I get asked this question a lot, especially when media parrot some ill- informed commercial press release (which happens a lot more than it should)
The short answer to this question is NO — we are very unlikely to find a single cure for cancer in our lifetime. That is not to say that there haven’t been enormous improvements in all aspects of cancer over the last few decades, brought about by cancer research and the application of the knowledge this is giving us. We are making and will continue to make enormous positive strides in individual cancers by investing in all aspects of cancer research.
The thing is cancer is not just one disease but a collection of many complex and often very different illness that target the body in a myriad of different ways and are found at different stages. They are grouped under the “heading” of cancer as they all start the same way — cells in the body begin to divide without stopping and spread to surrounding tissue.
As with any complex problem there is no single solution but research has already identified many new ways that we can readily improve the cancer situation and further research will undoubtedly improve things even further. For example,
- 50 years ago leukaemia in children was always fatal, often rapidly, horribly so. Today the majority of children with leukaemia in Ireland will be taking part in clinical research and more than 9/10 of them will be fully cured of their disease.
- In testicular cancer, even in the most advanced stages (which are now rare) ¾ men will be fully cured and 19/20 will be cured if caught in the much more common early stage.
- Similar advances in have been seen with breast, prostate and other cancers where survival rates have increased dramatically over the last 20 years.
Unfortunately, we do have a long way to go with some other cancers — lung, pancreas and ovarian, for example, — where treatment advances have led to more modest improvements in outcome and survival.
It is the case now though that well over half of everyone who receives a cancer diagnosis in Ireland (and most developed countries) will be CURED of their cancer. This is good news but we have to remember that the numbers of people being diagnosed is also growing each year.
How do we continue advances in cancer outcome and save more lives?
There are things that can be done to ensure that survival rates continue to increase and the numbers of those getting cancer in the first place start to fall. Many of these aren’t fancy or headline grabbing and involve difficult step by step organisational, practical and cultural changes:
- Prevention- We now know that roughly 4/10 cancer cases are preventable by reasonably simple lifestyle changes, particularly if they are adopted early in life. So not smoking, minding our weight, eating a mixed diet that doesn’t have too many calories, being active, avoiding alcohol, avoiding too much sun exposure on our skin and getting vaccinated against HPV would collectively reduce the numbers of cancers by thousands each year in the future.
- Early detection- Most cancers are curable if caught early, for example, 19/20 Irish bowel cancers caught in the early stage (stage 1) are cured, while the prognosis is much poorer for those diagnosed at a later stage. So engaging with cancer screening and chatting with our GP if we have unexplained symptoms lasting more than a few weeks could save even more lives every year.
- Diagnosis and treatment- Amazing advances in diagnostics, medicines and surgery, and combining all of these approaches have greatly improved outcomes, for those affected particularly with more advanced cancers. However, these advances cost money and need lots of experts so we will only continue to reap their rewards if we invest in research in these areas and also encourage people to dedicate their lives to supporting advances in cancer treatment. There are challenges here though: this stuff is very expensive and we also have to be incredibly careful not to be blinded by the technology and ask real hard questions as to whether it generates real improvements in outcome or just a high tech razzmatazz.
- Survivor supports- It is now very clear that those good lifestyle actions that help prevent cancer in the first place probably apply even more to those who finish their initial cancer treatment. For example, keeping a healthy weight and exercising right through treatment (as best one can) and especially after enormously improves the chances of not dying from cancer or the indirect effects of cancer afterwards in breast, bowel and prostate cancer and possibly several others. Proper supports to overcome fatigue and disability can reap enormous positive benefits to everyone impacted by cancer.
The bottom line is we should not live in fear of cancer. Shortly in Ireland, more than one out of every twenty people will be a cancer survivor.
Some cancers becoming “chronic”
My nursing and clinical colleagues in hospitals increasingly tell me of patients they have who are now living with advanced incurable cancers, which 10 or even 5 years ago would have been invariably fatal. New approaches, radiation and medicines are extending life for some, and giving them a high-quality active life as well. For some cancers, such as a high portion of early stage prostate cancers, patients are counselled that watchful monitoring is far more effective at giving them quality life, than aggressive treatment. Most of these men will actually die with a cancer in their body rather than than die from it. Management of symptoms, side-effects and the psychological burdens of such things going on in one’s body is a new vista for researchers to try and engender real improvements too. Increasingly such people are of working age so employers will need to take account of their staff (and colleagues) who they will have invested in over years and decades and still have lots to give and offer to the workforce.
So where is this all going then?
We need to give balanced support to the the aspects of health that we already know can reduce cancer burden.
Research is truly improving outcome for many people impacted by cancer, but this is more usually a steady improvement and a singular eureka moment of magical change.
We need to be wary of media parrots and sensationalist headlines!
In particular, the idiom, “if it sounds too good to be true it usually is” is a good guide in life and when we hear about cancer “cures”.