The Largest Single-Year Decrease In Cancer Deaths — It’s The Immunotherapy Revolution

“Immunotherapies for lung cancer, which won the nobel prize in 2018, are actually preventing people from dying,” Dr. Otis Brawley, Bloomberg Distinguished Professor of Oncology and Epidemiology at Johns Hopkins University, tells SurvivorNet. Brawley previously served as Chief Medical and Scientific Officer for the American Cancer Society. “It is rare that in cancer epidemiology, that you can point to one treatment, and say that overall death rate from all cancers is going down because this one treatment became available. In this case we can do that.”

In addition to the recent decline, over the past three decades, there has been a remarkable decline in cancer deaths. “The continuous decline in the cancer mortality rate since 1991,” says the study, “has resulted in an overall drop of 29%, translating into approximately 2.9 million fewer cancer deaths.” In public health, small percentages mean a lot of lives.

Researchers attributed the overall decline in cancer to reductions in smoking cigarettes. “The main reason we see long term declines in lung cancer mortality is because reduced rates of cigarette smoking have resulted in lower lung cancer incidence,” Dr. James D. Sargent, Co-director of the Cancer Population Sciences Research Program at the Norris Cotton Cancer Center told SurvivorNet.

What is Immunotherapy?

In the past few years, there has been a revolution in cancer treatment due to new immunotherapy drugs. Immunotherapy drugs use the body’s own immune system to attack the cancer.

Dr. Jim Allison, Chair of the Department of Immunology at MD Anderson Cancer Center, on the future of immunotherapy and cancer treatment

Immunotherapy for lung cancer uses what are called checkpoint inhibitors. Checkpoint inhibitors are man-made antibodies that shut down key proteins on immune cells such as PD-L1 that, when turned on, can give cancer a free pass to spread. Given intravenously, these immunotherapy drugs essentially wake up the immune system and encourage it to recognize the protein and attack it. Because these drugs are aimed at a specific target, there are fewer side effects than chemotherapy.

Smoking and Lung Cancer Risk

While lung cancer deaths have decreased as people stop smoking, cigarettes remain the leading cause of lung cancer in the United States. The tobacco in cigarettes is a carcinogen that causes mutations in lung cells and enables the growth of cancer. About 80% of lung cancer deaths are caused by smoking, according to the American Cancer Society. And several thousand other lung cancer deaths are caused by exposure to secondhand smoke. The good news is that if you quit smoking, your risk for lung cancer decreases.

Dr. Joseph Friendberg, Head of the Division of Thoracic Surgery at University of Maryland School of Medicine, on smoking and lung cancer risk

"If you're smoking, don't smoke," says Dr. Joseph Friedberg, Head of Thoracic Surgery at the University of Maryland School of Medicine. "You never return down all the way to the [level of] the person who never smoked as far as your risk of lung cancer goes, but it goes down with time."

The Future of Cancer Treatments

As there seems to be accelerating progress attributed to the decline in smoking, how else can we really move the needle for cancer? “The future is in personalized tumor-agnostic therapies including vaccines, personalized immunotherapies and molecules that interfere with cancer metabolism,” according to Dr. Allison Ocean, a Medical Oncologist at Weill Cornell Medicine and NewYork-Presbyterian told SurvivorNet.

Tumor-agnostic therapies, according to the National Cancer Institute, are a type of therapy that uses drugs or other substances to treat cancer based on the cancer's genetic and molecular features, regardless of the type of cancer or where the cancer started in the body.

The Importance of Screening and Vaccinations

In order to continue the progress in reducing cancer deaths, Dr. Dana Chase, a gynecologic oncologist at Arizona Oncology, tells SurvivorNet that screening and vaccinations are important factors. “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,” she says.

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.

Participating In Clinical Trials

Dr. Chase also said told SurvivorNet that ensuring people are comfortable being part of research that takes place in clinical trials is important to engendering progress in cancer care. “Finally educating patients and their families as to the importance of clinical trials and encouraging participation,” she says, as well as “destigmatizing clinical trials in general” is extremely important.

 

Learn more about SurvivorNet's rigorous medical review process.

---