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  Understanding the future of cancer care

Understanding the future of cancer care

Published : May 15, 2016, 9:51 pm IST
Updated : May 15, 2016, 9:51 pm IST

Age is the biggest risk factor for cancer; six out of 10 cases are diagnosed among people above 65. Due to longevity and increasing ageing population, cancer cases are increasing at an alarming rate.

Age is the biggest risk factor for cancer; six out of 10 cases are diagnosed among people above 65. Due to longevity and increasing ageing population, cancer cases are increasing at an alarming rate. Chemotherapy and radiotherapy have been the cornerstones of cancer treatment for long, but both have significant drawbacks. Chemotherapy lacks the selective capacity to distinguish between cancerous and normal cells and radiotherapy may cause additional cancer.

Mapping of human genome has broadened the understanding of how cancer develops at a molecular level. The therapeutic approach targets personalised genomic medicine. This has made a paradigm shift in cancer treatment methods.

Cancers are fundamentally caused by mutations in the genes and develop either due to inherited genetic variations or accumulating damage to the DNA of normal dividing cells. Genomic testing and targeted therapy for breast and lung cancer have been the standard of care for years. However, a few aggressive cancers such as that of brain and pancreas do not respond favourably to therapies because the root cause differs in each tumour, thereby requiring specific targeted therapies. Advanced genomic testing identifies mutations in the cancer cell’s genomic profile and specifically tailored targeted therapies are deployed. The shift is from an organ-focused to a gene-focused therapeutic approach.

Scientists have developed nano particles which specifically target cancerous cells and deliver very high concentrations of anti-cancer drugs. The targeting agents can be drugs, or vaccines or can be achieved by genetically training the immune system’s killer cells, which can attack the tumour cells (cancer cells outsmart the body’s defense mechanism and escape being attacked by the immune system).

Since targeted therapy is an evolving branch, its use is restricted to patients whose tumour has a gene mutation for a specific targeted therapy and those enrolled for clinical trials. Cancer care is entering a new era where detailed genomic information about each cancer will be routinely used for effective targeted therapies.

(The writer is an obstetrician and gynecologist)