Research into the prevention and early detection of cancer is entering a new generation. With a greater understanding of how cancers develop and progress, encompassed with the availability of powerful new technologies, our approach to preventing cancer, including how we screen for it and how we manage early-stage disease is now more refined.
Recent studies have demonstrated the potential of using a genomic classifier to identify early lung cancer and of using precision medicine to reduce cancer risk in those who are at an elevated risk.
“If a tumor is detected early enough, the five year survival rate is over 97%. That makes it incredibly important for women and their health care providers to be able to understand their risks so that screening can potentially start sooner for women who are at higher risk.” — Pippa Mann, Partner of BREVAGenplus & Susan G. Komen
Identifying cancer at the earliest stages has long been a critical area of research. However, success in achieving this goal can be at times, a bit tricky. Effective screening tests, where the established benefits outweigh the potential harms, are available for only a handful of cancers, and, in many cases, it’s still unclear whether screen-detected cancers (and those detected as a result of an unrelated medical exam) always need to be treated.
There is evidence in prostate cancer, as an example, that routine screening has led to many cases of over-diagnosis and over-treatment—cases where people were diagnosed and treated for a cancer that likely never would have harmed them.
As modern day medicine evolves, new technologies in early cancer diagnosis and prevention are also evolving.
The Cancer Gene Fingerprint
Not all cancers are equally as lethal, but that doesn’t always tie to survival rates. For example, prostate cancer is tied for a longer survival rate than a malignancy in your brain.
Even prostate cancer, though, can range from manageable to deadly. By analyzing the mutated genome of a tumor, doctors are now able to pinpoint whether a cancer is sensitive to a certain chemotherapy, or a cancer that doesn’t respond to current treatments. Knowing the subtype might actually mean jumping directly to a clinical trial that could save your life along with someone else’s.
“Most cancer patients in this country die of chemotherapy. Chemotherapy does not eliminate breast, colon or lung cancers. This fact has been documented for over a decade. Yet doctors still use chemotherapy for these tumors. Women with breast cancer are likely to die faster with chemo than without it.” — Allen Levin, M.D. UCSF
The Breast Cancer Risk Identifier
Another emerging technology in the medical sphere comes with determining your risk for cancer, including breast cancer. BREVAGenplus is a clinically validated test for sporadic breast cancer, which combines clinical risk factors with a person’s genetic makeup to determine risk of developing breast cancer. BREVAGenplus examines your DNA to look for the absence or presence of genetic markers that are associated with an increased risk of developing breast cancer.
Based on results, your healthcare provider can then work with you to develop an individualized Breast Cancer Risk Reduction and Screening Plan that outlines the most effective means and timeline for monitoring your ongoing breast health.
The Cancer Pain Manager
Cancer and its treatments can induce extreme, chronic pain, and in the past, cancer patients were relegated to continuous, increasing doses of painkillers.
Companies are now developing devices that help ease symptoms and side effects. A good example is Quell, a wearable technology with intensive nerve stimulation that is clinically proven to help manage chronic pain. Its use is FDA approved during the day while the patient is active, as well as at night during sleep.
The Precision-Guided Cancer Treatment
The difficult goal in any cancer treatment is to kill the tumor while leaving healthy cells alone.
Recently, a better understanding of what makes cancer cells tick has allowed scientists to develop a class of drugs that pinpoint a weakness in cancer’s uncontrolled growth.
For example, in lymphomas and leukemias, scientists have determined that the growth is controlled by a protein called Bruton’s tyrosine kinase (BTK). After years of experimentation, doctors developed a new drug called Ibrutinib that blocks BTK.
A pair of studies in the New England Journal of Medicine this summer found that the oral pill helped 71 percent of chronic leukemia patients and 68 percent of patients with a type of non-Hodgkins lymphoma. Most importantly, Ibrutinib killed off the lymphoma while leaving the rest of the immune system alone.
“Breast cancer deaths in America have been declining for more than a decade. Much of that success is due to early detection and better treatments for women.” — Fmr. Sen. Larry Craig
Your body’s immune system fights off germs that cause infections but would if it could be trained to fight off cancer cells? That’s the idea behind new immunotherapy cancer vaccines, which train the immune system to use its antiviral fighting response to destroy cancer cells without harming healthy cells.
