Why Does Cancer Come Back? A Deeper Look into Cancer Stem Cells
At UCLA’s Broad Stem Cell Research Center, scientists are tackling a critical question that many oncologists have yet to fully address: Why do so many cancer patients experience a recurrence of their disease months—or even decades—after being declared cancer-free following surgery, radiation, and chemotherapy?
Despite aggressive treatment protocols, cancers like ovarian, prostate, lung, breast, lymphoma, and leukemia often return. The emerging consensus among researchers at UCLA and other leading cancer centers is that the key culprit may not be the cancer cells themselves—but rather cancer tumor stem cells.
When we undergo cancer treatment, the goal is typically to eliminate cancer cells. While this is important, it’s the cancer stem cells—a small but powerful subset of cells within the tumor—that are often left behind. These cells are highly resistant to conventional therapies and are believed to be the driving force behind recurrence and metastasis (the spread of cancer to other organs such as the liver or brain). Once cancer spreads to these vital organs, it becomes far more deadly.
In a conversation with an oncologist at a major cancer center, I asked: “You treat cancer cells, but what about cancer tumor stem cells?” His response was telling: “We only target cancer cells. If there’s a recurrence or metastasis, we repeat the same protocol. We don’t specifically address cancer stem cells.”
UCLA’s research has shown that repeating the same treatments often has limited success. Why? Because cancer stem cells have a protective protein coating that makes them highly resistant to both chemotherapy and radiation. Alarmingly, some standard chemotherapy drugs may even accelerate the growth of these resilient cells.
The encouraging news is that treatments targeting cancer stem cells do exist—and many are available in the U.S. Some are affordable, while others can be costly. Why more oncologists don’t discuss these options with patients remains unclear. However, patients should feel empowered to ask questions and explore all available treatments.
Cancer stem cells are a serious threat. Without proper treatment, they can survive, resurface, and lead to devastating recurrences. The conversation about cancer needs to evolve—because eliminating cancer cells is only part of the fight. Tackling the root cause of recurrence may be the key to lasting remission.
John Young, M.D.
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