There have been tremendous advancements in the cancer care world over the past decade as the medical community’s collective understanding of the disease and its many types continues to evolve.
“Moving forward, cancer care is going to change more in the next 10 to 15 years than it did [over the past] 100 years,” says Andre Goy, M.D., M.S., physician-in-chief of Hackensack Meridian Health Oncology Care Transformation Services, chairman and chief physician officer at John Theurer Cancer Center at HackensackUMC, and lymphoma division chief at John Theurer Cancer Center.
Contributing to this change are advancements in early detection and risk reduction, as well as how we think of cancer care, according to Goy, which includes a current shift towards less chemotherapy when possible.
“One of the biggest questions currently in cancer is trying to tailor the treatment of a specific patient based on the genetic makeup of that patient and their tumor,” Goy says. This is precision or personalized medicine.
“We have had significant developments in cancer research over the last few years,” agrees Dr. Minaxi Jhawer, MD, Englewood Hospital, and Holy Name Medical Center. “We’ve really moved the mark with personalized targeted therapies and immunotherapies in the medical oncology world. In the surgical oncology world, there have been a lot more robotic minimally invasive surgeries that have given better results and shorter hospital stays. And in the radiation oncology area there have been more focused treatment modalities, which spares normal tissue of damage.”
One example of this is Trinitas Comprehensive Cancer Center’s AccuBoost radiotherapy technology, which uses real-time, image-guidance via mammography to localize treatment. According to Clarissa Henson, MD, chair of radiation oncology at Trinitas, with AccuBoost, targeting is improved and a more effective dose of radiation is delivered to the tumor site.
There has been a lot of progress in multidisciplinary care, which Jhawer says helps to get all three of the above modalities working together in the right sequence, on the right patient, to give the best results. It’s all part of an increased emphasis on personalization of cancer care.
“Cancer treatment is not one-size-fits-all anymore,” Jhawer says. “If we have patients with advanced disease, [we can study] a molecular panel of the tumor, so we can then target and use drugs in the right sequence to get the best results. Molecular testing is very meaningful and helpful to personalize the care.”
Dramatic advances in laboratory and computer technology have also led to an explosion of knowledge about molecular biology in general, and specifically cancer, according to Ephraim S. Casper, MD, FACP, chief medical officer, Valley-Mount Sinai Comprehensive Cancer Care, and professor of medicine, Icahn School of Medicine at Mount Sinai.
“Brilliant research using those new tools has deepened our understanding about the genetics and biochemistry of the cancer cell, the body’s immune response to cancer, and has led to breathtaking therapeutic advances. Of course, the more we learn, the more questions we have. I think that we are just scratching the surface,” Casper says.
Casper describes immunotherapy, which is a form of biological therapy that uses the body’s own natural defenses to fight cancer, as arguably the biggest innovation in cancer care over the past decade.
“The introduction of immune checkpoint inhibitors, in particular, has changed the way we treat many – though not all advanced – cancers,” he says. “In many selected patients, these drugs prolong survival and reduce or eliminate symptoms, often with minimal side effects.”
Casper says that patient selection is critical, which is where the related innovation of precision medicine comes into play. “This means evaluating the characteristics of each patient and their individual cancer for indicators of response or resistance to our available therapies,” he says. “This allows us to offer personalized cancer care.”
When it comes to an individual’s risk level for cancer, Jhawer says that in addition to the role genetics plays, there is also an environmental role, which includes nutrition and exercise, as well as other types of predisposed medical issues.
She adds that at Englewood, all oncology patients get a complimentary nutrition consult when they come to the hospital, providing them with a plan for good diet habits when they are getting treatment and surgery.
“We have good reason to believe that maintaining a healthy weight, eating a diet that is low in animal fat, moderating alcohol intake, and exercising regularly reduce cancer risk,” Casper says. Additionally, he adds that efforts to make smoking socially unacceptable have been effective in reducing smoking and smoking-related cancers.
Casper says that with advances in the understanding of tumor biology, coupled with innovations in pharmacology and technology, we will continue to see new cancer therapies that will result in more effective treatment and fewer side effects.
Goy says that he sees a continued acceleration in immunotherapy, early detection and cell therapy in the future.
“Aggressive cancers will hopefully be cured with the cell therapy approach, and the more chronic cancer, like [leukemia] for example, will be suppressed on a more chronic basis with targeted therapies,” Goy says.
“I think the biggest misconception is that cancer is incurable and always fatal,” Casper adds. “There are about 17 million cancer survivors in the United States. While survival varies by cancer, the 5-year survival rate for cancer has increased dramatically since the 1960s, in part because of early diagnosis, and in part because of more effective treatment strategies.”
To access more business news, visit NJB News Now.Related Articles: