Cancer has long been associated with fear, uncertainty, and impending doom. However, it is essential to dispel the myth that cancer is always a death sentence. While cancer remains a serious and potentially life-threatening disease, significant advancements in research, treatment options, and early detection methods have led to improved survival rates for various types of cancer. This article aims to shed light on the reality that cancer can be effectively treated, particularly through targeted therapy and early detection.

Targeted Therapy: Precision Medicine in Cancer Treatment

Targeted therapy has revolutionized the field of cancer treatment by providing personalized approaches that specifically target the molecular abnormalities within cancer cells. This approach aims to disrupt the specific mechanisms that allow cancer cells to grow and divide while sparing normal cells, leading to more effective and less toxic treatments. Before initiating targeted therapy, molecular profiling of the tumor is performed to identify specific genetic or molecular alterations that drive the growth and survival of cancer cells. This information helps oncologists select the most appropriate targeted therapy for an individual patient (1).

Patients who were treated for advanced cancer at UC San Diego Health's Moores Cancer Center had better outcomes if they received personalized cancer therapy, according to researchers at UC San Diego School of Medicine. By undergoing a therapy recommended by a molecular tumor board, patients were more accurately matched to the genomic alterations in their cancer and had improved survival rates. Patients who had the highest degree of matching and received personalized cancer therapy had a three-year survival rate of about 55%, compared to 25% in patients who received unmatched or low-degree matching therapy (2).

Resistance to targeted therapies can develop over time as cancer cells find alternative mechanisms to bypass the targeted pathway. However, ongoing research is focused on understanding resistance mechanisms and developing strategies to overcome them, such as combination therapies or next-generation targeted agents (3).

Cancer Genetics: Advancing Prevention and Early Detection

Recent advances in cancer genetics have ushered in a new era of possibilities for both prevention and early detection. With the ability to identify carriers of pathogenic variants through genetic testing, we now have valuable insights that can inform targeted preventive strategies, including prophylactic surgery and intensified screening, for individuals at increased risk of hereditary cancers. These advancements have the potential to revolutionize cancer care and empower individuals to take proactive measures in the fight against this formidable disease (4). 

The human genome consists of an intricate code that influences various aspects of health and disease, including cancer susceptibility. Through groundbreaking research efforts such as the Human Genome Project, scientists have gained a deeper understanding of the genetic alterations associated with cancer development. This knowledge has paved the way for the identification of specific genetic mutations that confer an increased risk of developing certain types of cancer (5).

Genetic testing has emerged as a powerful tool in cancer prevention and early detection. By analyzing an individual's DNA, genetic testing can identify the presence of pathogenic variants that are known to increase the likelihood of developing cancer. This information enables healthcare professionals to assess an individual's cancer risk more accurately, allowing for personalized and targeted interventions (6).

One of the significant implications of genetic testing is the ability to inform preventive strategies tailored to an individual's specific genetic profile. For individuals found to carry pathogenic variants associated with hereditary cancer syndromes, prophylactic surgery may be considered. Examples include bilateral mastectomy for individuals with BRCA1/2 mutations associated with a high risk of breast and ovarian cancer, or prophylactic colectomy for those with Lynch syndrome predisposing to colorectal cancer (7). 

In addition to prophylactic surgery, genetic testing results can guide intensified screening protocols for individuals at elevated cancer risk. Regular screenings, including imaging tests and specific biomarker assessments, can aid in the early detection of cancer or its precursor lesions. By detecting cancer at an earlier stage, treatment interventions can be initiated promptly, resulting in better outcomes and improved survival rates (8). 

Conclusion

While cancer remains a serious health concern, it is crucial to debunk the myth that it is always a death sentence. With its personalized approach, targeted therapy has revolutionized cancer treatment by specifically targeting the molecular abnormalities within cancer cells. Additionally, early detection through screening programs, advancements in imaging technologies, and non-invasive tests like liquid biopsies have significantly contributed to improved cancer outcomes. By promoting awareness, encouraging regular screenings, and investing in research, we can continue to challenge the notion that cancer is a guaranteed death sentence and provide hope for those affected by this disease.

References

1. Sharma, P., Hu-Lieskovan, S., Wargo, J. A., & Ribas, A. (2017). Primary, adaptive, and acquired resistance to cancer immunotherapy. Cell, 168(4), 707-723
2. University of California - San Diego. "Personalized cancer therapy improves outcomes in advanced disease." ScienceDaily. ScienceDaily, 2 October 2020. <www.sciencedaily.com/releases/2020/10/201002141905.htm>
3. Pao, W., & Chmielecki, J. (2010). Rational, biologically based treatment of EGFR-mutant non-small-cell lung cancer. Nature Reviews Cancer, 10(11), 760-774
4. Stratton MR, Rahman N. The emerging landscape of breast cancer susceptibility. Nat Genet. 2008;40(1):17-22. doi:10.1038/ng.2007.53
5. Stratton MR, Campbell PJ, Futreal PA. The cancer genome. Nature. 2009;458(7239):719-724. doi:10.1038/nature07943
6. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic (Version 1.2022). Accessed June 26, 2023. https://www.nccn.org/professionals/physician_gls/pdf/genetics_bop.pdf
7. Rebbeck TR, Friebel TM, Friedman E, et al. Mutational spectrum in a worldwide study of 29,700 families with BRCA1 or BRCA2 mutations. Hum Mutat. 2018;39(5):593-620. doi:10.1002/humu.23406 ↩
8. Wolpin BM, Rizzato C, Kraft P, et al. Genome-wide association study identifies multiple susceptibility loci for pancreatic cancer. Nat Genet. 2014;46(9):994-1000. doi:10.1038/ng.3052