Good News from Cancer’s Frontlines

2011 was a year of major advances in cancer research and treatment –and more progress is coming.

Cancer is beyond dreadful- it’s ghoulish. You can kill it, but it can come roaring back to life more wicked and destructive than ever. Yet in some respects, there has never been a better time to have cancer.

Last year there were major advances against deadly melanoma and promising evidence for using low-dose CT scans to screen for lung cancer. A new chemotherapy regimen pushed cure rates for children with acute lymphoblastic leukemia – once among the most deadly pediatric cancers – to above 80 percent. And these are only three of several major advances identified by the American Society of Clinical Oncology in its annual report.

It remains true that there’s no universal cancer cure. Given that many scientists now believe every cancer case is genetically unique to the patient – and that new mutations continue to emerge – there may never be one. Nevertheless, technology, medical research and accumulating scientific data are driving discoveries at an accelerating rate.

Smart Screenings

Let’s begin with a contradiction. There is one sure-fire cancer cure: prevention.

This is going to sound mundane. But one of the most effective ways to prevent cancer from developing is to get enough exercise and to have a well-balanced diet that includes lots of fruits and vegetables.

Because cancer can threaten even those who eat their broccoli and do their push-ups, biomedical interventions remain important for at least catching cancer in its earliest stages. The trick is determining the best ways to screen for cancer.

One landmark study last year was the first to identify an effective lung cancer screening for high-risk patients. More than 50,000 heavy smokers who had each puffed the equivalent of a pack of cigarettes a day over 30 years were screened using low-dose CT scans and their results compared to patients who received annual chest x-rays. “We cut all causes of mortality by 7 percent and lung cancer mortality by 20 percent”, Dr says for the CT scans.

Another recent study, let by gastroenterologist Sidney Winawer of Memorial Sloan-Kettering Cancer Center, showed even more dramatic results. Over two decades, the study tracked 2,600 patients who had undergone colonoscopies and had premalignant polyps removed – and found that the procedures cut colorectal cancer deaths by 53 percent.

More targeted treatments

The biggest advances of 2011 involved advanced melanoma, a virulent form of skin cancer. Since the early 1970s, incidences of the disease – often traced to childhood overexposure to the sun – have risen faster than any other type of cancer.

In 2002 researchers discovered that a mutation in the BRAF gene is one cause and last year a phase III clinical trial showed that the drug vemurafenib targets that genetic defect, improving survival in the six out of 10 melanoma patients who carry the mutation. Approved by standard for treating patients with the BRAF mutation, says oncologist.

Just as important is a trial involving ipilimumab. The new immunotherapy drug helps a patient’s T cells attack and destroy melanoma cells.

Combined with standard chemotherapy, ipilimumab improved coverall survival of patients with previously untreated metastasized melanoma. Ten percent to 15 percent of the patients may even see long-term remission. Future trials will test the therapeutic benefits of combining vemurafenib and ipilimumab.

Whereas you never previously had a drug for melanoma treatment, now suddenly you have two drugs, both of which can make the cancer disappear.

Oncologist Cassian Yee is tackling melanoma using a related immunotherapy – harvesting T cells from patient blood samples, cloning billions of copies and flooding them back into the patient’s veins. The idea is to bolster the immune system to mount massive attacks against tumor cells.

“In some cases”, Yee says, “it can either halt the growth of the tumor and stop it in its tracks for a period of time or it can actually eliminate the tumor. That was the case in one patient, who is still disease-free after three and a half years”.

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