The Food and Drug Administration (FDA) already has approved these vaccines for the treatment of advanced prostate cancer and melanoma. Current research is focused on pairing new and old vaccines, including the tetanus vaccine with a newer cancer vaccine to treat one type of brain cancer, glioblastoma. Those who received the dual vaccine lived three to seven more years after treatment than those who received an injection without the tetanus portion. Among the most eagerly anticipated vaccines is a lung cancer vaccine and work on such a vaccine, first developed in Cuba, is already underway in America.
Better Cancer Screening
Some of the deadliest, most difficult-to-find cancers may be detected by analyzing blood for abnormal proteins. Cancer is what produces these abnormal protein structures. Up to now, blood tests weren’t sensitive enough to identify them.
A new type of analysis allows researchers to find the proteins earlier, which means cancer treatment can be started at an earlier stage. Experts predict this will lead to more effective tests for pancreatic cancer, considered the most deadly type with only about 7 percent surviving five years, as well as for prostate and ovarian cancer.
A new test trial using protein analysis identified twice as many cases of ovarian cancer at an earlier stage than current tests.
“There can be life after breast cancer. The prerequisite is early detection.” — Ann Jillian, actress and breast cancer survivor
Smartphone-Size Devices That Can Diagnose Cancer
A startup has invented a DNA analyzer that may revolutionize healthcare in the developing world — a low-cost diagnostic DNA analyzer the size of a smartphone.
Q-Poc, billed as a “handheld lab,” is the idea of British tech firm, QuantuMDx, which says the analyzer can accurately diagnose everything from cancers to infectious diseases in a simple matter of minutes. The product is currently in the alpha testing stage, but the company hopes to get the product in the hands of doctors by early 2018.
Running on a solar-powered battery or wind-up device, the cancer-diagnosing device is designed to read biological samples submitted via a credit card-size cartridge.
Analyzing the DNA of pathogens rather than the proteins within the sample, the device depends on microfluidic technology , which essentially allows fluids to pass through different microscopic channels of different diameters.
Subject to regulatory approval by the World Health Organization (WHO), QuantuMDx hopes to initially roll out the Q-Poc unit in South Africa, before expanding to other markets across the continent. The startup already counts a number of development nonprofits among its strategic partners, including the Gates Foundation and the Clinton Foundation.
An Innovative Way to Target Cancer
Researchers are closing in on the day when a single drug will treat many different cancers. While traditional clinical trials focus on testing a drug for a particular type of cancer based on its location — breast or lung, for example — new studies are testing therapies that target a specific genetic mutation found in a tumor, regardless of where the cancer originated.
Results of an international basket trial found that a drug focused on a single genetic mutation can be effective across multiple cancer types, including a common form of lung cancer and a rare form of bone cancer.
An Alternative to Chemotherapy
Everyone knows the storied side effects of chemotherapy. That’s because chemo drugs destroy cells that multiply quickly, whether they’re cancerous or healthy. But scientists are finally finding success with a more selective approach: immunotherapy.
These treatments harness your body’s natural defenses to beat cancer back. “What we’ve discovered is that cancer cells evade your immune system by putting it into overdrive, causing it to tire out and give up. The new drugs interrupt the cycle so your body can fight, and the results so far have been staggering:
It’s not an overstatement to say this is a turning point in cancer research, especially for patients with melanoma. Treatments for cancers of the kidney, lung and pancreas could be up next.
A new way to fight breast cancer
Women with ductal carcinoma in situ (DCIS), an abnormality that can become invasive breast cancer, or a strong family history of the disease are often prescribed tamoxifen to prevent it. But many women won’t even start taking it, because they’ve heard of side effects like hot flashes and blood clots.
To see if there might be a better way, Dr. Seema Khan, MD, of Northwestern Memorial Hospital in Chicago prescribed tamoxifen in the form of either a pill or a gel applied to the breast to 26 women awaiting surgery for DCIS. Women who used the gel showed the same decrease in abnormal cell growth as the pill group—and they had no increase in blood markers linked to clots and other symptoms. The availability of the gel is still a few years away, but Dr. Khan says a topical gel might work for other drugs as well, suggesting that this is one discovery that could lead to many more.