Cancer researchers often focus on developing novel treatments or combining therapies in new ways, all with the goal of lengthening survival for patients. But some cancer research has a different goal: to reduce the amount and intensity of treatment patients receive while maintaining equally good cancer outcomes. In the summer 2019 issue of Cancer Today, digital editor Kate Yandell writes about the challenges and successes of this approach, called treatment de-escalation.
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When new cells are needed to replace old, worn-out cells in our organs and tissues, the DNA that encodes the blueprint for all cellular components from one cell must be replicated faithfully in each of the new cells. During replication, when one cell divides to create two cells, as many as 100,000 mistakes occur. Fortunately, the replicating cells fix almost all of the mistakes, though about 10 errors persist for each new cell formed. These errors are called mutations.
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Rare cancers, when taken all together, make up an estimated 20 to 25 percent of all cancers diagnosed. With more than 1.7 million people in the U.S. expected to be diagnosed with cancer this year, that could mean as many as 400,000 people will learn they have a rare cancer. Often, these patients have few treatment options.
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Every person who hears the words “you have cancer” has a unique story. As part of Cancer Today’s mission to provide “practical hope” and “real knowledge” to those who are affected by cancer, we strive to highlight those stories to provide a real-life glimpse into the challenges of treatment and what comes after.
As National Cancer Survivor Month comes to a close, we’d like to take an opportunity to reflect on some of the lessons we’ve learned from the cancer survivors who have shared their stories with Cancer Today, the magazine and online resource for cancer patients, survivors, and caregivers, which is published by the American Association for Cancer Research.
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Since the 1990s, the cancer mortality rate in the U.S. has steadily declined. Yet liver cancer death rates in the U.S. have increased. Why?
Liver cancer is caused principally by the combination of a chronic hepatitis B virus infection and dietary exposure to aflatoxin B1, a contaminant that grows on corn and peanuts. Recent efforts to better control liver cancer globally include wide distribution of hepatitis B virus vaccines—more than a billion so far—and deployment of food safety tactics to prevent exposure to aflatoxin B1.
At long last, cancer survival statistics are beginning to reveal real progress. From 1991 to 2015, the cancer death rate in the U.S. dropped by 26 percent, resulting in an estimated 2.4 million fewer cancer deaths. In 2016, more than 15.5 million Americans with a history of cancer were alive; that number is projected to exceed 20 million by 2026. The U.S. health care system faces a looming challenge: how to deal with the wide array of health and wellness aftereffects faced by children and adults who were once cancer patients.
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Thanks to decades of cancer research that have brought us groundbreaking discoveries and treatments, 15.5 million U.S. cancer survivors have more time to spend with their loved ones. That number is only going up, to an estimated 26.1 million by 2040.
For most of these survivors, their journey comes with complications and lasting side effects. Many continue to deal with the physical, mental, and emotional impact of their cancer diagnosis long after their final treatment. Thousands of survivors face financial challenges resulting from or made worse by their cancer diagnosis and treatment.
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In the 1970s television series The Six Million Dollar Man, the narrator says of severely injured astronaut Steve Austin: “We can rebuild him. We have the technology. We can make him better than he was. Better, stronger, faster.” The narrator was referring to “bionic” technologies that provided higher visual acuity, stunning strength, and the ability to run at speeds greater than 60 miles per hour.
Over the past few years, cancer immunologists have achieved a comparable feat. They have taken T cells—the immune cells capable of destroying infectious agents, foreign cells, and cancers—and rebuilt them to be better than they were, better at recognizing and killing cancer cells.
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As part of ongoing efforts to increase dialogue between cancer patients, survivors, physicians, and researchers, Cancer Today hosts an online discussion about a book that provides a unique take on the cancer experience. This summer, the editors have chosen to talk about The New York Times best-selling memoir When Breath Becomes Air by Paul Kalanithi.
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Treatment with checkpoint inhibitors is often billed as gentler than chemotherapy—and it is true that immunotherapy doesn’t come with the same acute side effects, such as hair loss, characteristic of many chemotherapy drugs. But checkpoint inhibitors are not without side effects.
In a story published in the summer 2018 issue of Cancer Today, digital editor Kate Yandell discusses what is known about checkpoint inhibitor side effects and how to spot and treat them.
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