Revolutionizing Cancer Care with Circadian Rhythms: Experts Discuss the Potential of Chronotherapy as an Alternative Treatment Option.
The impact of your circadian rhythm is not limited to your sleep schedule, as it can also play a significant role in cancer development, diagnosis, and treatment.
The timing of cancer diagnosis and treatment can be influenced by the circadian rhythm, beyond just regulating sleep. A new review paper published in the journal Trends in Cell Biology today delves into the connection between circadian rhythms and tumor progression, proposing strategies to optimize the timing of cancer testing and therapy for enhanced diagnostic precision and treatment efficacy.
“The circadian rhythm governs most of the cellular functions implicated in cancer progression,” adds the authors, “and therefore its exploitation opens new promising directions in the fight against metastasis.”
Our internal circadian rhythms play a crucial role in coordinating various bodily functions, such as gene expression, immune response, and cellular repair, throughout the day. However, disruptions to our circadian rhythms resulting from factors like shift work, jet lag, or irregular sleep patterns can increase our susceptibility to various health conditions, including cancer. Recent research has revealed that circadian rhythms not only contribute to the onset of tumors, but also determine the progression of cancer and its spread to secondary sites in the body, known as metastasis.
Metastasis remains the primary cause of mortality in cancer patients. For cancer cells to metastasize, they must break free from the original tumor, circulate in the bloodstream, and invade new organs.
Studies have uncovered that the rate at which cancer cells detach from the primary tumor and enter the bloodstream fluctuates periodically throughout the day, but the timing of these fluctuations varies depending on the cancer type.
For instance, breast cancer tends to metastasize during the night while we are asleep, while prostate cancer and multiple myeloma experience peak metastasis at other times of the day.
According to the authors, by utilizing this knowledge, we could strategically time the administration of chemo- and immunotherapies to better target tumor cells. This practice of delivering treatment at specific times of day is known as chronotherapy.
“Circadian rhythm-based metastasis formation should be seen as an opportunity to intervene in the most timely and effective way,” the authors adds. “Chronotherapy holds promise to be a valuable alternative treatment option in the fight against cancer.”
Chronotherapy, the practice of administering medication and immune therapies at specific times of day, has been shown in clinical studies to reduce the severity of side effects experienced by patients and can also impact treatment effectiveness. Recent research has revealed that the optimal timing for administering therapies varies for different cancer types and can be influenced by factors such as a patient’s sex and genetic background.
In one study, melanoma patients who received immunotherapeutic drugs before 4:30 pm were nearly twice as likely to survive as those who received the treatment later in the day. Furthermore, knowledge of the circadian rhythms of cancer cells could also aid cancer diagnosis. Cancer cells produce proteins at different rates throughout the day, some of which are used as diagnostic molecular markers. Collecting and testing biopsies at the time of day when the concentration of these proteins is highest could help decrease the chances of misdiagnosing a patient.
“More mechanistic understanding of these processes will be required to fully unleash its potential on the clinical side,” they write. “Defining the circadian-rhythm-controlled timing of proliferation and release of circulating tumor cells into the bloodstream in additional cancer types may help to identify the optimal time window for therapy administration.”
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