Bowel cancer tumours hide in plain sight by ‘disguising’ themselves as stem cells to avoid detection by the immune system, breakthrough research has discovered.
The study answers a question that has perplexed doctors for decades – why the body ignores the disease, which kills around 46 people in the UK every day.
It is hoped the discovery will one day enable a treatment to reverse or prevent the process, allowing the immune system to ‘see’ and destroy bowel cancer when it appears.
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The gut is lined by different layers of cells. The top layer is made of epithelial cells, which play an essential role in the digestion of food and uptake of nutrients. It is also where bowel cancer starts.
This region is ‘patrolled’ by immune cells known as T cells, which attack any threats such as bacteria or small tumours. However, by concealing themselves as stem cells, cancer cells drive out the T cells by suggesting ‘there’s nothing to see here’.
‘Normally immune cells keep things as they should be, patrolling the bowel like security guards, tackling any harmful bacteria, and keeping the gut healthy,’ said Dr Seth Coffelt of the Cancer Research UK Beatson Institute and University of Glasgow, who led the research.
‘However, when cells in the bowel become cancerous, they fire these “security guards” and all the methods these immune cells use to talk to each other to coordinate an immune response no longer get produced.
‘Cancer doesn’t want immune cells recognising them as a threat so they manipulate the immune cells – you don’t want T cells to accidentally kill stem cells, or it’s game over.
‘[This means] they can’t see the threat, and simply pass on by – leaving the cancer to do its damage.’
The team analysed tissue samples donated by bowel cancer patients, which enabled them to pinpoint the specific mechanism that led to this cancer ‘blindness’.
The research, funded by Cancer Research UK, the Medical Research Council and Wellcome, answers a question that has long puzzled doctors – and offers hope of future treatments to reverse the mechanism.
Bowel cancer: the symptoms
- Changes in your poo, such as having softer poo, diarrhoea or constipation that is not usual for you
- Needing to poo more or less often than usual for you
- Blood in your poo (which may look red or black)
- Bleeding from your bottom
- Often feeling like you need to poo (even if you’ve just been to the toilet)
- Bloating
- Tummy pain
- Feeling very tired for no reason
- Losing weight without trying
See your GP if you have any symptoms of bowel cancer for three weeks or more
Source: The NHS
‘Our discovery means that if a way can be found to artificially engage the “blinded” T cells with a drug so that the T cells can “see” the cancer again, we could find a new effective way to treat bowel cancer,’ said Dr Coffelt.
The study is published in Cancer Immunology Research.
Bowel cancer is the second most common cause of cancer death in the UK.
This month will mark the one-year anniversary since the death of podcaster and campaigner Dame Deborah James, who used her bowel cancer journey to inspire others to get checked out if they had symptoms.
Her Bowelbabe Fund, set up in May 2022, has already raised more than £11million for research into early detection and treatment.
In her final message, Dame Deborah said: ‘Find a life worth enjoying, take risks, love deeply, have no regrets and always, always have rebellious hope.
‘And finally, check your poo – it could just save your life.’
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