Cancer. It's potentially the scariest diagnosis a person can receive from their doctor, but it's something roughly 14 million people around the world will hear this year, according to the World Health Organization. In a little less than two decades, the number of annual cancer diagnoses is expected to rise to 22 million.
Within the United States, based on 2015 data from the American Cancer Society's Facts and Figures Report, 1.66 million people were expected to be diagnosed with cancer, with another 589,430 dying from the disease. Cancer now trails only heart disease as the leading cause of death in the U.S., and it's expected to take the dubious top spot in the coming years.
Researchers' optimistic cancer forecast
As researchers from University College London (UCL) and King's College London noted this past July, everything is a matter of perspective. Growing incidence rates might suggest a glass-half-empty approach, but these researchers actually believe we're getting a stranglehold on cancer. In fact, they're so confident, they believe deaths from cancer will be "eliminated" for all persons under the age of 80 by 2050 in the U.K., with only those in "late old age" dying from cancer.
David Taylor, the emeritus professor of pharmaceutical and public health policy at UCL, had this to say:
What makes this a special point in history, is that cancers are in the process of becoming either preventable or effectively curable.
The proof has been in the pudding for Taylor and his colleagues, who can point to a drop in death rates from the most common forms of cancer by around a third from just 20 years prior. While researchers cautioned that no "magic bullet" was around the corner to rid the world of cancer, they did list five factors that have allowed for significant headway against oncological diseases over the past couple of decades, and that could lead to the elimination of cancer in persons under age 80 by 2050.
The five-point strategy for eliminating cancer in people ages 80 and under
To begin with, adult smoking rates have declined. Among cancer risk factors, few arguably rank higher than smoking tobacco products, which have been linked to lung cancer, heart disease, and a host of other ailments. As smoking rates decline, the incidence rate of certain cancers would be expected to see a concurrent decline as well.
Secondly, we've witnessed a rise in personalized medicine. The use of molecular diagnostic tests is allowing physicians to attack specific cancer biomarkers. Doing so removes the one-size-fits-all treatment pathway we've been used to and exposes the patient to a treatment course fitted specifically for them and their type of cancer.
Third, we're seeing cancers diagnosed earlier than ever. Diagnostic tests are playing a key role in helping patients and physicians identify biomarkers and signals that could signal the presence of cancer. As you're probably well aware, catching cancer early substantially improves the treatment prognosis.
Fourth, we've witnessed a substantial improvement in the quality of oncology drugs hitting pharmacy shelves. These drugs are assisting cancer patients with early- and late-stage disease, and they're not only boosting survival in most instances, they're also providing improved quality of life.
Finally, researchers suggest healthier lifestyles will be key to controlling cancer incidence rates and deaths. Obesity has been linked to cancer risk in a number of common cancer types, so getting people to accept a more active lifestyle should help reduce the risk of cancer development.
Some of these factors, like smoking rates and lifestyles, are completely up to the effort put in by each individual. Other factors, such as molecular diagnostics and better drugs, are beginning to gain steam and have a real impact. Let's take a brief look at some of the ways personalized medicine and better therapies are changing the game.
Personalized medicine and molecular diagnostics mesh well
One of the pioneers of oncology-based molecular diagnostics is Myriad Genetics (MYGN -3.95%). The company is perhaps best known for its BRACAnalysis gene tests that analyze whether or not a woman is a carrier of the BRCA1 or BRCA2 mutant gene. Carriers of this gene have a higher risk of developing breast and/or ovarian cancer. Actress Angelina Jolie tested positive for these mutations, ultimately choosing to undergo a preventative mastectomy in 2013. She also had her ovaries and fallopian tubes removed two years after undergoing her mastectomy. Although her chances of getting breast cancer aren't 0%, Jolie has done everything in her power to reduce the likelihood of getting a BRCA-mutation generated cancer.
Myriad is also the developer of Prolaris, a fairly new test for men with prostate cancer. Prolaris uses tissue samples from a patient's biopsy to aid with staging and a treatment plan. Based on the company's proprietary Prolaris Score, a 10-year prostate cancer-specific mortality risk can be given to the patient by his physician.
Exact Sciences (EXAS -4.69%) is also a molecular diagnostics revolutionary. Its noninvasive colorectal cancer detection tool known as Cologuard examines a patients' stool sample for abnormal DNA signatures based on cells shed from inside the intestinal wall. Any abnormal DNA signature would imply the presence of colon cancer, or perhaps an advanced adenoma, and would be a signal for the patient in question to get a colonoscopy. Exact Sciences has suggested that colon cancer is the most preventable form of cancer since adenomas can take 10 to 15 years to develop into cancer. Thus, regular screenings with Cologuard could be an effective colon cancer prevention tool.
Drugmakers are making waves in the fight against cancer
Drug developers are doing their part as well. No new cancer therapies have arguably been as encouraging as Bristol-Myers Squibb's (BMY 2.31%) Opdivo and Merck's (MRK -0.50%) Keytruda. Opdivo and Keytruda are part of a new class of drugs known as cancer immunotherapies, which are designed to halt cancer's ability to hide from the immune system while simultaneously kicking a patient's immune system into high gear. Clinical results have regularly shown a higher response rate than prior standards of care, improved quality of life, and -- in many instances -- longer overall survival.
The plan for Bristol-Myers Squibb's Opdivo and Merck's Keytruda appears to be to test these therapies as combinations in dozens of cancer types. Although both have shown promise as monotherapies, their effectiveness has really shone through when given in combination with existing cancer therapies.
Ziopharm Oncology is involved in chimeric antigen receptor T-cell technologies, or CAR-T research. The idea being to take some of a patient's T-cells, genetically modify them to express a CAR that the immune system will use to recognize tumor antigens, and multiply those genetically modified T-cells for injection back into the patient. This alone is an exciting new treatment pathway.
Here's where things get interesting. Intrexon intends to combine its RheoSwitch technology, which can turn specific genes on or off, with Ziopharm Oncology's CAR-T technology to induce something of a supercharged immune attack on cancer cells that'll last, say, a few days or a week. The idea would be to focus the attack solely on targeted cancer cells, then turn the volume down, so to speak, on the immune system in order to reduce any potentially adverse effects. Intrexon and Ziopharm's combo is still unproven, but it offers a lot of promise.
As you can see, the tools to tackle cancer are at our disposal. Whether we can reach the lofty goals of these U.K. researchers remains to be seen, but we appear to be off to a good start.