The Hamilton Spectator

Improved cancer care is on horizon


Everyone hates needles, but it’s unlikely anyone hates them more than cancer patients, who face many more than most people.

For those who must receive regular treatments by multiple injections, frustratio­n and discomfort compound the needle problem.

As a researcher who cares for patients suffering from cancer and other diseases, I empathize with patients, their families and friends when I see the frustratio­n and anguish caused by uncomforta­ble treatments.

In Canada, more than 230,000 people were expected to be diagnosed with cancer in 2022, of whom about 85,000 would likely die.

These are huge and sobering numbers. According to Canadian Cancer Statistics, about two out of every five Canadians are expected to develop some form of cancer, and one in four Canadians is expected ultimately to die from cancer.

You may have heard the saying, “Wherever there is bad, there is always good nearby.” This is largely true for chemothera­py, an invasive drug treatment typically used for killing fast-growing cancer cells.

The origins of modern chemothera­py for cancer date back to chemical warfare during the First World War, when mustard gas was used to deadly effect. With the advent of the Second World War, concerns about the possible renewal of chemical warfare led to new research on mustard gas, including its potential therapeuti­c applicatio­ns. These led to the discovery of a compound derived from mustard gas called “nitrogen mustard” which, a few years later, gave rise to chemothera­py as a potential treatment for cancer.

Since then, chemothera­py has been refined considerab­ly and in its many modern forms remains a mainstay for treating cancer.

Cancer therapies are largely limited to chemothera­py, radiothera­py, and surgery, usually in some combinatio­n. In chemothera­py treatments, the maximum tolerable dose of a drug is often administer­ed to the patient, which can result in severe side-effects and may compromise general health.

Even though the maximum possible dose of chemothera­py drugs is often used in these therapies, only an extremely low amount of the drug dose is actually delivered to the tumor. Thus, even a slight increase in the efficiency of chemothera­py drugs would have significan­t potential to increase the response rate, decrease side effects, and reduce cancer mortality.

Although there has been remarkable progress in treating many diseases in recent decades, there has yet to emerge a powerful cancer therapy that combines high efficiency and success while minimizing patient discomfort.

Micro-technologi­es are showing great promise. Using them to facilitate a newer form of treatment, immunother­apy, is one way they are coming into clinical use. Chemothera­py loaded na no particles, particular­ly solid lipid na no particles, are also showing promise by enabling efficient delivery and controlled release of drugs directly to tumors.

Perhaps the area of greatest potential for treating cancer is in more complex nanotherap­ies. Such therapies combine drugs with the potential to remotely generate heat and image the cancer, to both kill cancer cells while imaging results as they happen.

There is also new interest and early success in using mRNA or siRNA-based therapies (not dissimilar to the COVID-19 vaccines) for treating or even preventing cancer (although the latter is certainly a lot farther off ).

Cancer care has come a long way, but too many people are still suffering or dying every day. We must make every effort to develop and test new treatments so we can get them to patients who need them as quickly as possible.

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