The Quest to Cure Cancer – Isabel Duarte

TL;DR

Can cancer be cured? Not as a single disease with a single solution. Cancer is many diseases, linked by shared biological rules. There is no universal cure because cancer evolves, spreads, and hides within our own biology. But the quest to cure cancer is real and advancing: immunotherapy, precision medicine, engineered cells, early detection, and smarter treatment combinations are steadily turning many cancers from fatal into curable or controllable diseases. Hope today is not hype, it is cumulative, evidence-based, and grounded in how cancer actually works.

The Full Story

“Cancer” is a single word that hides an uncomfortable truth: it refers to hundreds of different diseases.

We use the same label for a childhood leukemia, a melanoma caused by sun exposure, and a lung tumour driven by decades of smoking. This linguistic convenience is useful in everyday conversation, but scientifically it can be misleading. Much of the frustration around cancer - including the recurring question “Why haven’t we cured it yet?” - comes from taking that word too literally.

To understand where we stand today, it helps to unpack what we really mean when we talk about cancer.

Cancer: Not one disease, but many

Cancer is not a single entity in the way tuberculosis or measles are. It is a broad category defined less by cause than by outcome: cells that grow when they should not, refuse to stop, and sometimes spread.

A breast cancer and a pancreatic cancer arise in different tissues, accumulate different mutations, interact with different microenvironments, and respond to different treatments. Even two tumours from the same organ can behave like entirely different diseases once you look at their molecular profiles.

This is not a minor detail. It is the central reason why there is no single “cure for cancer”. Expecting one universal solution is like expecting the same drug to cure asthma, diabetes, and Alzheimer’s disease - simply because they all affect humans.

And yet, calling cancer only a collection of unrelated diseases is also unsatisfying.

What all cancers have in common

Despite their diversity, cancers do share something fundamental: they are diseases of broken cellular control.

Every cancer begins when normal cells accumulate genetic and epigenetic changes that allow them to ignore the rules governing growth, death, and cooperation within tissues. In that sense, cancer is not foreign - it is our own biology pushed into a pathological regime.

This tension - deep diversity built on shared principles - motivated one of the most influential ideas in modern cancer biology: the hallmarks of cancer.

The hallmarks: unity beneath diversity

In 2000, Douglas Hanahan and Robert Weinberg proposed that all cancers, regardless of tissue or origin, acquire a common set of capabilities during their evolution. These include:

Sustaining their own growth signals
Ignoring growth-inhibitory cues
Resisting cell death
Dividing indefinitely
Recruiting blood vessels
Invading and spreading to other tissues

Later additions included immune evasion, altered metabolism, genomic instability, and tumour-promoting inflammation.

The power of the hallmarks framework is not that it erases differences between cancers, but that it gives us a shared language. It explains how wildly different tumours can still converge on the same functional solutions: grow faster, survive longer, spread further.

From a research perspective, this matters enormously. It means we can design therapies that target capabilities rather than individual mutations - a partial unification in an otherwise fragmented landscape.

So why haven’t we cured cancer?

There is no single reason - but several recurring ones.

First, cancer is not static. Tumours evolve. They are genetically heterogeneous, and treatment itself applies selective pressure. Kill the sensitive cells, and resistant ones may survive and expand. This is evolution in real time, inside the body.

Second, the most dangerous feature of cancer is metastasis. Once cancer spreads, eliminating every last malignant cell becomes extraordinarily difficult. A handful of surviving cells can be enough for relapse.

Third, cancer cells are not invaders - they are altered versions of ourselves. This makes them hard to target without damaging healthy tissue. There is a narrow margin between effective treatment and unacceptable toxicity.

Finally, cancers actively hide. They suppress immune responses, remodel their environment, and co-opt normal cells to support their survival. They are not passive targets.

Seen this way, the absence of a universal cure is not a failure of effort or intelligence. It is a reflection of the problem’s depth.

Where hope genuinely lies

Despite this complexity, progress has been real - and in some cases, transformative, and what gives reason for hope today is not a single breakthrough, but a convergence of advances that are finally changing the rules of the game.

One of the most profound shifts has come from immunotherapy. Rather than attacking cancer directly, checkpoint inhibitors remove the molecular brakes that tumours use to suppress immune responses. In some patients, this leads to long-lasting remissions, even in advanced disease. CAR T-cell therapies go a step further by genetically reprogramming a patient’s own immune cells to recognise cancer. In certain blood cancers, this has produced outcomes that are effectively cures. While these approaches do not yet work for everyone, they have demonstrated something crucial: the immune system can eliminate cancer if it is allowed to function properly.

At the same time, precision medicine has transformed how we think about treatment. As tumour sequencing became routine, it became clear that many cancers are driven by specific molecular alterations. Targeted therapies designed against these drivers have turned some previously fatal cancers into manageable (and sometimes curable) diseases. Resistance remains a challenge, but each success reinforces a central lesson: deep biological understanding creates real therapeutic leverage.

Another important frontier is cell-based and gene-edited therapies. Beyond CAR T-cells, researchers are engineering immune cells to be more persistent, more precise, and less easily suppressed by tumours. Early clinical trials using CRISPR-edited immune cells show that it is possible to safely reprogram biology itself, shifting cancer treatment from passive drug delivery to active biological intervention.

Progress is also coming from prevention and early detection. Vaccines against cancer-causing viruses have already reduced cancer incidence, and emerging technologies such as liquid biopsies aim to detect tumours before they become clinically apparent. In cancer, timing often determines curability.

Finally, there is growing recognition that cancer must be treated as an evolving system. Combination therapies are increasingly designed to block multiple escape routes at once, reducing the chance of resistance. This approach reflects a more mature view of cancer biology: not as a single target, but as a dynamic process that must be outpaced rather than simply attacked.

There will be no single cure for cancer. But many cancers are already becoming curable, others controllable, and fewer inevitably fatal. Hope today is not speculative. It is incremental, evidence-based, and cumulative, and for the first time, it is moving faster than the disease itself.

Rethinking what “curing cancer” means

Perhaps the most important shift is conceptual.

The goal is no longer a mythical single cure for “cancer”. Instead, it is a future where:

Many cancers are cured outright
Others are controlled long-term
Diagnosis happens earlier
Treatment is precise rather than blunt

Cancer will not disappear as a biological possibility - it is too deeply tied to multicellular life and evolution. But its capacity to devastate lives can, and increasingly does, diminish.

Understanding cancer as many diseases with shared logic does not weaken hope. It grounds it.

And in science, grounded hope is the kind that tends to work.

The BioLogical Footnote

I am a cancer researcher, and like many others, I have learned to avoid saying out loud that I want to cure cancer. It sounds naïve, unprofessional, even embarrassing, as if ambition itself were a flaw. We are trained to be bold in private and cautious in public, to write visionary proposals carefully wrapped in incremental language, to promise impact while minimising risk. This creates a quiet cognitive dissonance: we are asked to imagine radically better futures, but rewarded for proposing only what feels safe. In that tension, it is easy to lose a sense of agency over one’s own scientific trajectory, as if progress depended less on ideas than on which version of boldness a reviewer happens to prefer. And yet, when I strip away the jargon and the defensive phrasing, what remains is simple. I study cancer. And what I am really doing (even if imperfectly, even if indirectly) is looking for ways to cure it. Perhaps that is a dream. But science has always advanced by people who were willing to take difficult problems seriously, even when certainty was impossible. If curing cancer is not a single destination but a long, collective process, then aiming for it is not naïve. It is honest.

Sorry for the personal detour…