Despite the continuously increasing lifespan of human beings, the scourge of cancer paints a gloomy picture. The World Health Organization’s Cancer Profile 2020 puts the global burden of cancer for the year 2018 at over 18 million, and the total number of cancer deaths at over 9.55 million. And the numbers have already by far surpassed the WHO’s 2003 projection of crossing 15 million cases by 2020. Alarming as these figures are, we may take refuge in the fact that cancer understandably remains one of the biggest and most well-funded areas in medical research. So, let us look at what is to come for cancer research in the upcoming days.
There were days when the treatments of cancer meant either surgery or radiation. Slowly for sure, but we have since come a long way. Along with improvements in the older approaches, chemotherapy, hormone therapy, stem cell transplant and most recently immunotherapy have revolutionized cancer treatment. The good news is that the overall cancer death rate has continued to decline in the last 10 years. Having said that, cancer treatment is very far from perfect, and cancer is a mystery which demands still more exploration.
Some of the recent advances in cancer research are –
- Development of immunotherapy, including CAR T-cell therapy, immune checkpoint inhibitors, and monoclonal antibodies
- The growing role of precision medicine
- Development and use of liquid biopsies
- Development and use of machine learning, which is helping scientists make sense of big data
- Increased understanding of how cancer spread is aided by the neighbours
- Increased understanding of how cancer spreads and thrives in a new site and escapes the immune system
- More people have started accepting the message that cancer is linked with obesity
- Smoking remains the most preventable cause of cancer death
- More have been discovered about the microbiome’s influence on cancer
- The knowledge that besides DNA mutations, epigenetic changes and/or microRNAs may be involved in cancer
- New understanding of cancer cell metabolism has opened the door for new drug targets
- The benefits of receiving palliative care early in cancer treatment have been highlighted
- Development of improved radiation techniques, e.g., three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, stereotactic radiotherapy, brachytherapy, radioimmunotherapy, and proton therapy
- Development of improved surgical techniques, e.g., robotic surgery
Given the present focus on precision medicine, the future research, besides continuing along the same lines, holds promise to make cancer treatment more targeted (thus reducing the side-effects and increasing effectiveness), including personalized cancer vaccines. Gene therapy presents another exciting area of research, and more so in this era of CRISPR and gene editing. Virotherapy too offers much potential in this regard.
Despite the major advances in oncological treatments, the pitfalls of chemotherapy continue to be a pervasive issue. Hence, the side-effects of chemotherapy and cancer drug resistance, including cancer stem cells, would remain a mainstay of cancer research in the near future. Also, with increasing understanding of the microbiome’s links with cancer, improved treatments, including stem cell transplant and immunotherapy harnessing these links are underway.
Lastly, although the COVID era has seen an unavoidable dip in the cancer research activity, we must keep in mind that these are very much temporary hurdles. Looking at the bigger picture, the future of cancer research should indeed save the day for us!