Scientists have discovered a common cancer has a 'Big Bang' moment which determines how it will grow.
Cancer is the second biggest killer in the US, with heart disease claiming first place.
Roughly two million Americans are expected to be diagnosed with some form the disease this year.
Now, scientists in the UK have discovered why some forms of a common cancer grow faster than others, hopefully making it easier to treat in the future.
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Researchers from Cancer Research UK and Wellcome Trust shared their findings in a paper published in the Nature Genetics journal on Wednesday (November 5).
It concerns bowel cancer, also known as colorectal, the third most common across the nation, behind breast and bladder cancers.
There were some 154,270 estimated new cases of the disease this year.
The lifetime risk of developing colorectal cancer is approximately one in 24 for men and one in 26 for women, as per the American Cancer Society.
The scientists pinpointed that these cancer cells escape detection from the immune system via what's known as epigenetic changes that alter how DNA is read.
This reduces the presence of 'red flag' proteins called neoantigens that usually alert immune cells to attack.
So, the immune system fails to recognize the cancer as a threat, doesn't attack it and allows it instead to grow and spread undetected.
Director of Research at Cancer Research UK, Dr Catherine Elliott, said: "To beat bowel cancer for everyone, we need to understand what happens at the very earliest stages of the disease.
"No matter how different bowel cancer tumours can look, one defining moment at the start makes a big difference to how the cancer grows. "
This early immune evasion shapes the entire course of the cancer’s growth and explains why some bowel cancers don’t respond to immunotherapy, which is when the body's own immune system is helped to recognize and attack cancerous cells.
"Bowel cancer has an insidious ability to resist treatment," Dr Elliott explained. "Immunotherapy is starting to work well for patients, but it doesn’t work for everyone.
"This research helps us understand why, as well as giving us new insights to make immunotherapy work better for bowel cancer."
Research Lead for Discovery Research at the Wellcome Trust, Tom Collins, added: "Through tracing the earliest stages of bowel cancer, the research team has shed valuable new light on a mechanism that could lead to more targeted, effective and early treatments.
"This is a powerful example of discovery science. Research at this molecular level has provided a deeper understanding of how bowel cancer develops, which could lead to the improved health outcomes for patients in the long-term."
If you’ve been affected by any of these issues and want to speak to someone in confidence, contact the American Cancer Society on 1-800-227-2345 or via their live chat feature, available 24/7 every day of the year.
Ellie Kemp