Some physicians who treat cancer are saying we've entered a new golden era of cancer research. They're upbeat about current research and new treatment options that are saving lives.
Cancer, once considered a disease like many others to be conquered and destroyed, is now more accurately understood as many diseases, characterized by uncontrolled cell growth. While no one expects a cure for cancer in the next decade, some scientists say we've entered a golden era of cancer research and treatment.
Dr. Karen Antman, who directs cancer research at the National Institutes of Health outside Washington DC, is one of those who is optimistic. She points to three major advances: drug development, vaccine research and vast improvements in imaging and body scanning technologies.
"Well, when I went to medical school 25 years ago we did operations in order to find out how far a cancer had extended. Then something called CT scans came into being and you could get a pretty decent picture.
Then MRI's (magnetic resonate images) became even better for soft tissue, and now we have something called functional imaging where you can actually see the activity of the tumor in using up oxygen for example. And you can therefore, instead of seeing a shadow on an x-ray, you can actually see the metabolism and therefore you can tell the difference between something that's a cancer and something that's a benign growth, which we couldn't do previously.
Now the next step is molecular imaging: we go from optical imaging, where you look with your eyes, to functional imaging where you can actually see the use, the energy use of a tissue, to molecular imaging where you can actually see which genes are turned on or off, and that will even be more precise. That day is on the horizon, yes, so imaging has gotten better; you don't have to have operations anymore, you have a picture taken," says Dr. Antman.
So why is cancer on the rise almost everywhere in the world?
"You really have to watch the cancer mortality however, which gives you a much cleaner in point. I think the incidence goes up, because people are getting increasing screening. Screening has gotten improved for breast cancer, colon cancer, maybe psa for prostate cancer, and the treatments have gotten better, so mortality is actually dropping in the United States," explains Dr. Antman.
Cancer mortality rates are rising dramatically elsewhere. Dr. Antman says, "Well, probably the major explanation is that tobacco is becoming more common in the developing countries and their risk of dying of lung cancer is increasing substantially like ours did several decades ago."
Poorer nations have less screening and fewer treatment options, but in the West? "In the last two decades science has given us a critical amount of new information, and we now have a number of different pathways that can be targeted pretty precisely, and therefore the drugs are more effective, and the side effects are fewer," says Dr. Antman.
In America 40 percent of those alive today will be diagnosed with some form of cancer and that number will climb to 60 percent by 2010; 64 percent of Americans diagnosed with cancer survive it, and that number would be much higher if they were screened and treated earlier.
Many thousands more could survive but 30 to 50 percent of people diagnosed with cancer never receive treatment. Better screening means earlier diagnosis; means more treatment options. Vaccines are becoming more effective against certain cancers, and the West is benefiting from a rapid development of better drugs with fewer side affects, and a new diagnostic tool called gene chip technology.
"There are now chips where you can put down a few thousand genes in a tiny little area on a slide. Then you drop a biological fluid, or piece of tumor onto that slide, and some of the genes will be increased in activity. Some of the genes will be decreased in activit. If you compare cancer and normal adjacent tissue, and it's emerging that certain diseases such as breast cancers that are treated with hormones or lymphomas. You can predict better on the basis of which genes are activated or repressed than you can on the basis of the kinds of medical things that we knew in the past, so gene chip technology is allowing us to tell a patient 'You're at high risk and therefore we're going to treat you more aggressively' or, 'You're at low risk and therefore you don't need the side effects of being treated aggressively,' " says Dr. Antman.
By focusing, not on a cure for cancer but on better detection and treatment, researchers are making outstanding progress in the war against cancer.