One of the great mysteries of cancer is why it primarily, and almost exclusively, targets people middle-aged or older.
You are twice as likely to die in the first 50 years of your life In a car accident than From cancerBut things change dramatically after half a century: “90 percent of cancers occur after age 50,” says Dr. James DeGregori, vice president of the University of Colorado Cancer Center.
Why do our bodies suddenly become cancer-proof once we hit 50? Some theories point to accumulated cellular damage and a weakened immune system, but there’s a new culprit that’s been driving cancer research in recent decades: inflammation.
Inflammaging is “a mix of inflammation and aging,” says Dr. Brian Brown, director of the Icahn Genome Institute at Mount Sinai in Manhattan. “It’s a new driver of the aging process and one of the factors that contributes to the increased incidence of cancer in older adults.”
“Everything science once believed about inflammation has changed,” said Dr.“The Silent Fire: A Story of Inflammation, Diet, and Disease” (WW Norton, on sale now).
“The relationship between inflammation and cancer is more complicated than previously thought,” she told the Post. “In fact, inflammation is one of the ‘hallmarks’ of cancer.”
Inflammation is essentially a good thing. It’s part of your body’s immune response and what keeps you alive every time you get an infection. “When you’re healthy, your immune system fights off the infection, gets rid of the cancer cells, and gets the job done,” Brown says. “Then the immune system shuts itself down.”
But that changes as we get older. “Especially after 40, your body has a harder time suppressing inflammation,” Brown says. “That’s why older people get so much worse with COVID-19. It wasn’t the virus that killed a lot of older people, it was the inflammation that the virus caused. They couldn’t stop it.”
Inflammatory aging, or chronic inflammation, keeps the immune system on high alert and “makes it less able to effectively detect and attack cancer cells,” according to the new study.Lose Total Body Fat: A Science-Based 7-Day Plan to Reduce Inflammation, Heal Your Gut, and Build a Healthier, Leaner Body“It’s like a fire department that has to keep responding to false alarms.”
White blood cells continue to release large amounts of cytokines, which create a constant state of inflammation and make it more difficult for the immune system to detect and attack cancer cells.
It’s still a relatively new theory, and one that remains controversial, according to Ian Neal, PhD, an associate professor of medicine at the University of California, San Diego. “Is inflammation an indicator of chronic disease, or is it something that’s causing chronic disease?” Cause “What is the relationship between chronic disease and inflammation?” he asks. “Through research into inflammation and various disease states, we’ve found a lot of correlations, but that doesn’t necessarily lead to causation.” In other words, the link between chronic inflammation and cancer remains controversial.
But Ravella argues that this idea represents “the biggest paradigm shift in decades.” While inflammation was once thought to be merely a consequence of disease, a growing body of research is showing that it may actually be an independent cause of chronic diseases such as cancer, he says.
“The relationship between inflammation and cancer goes both ways,” she told The Washington Post. “Inflammation fuels cancer, and cancer fuels more inflammation.” Whether inflammation is present in the body before or after a cancer diagnosis, inflammation affects every stage of cancer. It’s part of what Ravella calls the “tumor microenvironment,” which influences “from the early genetic changes that turn healthy cells into malignant cells, to the continued growth and spread of cancer tissue throughout the body.”
Even low-level inflammation, something doctors don’t typically test for, can promote cancer, Ravella said.
So what do we do? Until now, doctors have tried to treat disease by suppressing inflammation altogether. But that’s like trying to fix police corruption by firing the entire police department. “Inflammation is part of the normal immune process,” says Brown. “Eliminating inflammation would probably mean immune suppression, but we don’t want to do that because we need the inflammatory process to fight infection and cancer. All we want to do is suppress excess inflammation.”
Part of this can be achieved through nutrition. For example, Perrin recommends an “anti-inflammatory” diet that avoids inflammation-promoting ultra-processed foods (“pre-digested,” as he calls them) and eats a diverse mix of plant-based foods. “The more plant variety you have in your diet — at least 30 per week — the healthier your gut microbiome will be and the less inflammation you’ll have,” Perrin told The Washington Post.
