Tuesday, November 22, 2011

Cancer survival

There is a report in today's newspapers in the UK about progress in cancer survival. There has been some improvement but it is not a record of magnificent success. Most of the improvement has come from surgery, particularly with breast and colon surgery - often when combined with adjuvent chemotherapy. Some of the improvement has been because of early diagnosis - not that patients are living longer than they did, merely that are living with the diagnosis for longer. This is particularly true for breast and prostate cancer.

Hormones have made a great impact on cancer survival, particularly for breast cancer.

Chemotherapy has made a great impact on Hodgkin disease and childhood acute leukemia but limited impact elsewhere except in the adjuvent setting. Adult AML has shown little if any benefit from chemotherapy

Monoclonal antibodies have made an impact in CLL, diffuse large cell lymphoma and follicular lymphoma (actually it's all rituximab).

Targeted therapy ahs made an impact on CML, and possibly kidney cancer and a rare form of adenocarcinoma of the lung in Indian female non-smokers. There is some promising news about melanoma.

Bone marrow transplantation has saved some lives but the risk is so great that the butcher's bill is hard to calculate.

Longer survival may come from better disease definition as in some skin cancers and lymphomas.

As for the common solid tumors like lung cancer, pancreatic cancer, brain cancer and the rest, there has been very little improvement since I became and oncologist 37 years ago

1 comment:

Anonymous said...

How true and how sad that with all the billions of dollars and pounds we have thrown at this quite varied disease we call cancer little overall increased life expectancy has resulted. In looking back at my Mother's diagnosis in 1982 of the rare lymphoma of the brain very little has changed in protocals for treating this disease. As a lay person I often wonder why in all these years those smarter than I have not concluded that individual immunology should be where these massive monies should be going on a global scale with an insistance on reseach sharing. Just my two cents.