In terms of medical diagnoses, there aren't many things scarier than hearing the phrase, "you have cancer."
The numbers partially tell the tale. Globally, according to the World Health Organization, there are 14 million people diagnosed with cancer annually, and this figure is expected to swell to 22 million in roughly two decades.
The American Cancer Society estimates that there were 1.66 million cancer diagnoses in the United States last year. The ACS also estimated that more than 589,000 people would lose their lives as a direct result of cancer in 2015. Within the U.S., cancer ranks behind only heart disease as the leading cause of death, although it's expected to surpass heart disease as the leading cause of death in the coming years as cancer incidence rates rise.
However, it's not just these large numbers that are terrifying; it's that many of the triggers for cancer are still largely unknown. This isn't to say that researchers don't have a decent bead on what constitutes a risk factor for cancer -- old age, using tobacco, and consuming alcohol are all well-accepted risk factors for most cancer types -- so much as researchers still aren't entirely certain what triggers cancer to develop. In other words, researchers can't explain why one person will develop cancer and another won't despite having similar lifestyle habits.
Debunking cancer's greatest myth of all
This "unknown" of cancer and its high mortality rate in the U.S. make it a particularly scary disease. But the unknowns of cancer also gives rise to the greatest cancer myth of all -- namely, that a cancer diagnosis is a death sentence.
Between 1975 and 1977, according to data from the Surveillance, Epidemiology, and End Results Cancer Statistics Review, all cancer diagnoses resulted in an average five-year survival rate of 48.9%. However, things have changed drastically since then. SEER data between 2005 and 2011 shows that the five-year survival rate for all cancer types is now 68.7%, and presumably even higher today since this data only covers 2005 through 2011 and survival rates have improved over all 11 time periods studied since 1975.
Though five-year survival rates will be more a function of an indiviudal's cancer type, some types of cancer have witnessed substantial five-year survival rate improvement over the past three-plus decades. Based on ACS data between the periods of 1975-1977 and 2004-2010, prostate cancer's five-year survival rate has climbed from just 68% to better than 99%. Breast cancer, melanoma, and Hodgkin lymphoma have also seen marked improvements in five-year survival rates, going from 75%, 82%, and 72%, respectively, to 91%, 93%, and 88%.
The point being that a cancer diagnosis, while scary, is not a death sentence any longer thanks to access to better medicine, diagnostic equipment, medical care, and health education.
Still work to be done
While the data continues to be encouraging when taken as a whole, the reality is that certain cancer patients still have a tougher road to traverse than others based on their cancer type. Five-year survival rates for pancreatic cancer (7%), lung cancer (18%), liver cancer (18%), and myeloma (47%) are still far too low. Here are some of the ways researchers are looking to change that.
First, we're seeing a major push into cancer immunotherapies. Immunotherapies work by essentially supercharging a patient's T-cells, or the cells that are responsible for destroying foreign cells. Cancer has a unique knack for hiding from these cells inside our bodies, so immunotherapies work by turning off their ability to hide, giving your immune system a literal fighting chance.
Right now there are two FDA-approved immunotherapies in the spotlight: Bristol-Myers Squibb's (NYSE:BMY) Opdivo and Merck's (NYSE:MRK) Keytruda. In the early going both immunotherapies have shown a particular knack for fighting tumors expressing PD-L1. In metastatic melanoma and metastatic non-small cell lung cancer studies, Bristol-Myers' and Merck's immunotherapies have delivered overall response rates for high-PDL1-expressing patients that were in some cases double (or higher) than prior standards of care. Both therapies have also lent to improved overall survival in those patients who've responded. Think of Opdivo and Keytruda as foundation therapies that could be combined with many of today's existing cancer products to improve response rates and overall survival in the coming years.
We're also seeing researchers individualize patient care to improve their chances of survival. One of the more unique treatment methods being examined is what's known as CAR-T therapy. In CAR-T, researchers take blood from a cancer patient and harvest their T-cells. Researchers then genetically modify these T-cells to produce chimeric antigen receptors (CARs) that can help them locate and bind to specific cancer cells. Once millions of these T-cells are grown in a lab, the sample is then injected back into the cancer patient where they'll, in theory, multiply and attack cancer cells.
Two of the more intriguing companies involved in this space are Intrexon (NASDAQ:PGEN) and Ziopharm Oncology (NASDAQ:ZIOP), which just so happen to be working together. These two are not only testing the limits of CAR-T technology, but they're devising a way to make its effect more precise and safer than ever. Utilizing Intrexon's RheoSwitch technology, the duo of Intrexon and Ziopharm aims to use an activator to control the expression of IL-12. Doing so essentially allows your T-cells to go into hyperdrive for a short period of time (say a week), and then return to normal levels so you don't experience immunotherapy-related toxicities. Needless to say, CAR-T may have applications in all types of solid and blood-borne cancers.
Although a cancer diagnosis is unwelcome and scary, know that researchers are indeed putting new therapies and diagnostics in the hands of physicians that are slowly but surely improving patient outcomes and helping to push the most pervasive cancer myth firmly into the past.