The immune system's postulated role in preventing cancer by destroying cancer cells, along with other evidence, tells us it can also help destroy cells of established cancers. Its ability to do so, referred to as antitumor immunity, involves both the innate and adaptive immune systems. For example, recent evidence suggests the immune system may be capable of detecting the protein products of oncogenes on the cell surface; immune responses to the HER-2/neu protein and mutated ras and p53 gene products have been re-ported.20,21 In addition, antibodies against the patient's own tumor have been identified in the sera of some patients with soft-tissue sarcoma, malignant melanoma, ovarian carcinoma, and lung cancer.22
The degree to which the immune system can destroy established cancers, however, has not been established. In general, the immune system may be more effective against small tumors and metastatic spread than against established solid tumors. What is clear is that the success of the immune system is severely hampered by the ability of tumors to evade immunologic reactions, a problem now discussed in more detail.
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