The emerging field of Cancer Neuroscience is funded on recent discoveries that the nervous system plays a central role in the initiation, growth and therapeutic resistance of many tumors. In turn, cancers and cancer therapies can alter the function of the nervous system, with negative effects on patients’ well-being and functioning, but at the same time beneficial feedback effects on cancer itself. Finally, tumor cells can hijack neural and neurodevelopmental mechanisms for growth and survival. All this came as a surprise to many, but can help to explain many open questions in cancer research and medicine: why do many cancers that are uncurable until today form in the first place? How do they grow so efficiently, resisting defense mechanisms of the body and also current anticancer therapies?
All in all, deeper insights into these intricate relations between the nervous system and cancer can generate new opportunities and concepts: for cancer research and oncology, but also for neuroscience and neuro-medicine.
Direct (a) and indirect (b) synaptic interactions, molecular mechanisms and tumor biological effects in gliomas and brain metastases. These unexpected connections between normal neurons (presynaptic – “senders”) and tumor cells (postsynaptic – “receivers”) have been discovered at three independent places: by a collaborative effort from Heidelberg and Mannheim groups (Venkataramani, Nature 2019), and by groups in Stanford and Lausanne (Venkatesh, Nature 2019; Zeng Nature 2019). Image: Taken from Venkataramani et al., Neurooncology 2021
Varun Venkataramani, Dimitar Ivanov Tanev, Thomas Kuner, Wolfgang Wick, Frank Winkler, Synaptic input to brain tumors: clinical implications, Neuro-Oncology 2021; 23 (1): 23–33. By permission of Oxford University Press on behalf of the Society for Neuro-Oncology.
Paracrine mechanisms driving the cross-talk between neurons and tumor cells in different cancer entities. Taken from Gillespie, Monje, Ann Rev Can Biol 2019.
Gillespie, Shawn, and Michelle Monje. The neural regulation of cancer. Annual Review of Cancer Biology 4 (2020): 371-390. Reproduced with permission from the Annual Review of Cancer Biology, Volume 4 © 2020 by Annual Reviews, http://www.annualreviews.org
The challenge is: how to bring knowledge and methods from neuroscience to cancer research, and vice versa. Because future advances in the field of Cancer Neuroscience depend on this close interaction, and on many fruitful collaborations between scientists and clinicians. Working together is also mandatory to foster translation and transfer of new discoveries into the clinic.
Our aim for the Cancer Neuroscience initiative in Heidelberg and Mannheim is to achieve fundamental discoveries and breakthrough innovations – by sharing knowledge, by developing new tools and technologies, and finally by translating discoveries into new cancer therapies.
All in all, Cancer Neuroscience opens up the possibility to fundamentally change our understanding of cancer, and at the same time can help to develop a novel approach for anticancer therapies which might very well become a new treatment pillar in oncology in the future – but only if we join forces to better understand the scientific basis of nerve-cancer interactions, and explore promising avenues of how to tackle them.