But diet alone isn’t enough, Brown says. “You can’t overcome the genetic predisposition or environmental factors that cause inflammation with diet.” Despite the widespread claim that all inflammation starts in the gut, inflammation can actually “start in any tissue,” Brown says. “A viral infection in the lungs can cause inflammation there. A buildup of cholesterol in the arteries can cause inflammation in the blood vessels. Tumor growth in an organ like the pancreas can cause inflammation.”
A better solution is a combination of a healthy diet and the right medication, Brown points out, and that is statins and LDL cholesterol (or “bad” cholesterol). “Even if you eliminate all sources of LDL cholesterol from your diet, your body can still make LDL,” Brown says. “So there are non-dietary benefits to taking statins.”
The right drugs to combat inflammation-aging are still being researched, with everything from silibinin (an extract of milk thistle that has anti-inflammatory properties) to investigational drugs currently in testing. By Italian researchers — Metformin, a drug used to treat type 2 diabetes Lowering risk Of certain gastrointestinal cancers.
Rapamycin is a drug commonly used in post-organ transplant care. Encouraging Results Experiments by German researchers have shown that lab mice can live longer, but Dr. Original research into rapamycintold the Post that it’s too early to get excited.
“When you suppress the normal function of the immune system, which normally guards against cancer, you actually increase “It’s linked to reduced cancer risk,” he says. “Increasingly, people are taking rapamycin off-label for anti-aging purposes, but there is currently no evidence that rapamycin extends healthy aging in humans.”
One of the most promising studies involves macrophages, the white blood cell “first responders” that are the body’s best defense against cancer, and in the case of inflammation-aging, “So, Brute?” traitor.
Brown told the Post that macrophages have been key to discovering the link between inflammation and cancer. Macrophages and their precursors, monocytes, are “one of the most important immune cells for clearing infection,” he said, “but they’re also important mediators of inflammation.”
Recent Research Cancer not only outwits macrophages, recruit Macrophages produce chemicals that suppress inflammation and promote tumor growth. “In fact, in some cancers there are more macrophages than cancer cells,” Brown says. Finding ways to control and redirect macrophages “will have a profound impact on cancer and even aging,” he says.
That’s exactly what Yara Abdou, PhD, an assistant professor of oncology at the University of North Carolina, has been trying to do. In her work with colleague Michael Kryczynski, PhD, Abdou told The Washington Post that they’re looking for ways to “trick macrophages into thinking that cancer cells are foreign invaders.”
They do this by introducing receptors that are engineered to recognize specific cancer targets. When the engineered macrophages come into contact with cancer cells, “they react the same way they would if they came into contact with bacteria,” Abdou says. “The macrophages eat the cancer cells, kill them, and cause inflammation in the tumor, which in this case is a very good thing. We’re using the patient’s own immune cells to attack the patient’s own cancer.”
Although their research is still in its early stages, Phase I TrialsAbdou says the results are “very promising.” “We’ve demonstrated that we can make engineered cells from patients with very advanced cancer, and after one dose of CAR macrophages, we saw some of the lesions shrink,” he says. And while their work is focused on patients with breast, ovarian and esophageal cancer, it could potentially be expanded to other cancers. “One of the great things about this technology is that it’s a plug-and-play system,” Abdou says.
Samuel Waxman Cancer Research Foundation
Cancer is just the beginning. “We now have a clear connection between aging and inflammation,” Brown says. Understanding how inflammaging plays a role in disease could lead not only to treatments for cancer, but also heart disease, Alzheimer’s and arthritis.
“There is an urgent need to understand why inflammation becomes excessive with age and how to safely reduce inflammation without immunosuppression,” Brown says. “We are getting closer to this solution, which could help us live healthier lives.”
