September is Childhood Cancer Awareness Month. This helps highlight the impact of cancer on young people and their family.

This year, the International Science Conference ‘Childhood Cancer 2017’ was held in Newcastle on Monday 18th and Tuesday 19th September.

The Conference brought together some of the leading paediatric cancer research scientists from across the world to discuss advances in Precision Medicine and how it can be used to treat children and young people with cancer.

Cancer is a disease of the genes, caused when DNA damage becomes fixed in the cells of our body. Anyone can develop cancer as they age and genetic damage builds up in cells, but the genes a person inherits, their lifestyle and their environment all contribute to their risk.

Research aims to unravel the roles played by genes, behaviour and environmental exposures in the development of cancer, as a means of finding ways to identify people most at risk of cancer and helping them manage their risk. Understanding the causes of cancer can also provide important clues about how to treat it.

Some people inherit a particularly high risk of developing certain cancers. Around 5–10% of women with breast cancer, for instance, have inherited specific genetic mutations raising their risk of developing the disease. Scientists work on identifying both rare gene mutations that substantially increase the risk of cancer and much more common genetic variants that individually only have a small effect on risk. They have identified a large number of genetic risk factors for a wide variety of cancers, including breast, ovarian, prostate, lung, testicular, brain, haematological and childhood cancers.

Several long-term studies following large numbers of people over time are being conducted in order to explore how genetic, behavioural and environmental factors may together affect cancer risk. For example, the ICR hosts the Breakthrough Generations Study – funded by Breast Cancer Now – which is starting to unpick how lifestyle, and factors such as the age at which women hit puberty or the menopause, play a role in the development of breast cancer.

An understanding of the genetic, behavioural and environmental causes of cancer can help in finding new ways of detecting, managing or preventing cancers, and provide important clues about how cancer develops.

Cancer is caused when cells within the body accumulate genetic mutations and start to grow in an uncontrolled manner. Understanding how cancer develops and progresses, including how gene mutations drive the growth and spread of cancer cells, and how tumours interact with their surrounding environment, is vital for the discovery of new targeted cancer treatments.

Current research explores how genetic mutations allow cancer cells to divide more frequently, avoid cell death and invade neighbouring tissues to spread locally and around the body. The roles a cancer’s gene mutations play in evading the controls that keep healthy cells in check are being teased out so promising new targets for cancer drugs can be identified.

Research is also exploring the way cancer cells work together within the tumour ecosystem and exploit surrounding tissues to promote their own growth and spread – for example by encouraging the growth of blood vessels to feed them nutrients and oxygen. Most cancer patients die as result of cancer that has moved away from the original site and spread around the body. Research work is being done to understand the process by which cancer spreads, known as metastasis, with the aim of developing new treatments that prevent cancer spread or target metastatic tumours.

Whereas it was once thought tumours were largely homogeneous, it is now understood that an individual cancer is made up of different groups of cells, each with different arrays of genetic mutations. Scientists believe this genetic complexity arises in part because tumours develop through a process of evolution by natural selection, just as species of animals and plants have done. This helps cancer cells to adapt to their local environment, grow and survive, and avoid the effects of cancer treatments.

It is a general belief in the scientific community that an appreciation of the genetic diversity of tumours and of their dynamic evolution is essential to develop more effective cancer treatments. There is particular interest in understanding how tumours can acquire gene mutations conferring resistance to cancer treatments and how this knowledge can be used to overcome drug resistance through new treatments or treatment combinations.