杰里米·克拉克顿患有侵袭性前列腺癌。但什么因素能让一些癌症比其他癌症更具侵袭性呢？
Jeremy Clarkson has aggressive prostate cancer. But wha…
Jeremy Clarkson says his prostate cancer is ‘aggressive’. Here’s what that actually means.
杰里米·克拉克顿说他的前列腺癌是“侵袭性的”。这到底意味着什么？
UK media celebrity Jeremy Clarkson this week revealed he has been diagnosed with an aggressive form of prostate cancer.
英国媒体名人杰里米·克拉克森本周透露，他被诊断出患有一种侵袭性的前列腺癌。
He told his co-stars about the diagnosis on air during the latest season of Clarkson’s Farm. At the time of filming, he said he didn’t know whether he would be back for another season. However, he said the cancer had been caught early and he was receiving treatment.
他在《克拉克森农场》最新一季的节目中向他的合作演员们透露了这一诊断。他在拍摄时说，当时他不知道自己是否还能参加下一季。然而，他说癌症是在早期被发现的，并且他正在接受治疗。
Clarkson specifically noted his cancer was “aggressive”.
克拉克森特别提到他的癌症是“侵袭性”的。
So what does this actually mean? And what makes some cancers more aggressive than others?
那么，这到底意味着什么？是什么让一些癌症比其他癌症更具侵袭性呢？
What is an aggressive cancer?
什么是侵袭性癌症？
When doctors and scientists refer to a cancer being aggressive, they mean it’s fast-growing.
当医生和科学家提到某种癌症是“侵袭性”时，他们指的是它生长速度快。
This is the definition authorities, such as the National Cancer Institute in the United States or the Cancer Council Victoria in Australia, use.
这是美国国家癌症研究所或澳大利亚维多利亚州癌症委员会等权威机构使用的定义。
Cancers occur when your body’s cells acquire DNA mutations that alter their behaviour. For instance, certain mutations might lead cells to evade death or divide uncontrollably. Mutations can also affect how fast this division occurs.
癌症的发生是由于身体细胞获得了改变其行为的DNA突变。例如，某些突变可能导致细胞逃避死亡或不受控制地分裂。突变还影响着这种分裂的速度。
For instance, DNA mutations leading to excessive production of the MYC protein allow cells to grow and divide more rapidly. Dividing quickly and uncontrollably is the simplest measure of cancer aggression.
例如，导致MYC蛋白过度产生的DNA突变能让细胞更快地生长和分裂。快速且不受控制地分裂是衡量癌症侵袭性的最简单指标。
As the name suggests, aggressive cancers are quite dangerous. The speed at which they can develop and grow means they are more likely to be diagnosed only once they have reached a more advanced stage and spread to other parts of the body.
正如名称所示，侵袭性癌症相当危险。它们发展和生长的速度意味着，人们更有可能只有在疾病达到更晚期并扩散到身体其他部位时才被诊断出来。
Sadly, once cancers have spread and are considered “advanced”, they are very difficult to treat.
遗憾的是，一旦癌症扩散并被认为是“晚期”，它们就非常难以治疗。
However, if an aggressive cancer is caught early, there are usually treatment options.
然而，如果侵袭性癌症能早期发现，通常会有治疗方案。
How about treatment?
治疗方面如何？
Sometimes, the aggressiveness of a cancer can be exploited as a weakness and used against it.
有时，癌症的侵袭性可以被利用为弱点，并用来对抗它。
For example, chemotherapy works by damaging DNA. When cells divide, if their DNA is also damaged, they die. But as cancer cells grow faster than most other cells in our body, the chemotherapy essentially destroys the cancer cells first. Therefore, fast-growing cancer cells can be more susceptible to chemotherapy.
