What has changed in the way cancer is understood, diagnosed and treated?

“There are major developments happening in cancer. Newer techniques and technologies are being developed that have helped in the better understanding of the biology of cancer. This, in turn, is improving the ways we could help diagnose and treat cancers. For example, the growing list of ‘targeted therapies’ available is a shift away from the conventional toxicity-prone chemotherapy. One of the targeted therapy, Imatinib, used in a form of chronic blood cancer, has not only helped control the disease much longer than we could do earlier using the conventional chemotherapy but also several patients can be considered to be cured. Another major advance over the past few years is Immunotherapy, wherein the patient’s immune cells are being helped to fight and eliminate cancer. In particular, new monoclonal antibodies targeting an immune pathway called PD-1 and PD-L1, which is used by cancer cells to escape detection by the host immune cells, have shown some very good results in advanced cancers and have been approved by the Food and Drug Administration (FDA) for treating cancers, including that of malignant melanoma [an aggressive skin cancer], kidney cancer, lung cancer, urinary bladder cancer, a form of lymphoma. The downside, however, is that these newer therapies cost a fortune. Pembrolizumab could cost upwards of Rs 50 lakh, which most Indians may not be able to afford.”

DR T. RAJKUMAR, Professor and Head, Dept. of Molecular Oncology, Cancer Institute (WIA), Adyar, Chennai