A cancer therapy may shrink the tumor of a patient, and the patient may feel better. But unseen on a CT scan or MR image, some of the cells are undergoing ominous changes. Fueled by new genetic changes due to cancer therapy itself, these rogue cells are becoming very large with twice or quadruple the number of chromosomes found in healthy cells. Some of the cells may grow to eight, 16 or even 32 times the correct number. Quickly, they will become aggressive and resistant to treatment. They will eventually cause cancer recurrence.
Daruka Mahadevan, MD, Ph.D., professor and chief of the Division of Hematology-Oncology in the Long School of Medicine at UT Health San Antonio, has studied this progression for 20 years. In a paper published in April 2020 in the journal Trends in Cancer, he and co-author Gregory C. Rogers, Ph.D., explain a rationale for stopping it.