EDITOR-IN-CHIEF
FROM THE
inod Khanna was a huge star for my generation. He was also a friend. When cancer claimed him last month, it was yet another case of the disease’s seemingly relentless march. Worldwide, cancer is on the way to equalling cardiac disease as the biggest killer. In India, it is now the second biggest killer, after heart disease and stroke, up from seventh position in 2000, reports the World Health Organization. While cancer deaths are falling in the West, they are rising here, with 70 per cent lives snuffed out in the first year after dignosis, as 80 per cent patients consult doctors at a stage when recovery is impossible.
Yet, there is hope. Advances in molecular biology, nextgeneration gene sequencing, big data and innovative diagnostics are opening up a whole new world of possible cures. A new generation of lifesaving and lifeextending ‘smart drugs’ is currently being developed and tested, while India’s first vaccine for cervical cancer patients under Phase 2 clinical trials is a fine example of Make in India success. With the incidence of cervical cancer rising dramatically among Indian women—nearly 23 per cent of all cancers in women and over one lakh deaths a year—it might just be a gamechanger. One of the patients included in Phase I of the clinical trial at the Cancer Institute in Delhi, whose cervical cancer had spread to the lungs even after radiotherapy, has been diseasefree now for over nine years.
Major institutions across the country are working on basic, translational and clinical research. New and potentially therapeutic molecules have been identified at the Indian Institute of Science, Bangalore, there is a multicentre study under way at the National Institute of Biomedical Genomics at Kalyani, West Bengal, and Tata Memorial Centre’s Advanced Centre for Treatment, Research and Education in Cancer in Mumbai. At hospitals and laboratories across the country, innovative molecular genetic tests, technology and techniques are being used. India’s first commercial biobank and personalised medicine company is growing live cancer cells in Hyderabad to understand the complexity of a tumour, screen new drug candidates, use cultured cancer cells as models to investigate the changes that may have caused cancer, or its spread, or its resistance to a therapy.
Living with cancer is emerging as a possible option, where the conventional regimen of surgeryradiotherapychemotherapy is slowly but surely giving way to targeted, personalised treatments and more intricate diagnostic tools. The emerging field of cancer immunotherapy, or using the body’s own immune system to combat the disease, is especially promising. A paradigm shift is taking place, with the approach moving toward a regimen where cancer may not have to be cured, but controlled, like diabetes or heart disease. A whole range of new drugs today can shrink and kill cancer cells without collateral damage while the new accuracy of radiation technology makes it possible to hit tumours with minimal damage to surrounding normal cells.
There is no cure yet but the three brute force treatments—surgery, radiation and chemotherapy—may well give way to sophisticated methods of containment. Our cover story is written by Executive Editor Damayanti Datta, who has tracked the disease since 2007 and done five stories on the subject, two of which have already been on cover. She says this time she was depressed by the data she found on the rise of the disease but also exhilarated by the promise in breakthroughs: that scientists are priming the body to heal its own cancer, that they can now listen in to the ‘language’ of genes and that cancer could one day become just another disease that can be detected, managed and controlled for many, many years just by popping a pill—say, like diabetes.
This is really good news as there is hardly anyone these days who does not know someone who is not suffering from the Big C. It has been the most dreaded disease of modern times and for medical science to triumph over it will be a huge achievement for humanity.