Many times, nerves are the red headed stepchild of medicine. They are often overlooked as causes of various pain syndromes and in the cancer world, they are downright invisible. Now a new study suggests that for leukemia and related disorders, bad nerves causing bad stem cells may be the main cause of the disease.
Myeloproliferative disorders are a collection of diseases that include leukemia and all involve excessive growth of stem cells in the bone marrow. They have been linked back to a gene that goes awry that causes too much of an enzyme to be produced that in turn revs the stem cells into overdrive. The overstimulated stem cells in turn make bad mutant blood cells.
The new study involved an animal model of cancer where certain changes were made to the bone marrow environment. While the authors, like everyone else, would have thought that changing how blood forming stem cells differentiate into normal blood cells would have impacted the rate of cancer forming cells (causing some stem cells to mutate), that didn’t happen as expected. Instead, it was damage to the nerves in the bone marrow that allowed the cells to mutate to produce more enzyme. In fact, the authors could turn this effect off by giving the animals simple medications that caused the bad nerves to stop misbehaving.
If replicated in humans, this is a very important paper. Why? Our entire cancer fighting strategy has consisted of “dropping the big one” by giving patients potent cell poisons to kill cancer cells. The downside of course is that these poisons also damage normal cells (i.e. your hair falls out and you get very sick). Here, stopping the cancer was as simple as giving drugs to chill out the bad bone marrow nerves. The side effect profile of such a treatment would be minimal compared to chemotherapy. In addition, many of these drugs are off patent and cheap.
The upshot? Do bad nerves cause cancer? This is a big finding that may change how we approach leukemia patients. It could be that “fixing” leukemia is as simple as chilling out some misbehaving nerve cells!