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    Cancer: the Good, the Bad, and the Ugly

    We've made great progress since President Nixon declared war on cancer 30 years ago, but can the war be won?

    Treatment No Longer Worse Than the Disease

    "[These drugs] have changed our thinking," he says. "We don't use the word cure, but we now think of converting cancer to a chronic manageable disease like diabetes," he says. "When you see these patients, they are not very sick, their hair doesn't fall out, they don't have massive diarrhea and their spouses stay with them," he says. New treatments have decreased the toxicity and decreased the chance of drug resistance, he explains. "There are at least 40 other antiangiogenic drugs in the pipeline and some are doing very well," he says.

    The bottom line is that "you can live with cancer today," he says.

    Coming Soon?

    "The newer things are biomarkers of angiogensis or blood tests that are so sensitive they can pick up a 1-millimeter tumor in a mouse just before it switches on," he says. "Say you have colon cancer. We could do a urine or blood test every four months and if levels of a certain protein stays flat, you are fine, but if it goes up we know the cancer may be returning," he says.

    "Drugs like angiogenesis inhibitors that are approved are not as toxic as older cancer therapies, so you can take them for longer times, you don't develop resistance as fast and this is intersecting with biomarkers where we can diagnose cancers earlier and earlier," he says. "We are beginning to ask why do we care where the cancer is," he says. "If test is rising, why not treat with nontoxic antiangiogensis inhibitor until the numbers come down?"

    Other targeted drugs include Erbitux for colon cancer and herceptin for breast cancer. Both are considered antibodies, which are produced in a laboratory to target a very specific portion of foreign substances. Another drug, Gleevec, is a small-molecule drug that targets abnormal proteins that form inside cancer cells and stimulate uncontrolled growth. It is approved for certain forms of leukemia and rare stomach cancers.

    Overall, these new drugs "absolutely do help, but so far they are not revolutionary in seeing a halving of incidence of death rates or mortality rates," he says. "But they certainly suggest that we are making progress and are perhaps on the edge of making revolutionary progress," ACS' Glynn says. "We are in the early stage of drug development and need to now how best to use these drugs."

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