A year in review: cancer breakthroughs
It’s been 50 years since the National Cancer Act of 1971 was signed into law — aiming to defeat cancer. Since then, cancer-related deaths have declined, mostly because of improvements in prevention, detection and treatment.
■ Lung, oral cavity and bladder cancers have declined because fewer people smoke (that plummeted from 42% of adults in 1965 to 14% in 2018).
■ Fewer deaths from female breast cancer, as well as cervical, colorectal and prostate cancer, is a result of detection of premalignant lesions and early-stage cancers.
■ Improvements in surgery, radiotherapy, chemotherapy, precision medicine and combination therapies over the past five decades also contribute to reduction in cancer-related deaths.
■ For pancreatic cancer, however, the obesity epidemic and lack of major advances in prevention, early detection and treatment have allowed it to become the third-leading cause of cancer death in the U.S.
What’s percolating on the horizon — innovations in stopping tumor cells from replicating, bolstering the immune response and using stem cells to re-engineer your body’s response to cancer — will make the next 50 years truly revolutionary. Let’s take a look at a couple of the latest innovations and see what they say about the future of cancer.
■ A multi-cancer early-detection (MCED) blood test that accurately detects more than 50 types of cancer before any signs or symptoms appear may be added to screening strategies for people at high risk, according to a study published in June in the Annals of Oncology. Not perfect yet — overall, the test correctly identified the presence of cancer in about 51% of cases but was wrong (false positive) in only 0.5% of cases — it will be refined and improved over time. Catching cancers super early allows for intervention that may be far more effective in preventing spread and may allow use of treatments that are less debilitating than current chemo and/or radiation.
■ The Cleveland Clinic is conducting a new clinical trial that is testing the effectiveness of a vaccine that prevents recurrence of triple-negative breast cancer, the most aggressive and lethal form of the disease. That is revolutionary.
■ A saliva test for HPV — human papillomavirus — (the researchers call it a liquid biopsy!) might significantly improve early detection of head and neck cancer, according to research published September 21 in the Journal of Molecular Diagnostics. Head and neck cancer is on the rise in the United States.
Treatment possibilities: immunotherapy and beyond.
■ Speaking of head and neck cancers — a new treatment for those cancers, an alternative to chemotherapy, is in a phase three trial. It combines two immunotherapies — nivolumab and ipilimumab — and appears to cause fewer side effects than chemo and increase life expectancy.
■ Improving immunotherapy: Stealth attacks on cancer cells are being engineered by researchers at MIT. While conventional immunotherapy has vastly improved treatment of some cancers, it only works in a few types of the disease. But it turns out that the immune system can be prodded into killing off cancer cells by removing tumor cells from the body, treating them with chemotherapy, and then inserting them back into the tumor. When delivered along with drugs that activate T-cells, these injured cancer cells appear to act as a distress signal that spurs the T-cells into action.
■ CAR T-cell therapy — another step beyond immunotherapy — takes a cancer patient’s immune system T-cells, changes them by adding a gene for a synthetic receptor (chimeric antigen receptor or CAR) and then injects them back into the patient where they help the T-cells target the cancer antigen (proteins on the surface of those cancer cells).
These are but a few of the ongoing experiments, clinical trials and new therapies that are emerging in the fight against cancer. If you or someone you love has been diagnosed with cancer, make sure to inquire about relevant clinical trials and the newest therapies. And to help keep yourself healthy, always get your regular cancer screenings for breast, prostate, lung and colorectal cancers.
Health pioneer Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. His next book is “The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow.” Email your health and wellness questions to Dr. Mike at question@GreatAgeReboot. com.