例如，化疗是通过损伤DNA来起作用的。当细胞分裂时，如果它们的DNA也受损了，它们就会死亡。但是，由于癌细胞比我们身体中的大多数其他细胞生长得更快，化疗本质上首先会摧毁癌细胞。因此，快速生长的癌细胞更容易受到化疗的影响。
A good example is the blood cancer known as Burkitt lymphoma. Burkitt lymphomas generally express abnormally high levels of MYC protein, making them highly aggressive.
一个很好的例子是被称为伯基特淋巴瘤的血液癌症。伯基特淋巴瘤通常表达异常高水平的MYC蛋白，使其具有高度侵袭性。
Most Burkitt lymphoma patients (64–85%) can be cured with intensive chemotherapy. This was also one of the first cancer types to be cured by chemotherapy alone, back in the 1960s.
大多数伯基特淋巴瘤患者（64%–85%）可以通过强化化疗治愈。在20世纪60年代，这也是最早通过单独化疗治愈的癌症类型之一。
Why are some cancers more aggressive than others?
为什么有些癌症比其他癌症更具侵袭性？
Every cancer is different. Different genetic mutations drive different abnormal behaviours, and these behaviours are linked to the cancer’s aggressiveness. And, for every part of the body, there can be dozens of different sub-types of cancer.
每种癌症都是不同的。不同的基因突变驱动着不同的异常行为，而这些行为与癌症的侵袭性有关。而且，对于身体的每个部位，都可能有数十种不同类型的癌症亚型。
However, many cancers share certain characteristics, meaning we can make some generalisations.
然而，许多癌症具有某些共同的特征，这意味着我们可以做出一些概括。
For example, pancreatic cancers and a sub-type of breast cancer known as “triple-negative” are highly aggressive. They grow rapidly and have limited treatment options.
例如，胰腺癌和一种被称为“三阴性”的乳腺癌亚型具有高度侵袭性。它们生长迅速，且治疗选择有限。
But there are always new treatments being developed for many aggressive cancers once thought untreatable.
但对于许多曾经被认为无法治愈的侵袭性癌症，总是在开发新的治疗方法。
One example is the development of a new drug that targets the cancer-promoting protein, KRAS. In clinical trials, this drug nearly doubled the survival of people with aggressive pancreatic cancers.
一个例子是开发了一种靶向癌促进蛋白KRAS的新药。在临床试验中，这种药物使患有侵袭性胰腺癌的患者生存率几乎翻了一番。
How about Clarkson’s cancer?
克拉克森的癌症怎么样？
It is impossible to speculate about Clarkson’s case without more information. Most prostate cancers are not considered aggressive, and people can live for many years with slower growing, non-spreading, low-risk forms.
没有更多信息，无法推测克拉克森的情况。大多数前列腺癌不被认为是侵袭性的，人们可以随着生长缓慢、不扩散、低风险的形式活很多年。
For more aggressive forms, the prognosis often depends on how early the cancer is detected. Prostate cancer is more common in men over the age of 50, but symptoms are not always apparent early, and screening techniques are imperfect.
对于更具侵袭性的形式，预后通常取决于癌症检测的早期程度。前列腺癌在50岁以上的男性中更为常见，但症状并非总是早期明显的，而且筛查技术也存在不完美之处。
If you are concerned about your cancer risk, it’s best to see your doctor for personal advice.
如果您担心癌症风险，最好咨询医生获取个人建议。
Sarah Diepstraten receives funding from the National Health and Medical Research Council, Cure Cancer Australia and My Room Children’s Cancer Charity.
Sarah Diepstraten 获得了国家健康和医学研究委员会、澳大利亚治愈癌症基金会和我的房间儿童癌症慈善机构的资助。
John (Eddie) La Marca receives funding from Cancer Council Victoria. He is affiliated with the Olivia Newton-John Cancer Research Institute and the Walter and Eliza Hall Institute of Medical Research.
John (Eddie) La Marca 获得了维多利亚癌症委员会的资助。他隶属于奥利维亚·牛顿-约翰癌症研究学院和沃尔特与伊莉莎·霍尔医学研究所。
