Recent advances have changed the way cancer is treated. Here are some of the biggest leaps forward.
Personalized or Precision Medicine
Researchers have found that cancer in one person doesn't always behave the same way in another person.
Personalized or precision medicine lets doctors tailor cancer treatment to a person's tumor. Gene changes, or "mutations," that are unique to the tumor can help doctors decide which treatment is likely to work best.
As researchers learn more about these gene changes, they can develop treatments known as targeted therapy.
These work on things like genes, proteins, and blood vessels that help cancer cells grow and spread. They’re different from traditional cancer drugs like chemotherapy, which act on all fast-growing cells.
Because doctors match targeted treatments to your tumor, they may work better than other cancer options, with fewer side effects.
Examples of targeted drugs include:
- Trastuzumab (Herceptin) treats breast cancers that have the HER-2 gene mutation.
- Afatinib (Gilotrif) and cetuximab (Erbitux) block a substance called EGFR that helps colorectal and lung cancers grow.
- Dabrafenib (Tafinlar) and vemurafenib (Zelboraf) treat melanomas that have a mutated BRAF gene.
Targeted therapy has promise, but doctors can only treat a few kinds of cancer with it right now. As researchers learn more about cancer cells, they’ll find more targets.
These treatments help your body's own defenses -- your immune system -- find and attack cancer cells the same way it attacks bacteria and viruses. The main types used are:
Monoclonal antibodies: Your immune system creates proteins called antibodies that seek out cancer and other foreign cells. They attach to substances called antigens on those cells. Once attached, the antibodies send out a signal that tells other immune cells to launch an attack.
Monoclonal antibodies are man-made versions of them. They’re designed in a lab to target specific antigens found on cancer cells.
Some antibodies work alone. Others are linked to toxic substances like chemotherapy drugs that kill cancer cells.
Checkpoint inhibitors: Your body's cells have substances called checkpoints on their surface that tell your immune system they're friendly. Cancer cells sometimes hide behind these checkpoints so your immune system can’t find them. Inhibitors remove these checkpoints so your immune system can find and attack cancer cells.
Cancer vaccines: Regular vaccines teach your immune system to fight off diseases like mumps or measles. Cancer vaccines show it how to fight off cancer. There are two main types:
- Preventive (or prophylactic) vaccines, which aim to prevent cancer.
- Treatment (or therapeutic) vaccines, which strengthen your immune system to fight a cancer you already have.
In the U.S., you can get two types of cancer preventive vaccines: human papillomavirus (HPV) and hepatitis B virus. A treatment vaccine for metastatic prostate cancer is also available.
Cytokines: These proteins control the growth and activity of immune cells. They can help boost your immune system's response against cancer. They include:
- Interferons, which jump-start cancer-fighting immune cells
- Interleukins, which help immune cells talk to each other
CAR T-cell therapy: Your immune system has an army of fighter cells called T cells, which defend your body against viruses and other invaders. CAR T-cell therapy is a treatment that helps T cells attack cancer more effectively.
Doctors first remove T cells from your blood. Then they change genes in the cells to help them find and destroy cancer cells. Finally, they put the T cells back in your body.
The FDA approved tisagenlecleucel (Kymriah) for children and some young adults with B-cell acute lymphoblastic leukemia who haven’t gotten better with other treatments. Tisagenlecleucel and axicabtagene (Yescarta) both treat certain types of B-cell lymphoma in adults that have not improved with other treatments.
This treatment kills cancer cells with intense beams of energy. Newer forms of radiation include:
Intensity modulated radiotherapy (IMRT): A machine aims the radiation beam precisely at the affected area. This gets the highest dose of radiation to the cancer, but does the least damage to healthy tissue nearby.
Image-guided radiation therapy (IGRT): Your doctor uses imaging scans like an MRI or CT to focus the laser on the area to be treated. IGRT works well for areas of your body that move, like the lungs or liver.
Stereotactic radiosurgery (SRS): This treatment also delivers a high dose of radiation to a small area. It’s a good option for tumors in your brain and spine.
Proton therapy: This type of radiation treatment uses protons -- positively charged particles of energy -- to kill cancer cells.
It sends an intense burst of energy to a highly focused area. This means the treatment can destroy cancer cells without damaging healthy tissues nearby.
Proton therapy is being used to treat tumors in the:
- Head and neck
Using drugs that kill cancer cells has been around since the 1950s. It's still a leading cancer treatment.
Chemotherapy drugs haven't changed a lot in the last 60 years. But today doctors combine the medications so they work better. Scientists have come up with new ways to help get the medicine to the cancer cells more easily.
Operations are still a main cancer treatment. The goal is to remove as much of the cancer as possible.
In robotic surgery, your doctor inserts tools and cameras into small cuts in your body. He sits at a console and looks into a viewfinder while working the robotic arms with hand and foot controls.
The robotic arm is more precise than the surgeon's hands, and it can reach hard-to-get-to body parts. This type of surgery can reduce blood loss during the procedure and pain afterward. It can also shorten hospital stays.
Robotic surgery is used to treat several cancers:
There are downsides: It’s expensive, and the surgeon must be highly skilled.