Virginia Tech faculty members investigate not only potentially groundbreaking treatments, but also the biological mechanisms that help explain why and how cancer occurs. Often, their work begins with intellectual curiosity and a fascination with physiology, cellular biology, and more. In turn, their discoveries have enormous potential for real-world application. Published in scientific journals and textbooks, the findings contribute to the world's cancer knowledge and act as a foundation for future scientists. With colleagues from Tech and around the world, the researchers share information and collaborate. Associate Professor Rafael Davalos, for example, provides technical expertise and devices that often complement the work of others.

The adapters

While cancer research at the cellular level can feel only theoretical, veterinary medicine offers a bridge of sorts, providing foundational knowledge for those fighting cancer in animals and humans.

John Rossmeisl (M.S. veterinary medical science '03), associate professor of small animal clinical sciences in the vet med college, studies cancer in dogs whose tumors are closer in size and molecular and genetic heterogeneity to those in humans than are the tumors in rodents, which many researchers study.

"A mouse tumor may be 2 millimeters by 2 millimeters, but then you have to adapt it to humans, who may have tumors measuring 10 centimeters by 10 centimeters," Rossmeisl said.

Both Rossmeisl and Timothy Fan (biochemistry and nutrition '91, D.V.M. '95), an associate professor in the College of Veterinary Medicine at the University of Illinois at Urbana-Champaign, are collaborators on human trials with cancer treatments that originated in dogs.

Fan is recognized for his work with canine osteosarcoma, a type of bone cancer, and pain management for animals suffering from it. Like Rossmeisl, Fan's collaborators often partner with him to take treatments developed in rodents to the next level. Making the leap from discovery toward application, Fan is now investigating a drug being tested in human clinical trials in Chicago.

"It's very unusual for a small molecule or novel therapeutic approach that originates from a scientific investigator to move to a successful, new drug application and phase I clinical trial," Fan said. "Most agents making that path come from 'Big Pharma,' or large pharmaceutical corporations."

Similarly, Rossmeisl's work with Associate Professor Rafael Davalos on irreversible electroporation, a technology that uses electrical fields to precisely target tumors, has been commercially licensed, and their findings are being developed ahead of human clinical trials.

The distributor

Before the clinical trials, animal research, and cellular-level investigations, there is the matter of funding. As director of the American Cancer Society's (ACS) Preclinical and Translational Cancer Research program in the Extramural Research and Training Department, William Phelps (M.S. botany '80) coordinates committees of experts who weigh which grant applications to support.

At the American Cancer Society (ACS), William Phelps '80 coordinates committees of experts who determine how to allocate ACS funding to support the most-promising areas of cancer research. In 2014, ACS—the largest nonprofit, nongovernmental supporter of cancer research in the U.S.—spent $144 million on research.

"My job is to help make the best decisions to put money into the most-innovative and promising areas of cancer research," Phelps said.

Ultimately, only 10 percent of the applications receive ACS funding, but Phelps provides guidance to unselected applicants to help them win funding from other sources, such as the National Institutes of Health. Additionally, he plays a role in ACS fundraising, traveling around the country to share with donors how their money will be used.

Phelps' duties afford him a broad perspective on the fight against cancer. "Anybody engaged in a research enterprise has to understand that it is mostly an incremental industry. You're taking what someone has found and trying to incrementally learn something new. It's going to be fraught with failure, but that's the way you learn. One success comes out of 10 failures," Phelps said.

Still, those rare successes stack up to make progress. Since 1991, cancer mortality rates have fallen about 1 percent per year. That's not because of any one factor, Phelps said, but from many: a decrease in the number of people smoking, advances in medicine and treatment, and substantial progress in fighting particular types of cancers.

"Take childhood leukemia," Phelps said. "Ninety percent of kids less than four years old will be cured. That number didn't start out at 90 percent. It started much lower, but over the years, we have incrementally improved the survival and cure rates. It wasn't one thing, but the accumulation of thousands of studies that got us to a great success rate."

There is also rapid development in immune therapies for cancers like melanoma. "We got there because people have been unsuccessful with immune therapy for decades," Phelps said. "They'd try something, [it wouldn't] work. Try something else, going back and figuring out, 'Why did it fail?' That led to successes today."

The rally point

Video by J. Scott Parker | Visual and Broadcast Communications

"I remember standing under the tent, holding the scripts, [and] directing everyone," McCloud said. "I loved why I was there and loved being able to help out and make the night a great experience for other students. I knew then that Relay For Life was what I wanted to do with my college experience."

The manager

Ask scientists if cancer will be cured in the foreseeable future, and they're likely to hedge, saying that cancer someday will be more manageable, more of a chronic disease than a lethal one.

Making cancer manageable is the goal of Karen Roberto, a University Distinguished Professor in the College of Liberal Arts and Human Sciences' human development department who since 1996 has served as director of the Center for Gerontology.

Roberto's research focuses on rural Appalachia, where older adults carry a disproportionate share of the U.S. cancer burden and face environmental factors that present major challenges to treatment and survival. "Understanding differential cancer burden as a result of individual and life-course circumstances is necessary for the development and implementation of best practices to provide optimal care and support for all cancer survivors," she said.

As part of the Appalachian Cancer Network, Roberto and the Center for Gerontology work with churches in Giles County and Galax, Virginia, to offer a curriculum that includes faith, exercise, diet, and regular cancer screenings as preventative measures. The interactions have generated data on how health disparities are amplified by rural economics, perceptions, and age.

Those ages 65 and above comprise 13 percent of the U.S. population, but account for 54 percent of all new cancer cases, Roberto said, adding that approximately 60 percent of survivors are older adults. "Our view of cancer has changed from a death sentence to more of a chronic illness," she said.

As a result, the number of older cancer survivors is likely to continue to increase. Said Roberto, "It is important for medical and public health professionals, as well as family caregivers, to be knowledgeable of issues survivors may face, especially the long-term effects of treatment on their physical and psychosocial well-being."

Higher survival rates are a good problem to have, of course. But for those who've won their battles, and for their families and doctors, the extended lifetimes trigger a need to further explore and improve caregiving methods.

If each cancer is a world, as Finkielstein said, the Virginia Tech community is fully engaged in winning each battle—and the broader war—against cancer in all its forms.