What was the number one cause of death in USA in the year 2020/2021? If you guessed it Covid-19. You are wrong. Unfortunately, large number of people lost their life to covid-19 but it didn’t kill even half of the number of people lost their life to cancer alone. The governments around the world took it seriously and did everything in their power to stop spreading the virus and supported science to come-up with vaccines and therapeutics. The test to detect covid-19. qPCR or a quick antigen test was made available to almost everyone. The scientists developed vaccines within an unprecedented time period; a great example of war on a disease. Are we working with the same speed and strategy to fight cancer? 52 years ago, President Nixon signed the National Cancer Act, initiating what has been called “War on Cancer”. Despite of a great progress for certain forms of cancers, cancer still remains a major cause of death half a century after this war on cancer began. Are we fighting it as a war?
R&D to find newer therapies for cancer have made a great progress but in most cases patients still get non-specific drugs (Chemo therapeutics) which were approved as long back as 40-60 years.
An early diagnosis is the key for the treatment outcome. Are we doing as much as we could to detect cancer at early stages? Routine cancer screening like mammograms, colonoscopy, and PSA tests are saving lives. Unfortunately, there are other cancers which cannot be found before they start causing symptoms. What can be done? Could liquid biopsy be a solution? There are markers used in the clinic to monitor disease progression, prognosis and treatment outcome; for example, calcitonin, CA 15-3, 125, Beta-2- macroglobulin, CEA, a-fetoprotein, HCG and ALP. These are blood tests. Why can’t these test be done during routine physical exams for individuals of certain age or at higher risk? And of course, there is a need to find more predictive markers for early detection. Perhaps machine learning could be used wherever its possible. But it requires more resources and time.
Coming to the treatment side of it. Once a patient gets a diagnosis, getting an appointment with an oncologist becomes a challenge. Most of the time it takes several weeks and additional few weeks to start the course of treatment. What can be done to get an appointment fast enough to start treatment immediately? It’s a tough disease to treat but we can do better in terms of seen by a doctor fast enough. There is a need to develop a better system to help/educate patients and their families to explore clinical trials options available throughout the country; not limited to the hospital where the patient is being treated.
This war need to be fought collectively by patients, hospitals (doctors/staff) and pharma industry (researchers/scientists) and insurance companies have a role to play.
Dana-Farber Cancer Institute
Mass General Brigham
Memorial Sloan Kettering Cancer Center