Tremendous progress has been made in the cancer community over the past few years alone, so it’s not entirely surprising that the largest single-year drop of deaths from cancer was recently recorded — which, in turn, impacted more good news: the average age of American life expectancy has risen to 78.7 years.Read More
But of course there’s still much to do. The natural question then, is: What needs to be addressed next? SurvivorNet looks at the top 5 future trends in cancer.
1. Closing the Disparities Between Who’s Being Treated
Unfortunately, many people with cancer can’t afford treatment at comprehensive medical centers. An American Cancer Society report on the drop in deaths from cancer, for instance, pointed to a large disparity when it came to getting access to new, effective drugs.
“Cancer occurrence and outcomes vary considerably between racial and ethnic groups, largely because of inequalities in wealth that lead to differences in risk factor exposures and barriers to high‐quality cancer prevention, early detection, and treatment,” the report says.
Disparities are one of the most important factors to address, Dr. Otis Brawley, the Bloomberg Distinguished Professor of Oncology and Epidemiology at Johns Hopkins University, told SurvivorNet.
For instance, he said, researchers were “actually able to figure out that people who do not have insurance — and [that usually means] poor people — did not have a decline in the melanoma death rate, whereas insured people did have [an acceleration in the] decline in melanoma death rate. That implies that there are treatments, cures for cancer that Americans cannot get because they cannot afford them.”
And in the case of melanoma, he said, effective treatments “can clearly prolong life a long time, and in some instances can cure [their cancer].”
2. More Effective Use of New Therapies
There has been an enormous amount of progress in the development of immunotherapies, or the artificial stimulation of the immune system, for cancer treatment. There is evidence the treatment may be effective at fighting even more cancers now, including metastatic triple-negative breast cancer, lung cancer, ovarian cancer and head and neck cancer.
Next up is additional research that continues to look into when to use them, for whom, in combination with what drugs, and why don’t they work in some people.
“This is where research and clinical trials come in,” Dr. Brendon Stiles, a thoracic surgeon at Weill Cornell Medicine and NewYork-Presbyterian, told SurvivorNet in a previous conversation. “We have an unprecedented ability to sequence tumors and understand their immune micro-environment. New targets for cancer therapy are becoming apparent at a dizzying pace. We need to study these in the appropriate clinical context to learn how each fits into the next generation of cancer care.”
Dr. Brandon Stiles discusses immunotherapy and lung cancer
3. Combining Targeted Therapies with Immunotherapies
One of the major advances doctors are excited about is the combining of immunotherapy treatments with new targeted therapies, or cancer treatments that attack specific molecules involved with cell growth.
“We need better integration of ‘real-world’ data sources to accelerate regulatory approval of precision oncology therapies,” Dr. David Wise, a medical oncologist at NYU Perlmutter Cancer Center, told SurvivorNet in a previous conversation. “A better understanding of the effects of novel targeted therapies on the immune system will lead to new ways of combining these agents with immunotherapies.”
Nobel Prize winner Dr. Jim Allison, chair of the Department of Immunology at MD Anderson Cancer Center, also spoke to SurvivorNet about the effectiveness of combining immunotherapy as a complementary treatment to traditional “targeted” therapies like chemotherapy and radiation for many types of cancer.
“The most powerful combinations coming up are based on providing immune blockers and enhancers [and] drugs that can directly kill tumor cells to really have a double whammy,” he said.
Dr. Jim Allison explains what’s next in immunotherapy
4. Early Detection
“Continued efforts in early detection of cancer is the most effective step in preventing death and advanced cancers,” said Dr. Kurt Melstrom, colorectal surgeon and an assistant clinical professor, Division of Surgical Oncology at the City of Hope National Medical Center. More specifically, he said, what we need is “more advanced and sensitive blood tests and imaging” to help detect cancers earlier.
Dr. Wise at NYU Perlmutter Cancer Center agreed that the future of cancer care in part is in “better liquid biopsy techniques to assess disease burden at a molecular level. [This] will lead to earlier detection and improved response assessment of minimal residual disease in patients who have had curative treatments.”
In order to continue the progress in reducing cancer deaths, access must be improved for screening and vaccinations.
Dr. Dana Chase, a gynecologic oncologist at Arizona Oncology, told SurvivorNet that in her field, “improving access to and adherence to cancer screening tests, vaccinations such as the HPV vaccination, and promoting awareness in terms of concerning symptoms such as postmenopausal or irregular bleeding and abdominal or pelvic complaints is important.”
Dr. Bobbie J. Rimel, an OB/GYN and oncologist at Cedars-Sinai Medical Center, agreed that “continued attention to vaccination for HPV is critical to reducing rates of cervical, vaginal, vulvar, and head and neck cancers.”
HPV has been linked to a host of cancers, including cervical, oropharyngeal, anal, penile, vaginal and vulvar cancers, according to the National Cancer Institute. The HPV vaccine series is recommended for girls and boys at the age of 11 or 12, but the series can be started at age 9. A CDC survey reported that in 2018, 51.1% of adolescents ages 13-17 were fully vaccinated.