Cancer staff shortages are global ‘wake-up call’

Hello Nature readers,
This week, we hear that the world is facing a cancer workforce shortage, learn that gene therapy has been linked with a brain tumour in a rare case and shine a light on developments in lung cancer.

Staff shortages are global ‘wake-up call’

The world is facing a major shortfall in the number of staff needed to care for people with cancer. By 2050, there will be a shortage of 100-million nursing and clinical staff as cancer rates increase around 20% to 100,000 diagnoses a day. “Make no mistake, this is a wake-up call, no matter where you are in the world,” says co-author and digital health researcher Mark Lawler. More people are living long enough to experience cancer as a disease of ageing than in the past. “This demographic shift is not a failure — it reflects remarkable progress in global health, but it demands an equally ambitious response in cancer care,” says co-author and surgical oncologist Peter Kingham.

Rare case of a tumour after gene therapy

A gene therapy has been linked with the development of cancer, but experts say it’s an unusual case and isn’t generalizable to others. In January, two clinical trials were paused in the United States after a 5-year-old boy developed a brain tumour. The boy, born with Hurler syndrome, was injected with a virus carrying the genetic instructions for a functioning enzyme he otherwise would have lacked. But the virus integrated some of its components into his brain cells' DNA, switching on a cancer-associated gene. The tumour was successfully removed and the boy is still cognitively advanced for his age, suggesting that the gene therapy worked. The boy’s young age at treatment and his particular clinical history might have made him more susceptible to the tumour.

No ‘single smoking gun’ for cancer in youth

The rise of cancers in people under the age of 50 was a key talking point at two major US cancer conferences, with obesity, ultra-processed foods, microbial toxins and changes in screening or classification all being considered as potential drivers. What’s becoming clear is that there’s no one cause, experts say. “I don’t think there’s a single smoking gun,” says gastroenterologist Andrew Chan.

Obesity isn’t always a disease

Obesity can be described as a chronic disease, but this label shouldn’t be applied uniformly to a condition that can affect individuals’ health so differently, argues surgeon Francesco Rubino. Instead, there should be two diagnoses: clinical obesity, in which excess fat tissue directly impairs daily activities or causes demonstrable organ dysfunction, and preclinical obesity, in which it doesn’t. The former is “unequivocally disease” while the latter represents a higher risk of developing conditions such as diabetes, high blood pressure and cancer, Rubino writes. This distinction can help clinicians know who to prioritize for treatment and avoids labelling people as diseased when they might not consider themselves to be ill.

The human genome — but smaller

A synthetic ‘minimal human genome’ that contains the smallest set of genes it needs to function could be useful in biomedicine, argues synthetic biologist Sudarshan Pinglay. This abridged version of the human genome would be cheaper to synthesize and could potentially improve cellular therapies used in cancer where superfluous DNA can be a liability, writes Pinglay.