Dr. Anantbhushan Ranade, Ex President Indian Society of Medical and Paediatric Oncologist, Lokmanya Hospital Pune
World Cancer Day is an apt occasion to think about how to conquer cancer and lead a healthy pain-free life. Cancer is one of the biggest challenges, but in the past 10 years, science and medicine have taken a lot of baby steps in order to overcome the disease.
Cancer is curable if it is diagnosed early and in early stages. 50% of cancers are curable. In the first or second stage of the disease, the cure rate is much higher. The recent advances in the management of cancers are evident in all fields of cancer treatment. They may be categorized as follows:
1. Recent advances in diagnosis
2. Recent advances in local treatments
3. Recent advances in systemic treatments
4. Recent advances in understanding cancer as a disease
Recent advances in cancer diagnosis
Accurate diagnosis is the first important step that doctors who treat cancer or oncologists have to achieve. Once the cancerous cells are seen under the microscope in a given sample, cancer is diagnosed. But, at times it is difficult to get a correct sample, and often it is dangerous for the patient as well. One of the significant recent developments in this regard is ‘Liquid biopsy.’ It means considering the blood sample as the tissue sample and to get a correct diagnosis from it. When we cannot get a biopsy or sample from the cancer mass or node we become helpless. In such patients, the diagnosis can be done by taking blood samples and diagnosing cancer, based on it. It reduces the morbidities caused by various biopsies including surgical procedures.
Another tool that is widely available for the diagnosis of cancer is ‘Genetic Studies. The cancerous cells are subjected to genetic studies which will tell about the type of cancer it is and what are the exact abnormalities in the genetic material of the cancerous cells. Many new treatments have come into play because of these advances and with those, we are able to treat many of the cancers now which we thought to be untreatable in earlier days.
Recent advances in local treatments
· Surgery and radiation are the two major focuses of local treatments. Local treatments are the treatments that are carried out at the suite or organ or tumor. They treat the tumor at a particular place and rarely have any effects elsewhere in the body. The advances in radiation are mainly seen in the betterment of techniques of delivering radiation.
· As far as the surgeries are concerned, it is important to lose as less normal tissues as possible and prevent morbidities. For example – we now try to only remove the affected part of the breast and not the entire breast when surgery is performed.
· Robotic surgery is another advance in the field of surgery. A robotic with multiple ‘arms’ or tools are operated by a surgeon behind the robot is the most important aspect of robotic surgeries. Better and newer equipment and tools also have given more sharpness to surgeries in recent times.
Recent advances in systemic treatments
· Systemic treatments are the treatments that are given to the whole body and are not limited to local areas or a particular part of the body. Good old chemotherapy, targeted therapy, hormonal therapy, and immune therapy are examples of systemic treatments.
· The advances in chemotherapy are directed towards making it less painful and more effective. Various new regimens in chemotherapy are now practiced with fewer doses or modified doses. Also, there are many new drugs available to protect or nurture the normal cells of the body. The delivery systemic of various drugs are also evolving. The best example is the development of the ‘nano particle’ formation of various drugs
· Targeted therapies are being developed for particular abnormalities and mutations of various cancer types. They are effective only in those particular cancer cells and are comparatively less toxic to other parts of the body
· Immunotherapy is the latest treatment modality amongst the systemic treatments which is make our own body identify the tumor cells and then helps the body mechanisms to destroy those cells.
Recent advances in the understanding of ‘cancer as a disease’
Since the time that the world started diagnosis of cancer, mankind started thinking about how one gets cancer? And when he or she gets it? After human genome sequencing became a reality, we have been able to find a lot more about cancers. We know much more about the genetic changes that happen with cancerous cells and the effects of various environmental factors on them as well. Nowadays, we also know much more about familial cancers and various new treatment protocols for them. With all the advances in the field of oncology, one can comfortably believe that the day is not far away when we will be able to cure cancer.