessels, immune cells and various supporting cells. This is the tumour microenvironment. 

One of the key residents of the tumour microenvironment is the cancer-associated fibroblast (<span>CAF</span>), which attracts increasing interest of cancer researchers due to the fact that such cells may affect tumour growth, metastasis and therapy response. 

Normal fibroblasts have a supportive function in maintaining tissue integrity through the production of collagen and other structural components. However, when cancer arises, some <a href="https://www.healthandme.com/health-wellness/h-pylori-and-cancer-us-gastroenterologist-explains-how-a-common-stomach-infection-raises-risk-article-156350608" data-type="tilCustomLink">fibroblasts</a> located in or near the tumour acquire an additional function and become activated. Such activated fibroblasts are called CAFs.

<h2>How CAFs May Help Cancer Grow And Spread </h2>

Also read: <a href="https://www.healthandme.com/health-news/swimmer-archie-goodburns-plea-prompts-uk-action-to-speed-up-brain-cancer-treatment-article-156346903" data-type="tilCustomLink">Swimmer Archie Goodburn’s Plea Prompts UK Brain Cancer Research Review</a>

CAF involvement could be likened to that of a helper to the tumour. These cells are able to modify the stroma around the cancer cells and thereby facilitate growth and invasion into adjacent tissue. CAFs are also capable of releasing factors that facilitate angiogenesis as well as the behaviour of cancer cells. Evidence exists of a correlation between CAF involvement and tumour progression and metastasis in various types of cancer. 

Perhaps more significantly, CAFs can affect the immune response of the body. The immune system in humans is able to detect and target foreign bodies including cancer cells. However, some forms of CAFs play a role in ensuring an immunosuppressed environment that makes it difficult for the immune cells to interact effectively with the tumour cells. This could explain the wide variation in immunotherapy response among patients and different tumour types. 

The involvement of CAFs in treatment resistance is another issue that must be considered. Cancer-associated fibroblasts are known to remodel the extracellular matrix, an environment where cells are surrounded by proteins, and generate signals that help cancer cells resist stress induced by chemo and targeted therapy. CAFs therefore make treatment difficult for certain <a href="https://www.healthandme.com/health-wellness/can-panty-liners-pose-a-cancer-risk-what-science-says-article-156340789" data-type="tilCustomLink">tumours</a>.

<h2>Could CAFs Become A New Target For Cancer Treatment? </h2>

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This field of study is especially important when considering that cancer treatments are becoming increasingly personalized. Today, oncologists take into consideration such features of cancer as genetic mutation, its stage and molecular profile. Tomorrow, taking into account tumor microenvironment can give them additional knowledge on how to treat a specific type of cancer. 

But there is one major issue to be taken into consideration: CAFs are not one homogenous group of cells. There can be many types of CAFs that have very different functions, sometimes even opposing. Some of them contribute to tumor growth and some may hinder it. Thus, simply killing all fibroblasts will hardly help. Instead, there are studies on how to selectively target tumor promoting CAFs and how to reprogram them. Several such methods have already been tested clinically. 

There is one important point that this research gives to patients: <a href="https://www.healthandme.com/health-news/dr-rachna-shroff-indian-american-cancer-researcher-who-turned-her-diagnosis-into-advocacy-article-156349587" data-type="tilCustomLink">cancer</a> is not just a mass of aberrant cells. Cancer is an ecosystem where cancer cells constantly interact with their environment. 

Understanding this ecosystem might someday help oncologists tackle the mechanisms of tumor survival and resistance to therapy- and maybe make current cancer treatments more efficient. 

<strong><em>By Dr Pritam Kalaskar, Director, Co-founder and Medical Oncologist- M|O|C Cancer Care, India</em></strong>

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When one thinks about cancer, the first thing that comes to mind is a mass of irregular cells growing wildly. But what is a tumour? It is much more than mere cancer cells surrounded by an extensive network of blood vessels, immune cells and various supporting cells. This is the tumour microenvironment.  One of the key residents of the tumour microenvironment is the cancer-associated fibroblast (CAF), which attracts increasing interest of cancer researchers due to the fact that such cells may affect tumour growth, metastasis and therapy response.  Normal fibroblasts have a supportive function in maintaining tissue integrity through the production of collagen and other structural components. However, when cancer arises, some fibroblasts located in or near the tumour acquire an additional function and become activated. Such activated fibroblasts are called CAFs.How CAFs May Help Cancer Grow And Spread Also read: Swimmer Archie Goodburn’s Plea Prompts UK Brain Cancer Research ReviewCAF involvement could be likened to that of a helper to the tumour. These cells are able to modify the stroma around the cancer cells and thereby facilitate growth and invasion into adjacent tissue. CAFs are also capable of releasing factors that facilitate angiogenesis as well as the behaviour of cancer cells. Evidence exists of a correlation between CAF involvement and tumour progression and metastasis in various types of cancer. Perhaps more significantly, CAFs can affect the immune response of the body. The immune system in humans is able to detect and target foreign bodies including cancer cells. However, some forms of CAFs play a role in ensuring an immunosuppressed environment that makes it difficult for the immune cells to interact effectively with the tumour cells. This could explain the wide variation in immunotherapy response among patients and different tumour types. The involvement of CAFs in treatment resistance is another issue that must be considered. Cancer-associated fibroblasts are known to remodel the extracellular matrix, an environment where cells are surrounded by proteins, and generate signals that help cancer cells resist stress induced by chemo and targeted therapy. CAFs therefore make treatment difficult for certain tumours.Could CAFs Become A New Target For Cancer Treatment?             This field of study is especially important when considering that cancer treatments are becoming increasingly personalized. Today, oncologists take into consideration such features of cancer as genetic mutation, its stage and molecular profile. Tomorrow, taking into account tumor microenvironment can give them additional knowledge on how to treat a specific type of cancer. But there is one major issue to be taken into consideration: CAFs are not one homogenous group of cells. There can be many types of CAFs that have very different functions, sometimes even opposing. Some of them contribute to tumor growth and some may hinder it. Thus, simply killing all fibroblasts will hardly help. Instead, there are studies on how to selectively target tumor promoting CAFs and how to reprogram them. Several such methods have already been tested clinically. There is one important point that this research gives to patients: cancer is not just a mass of aberrant cells. Cancer is an ecosystem where cancer cells constantly interact with their environment. Understanding this ecosystem might someday help oncologists tackle the mechanisms of tumor survival and resistance to therapy- and maybe make current cancer treatments more efficient. By Dr Pritam Kalaskar, Director, Co-founder and Medical Oncologist- M|O|C Cancer Care, India

cancer isn't just cancer cells: the hidden cells helping tumours survive

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