Winning the War
Progress on various fronts helps people battling cancer in its many forms
by Jennifer Updike

Cancer. Some consider it the worst word in the English language, and for good reason: its stealth in escaping detection; its ability to survive, if not sidestep, even the most aggressive forms of treatment; the unrelenting wickedness of its symptoms; the way it can not only alter a person’s life but also take it.

Everyone knows someone who has been diagnosed with cancer, and most know someone who has succumbed to some form of the disease. In 2015, an estimated 1.65 million new cases of cancer—the most common cancers are projected to be of the breast, lung, prostate, colon and rectum, bladder, skin, lymph system, thyroid, kidney, endometrium and cervix, blood and pancreas—will be diagnosed in the United States, according to the National Cancer Institute (NCI). Nearly 590,000 people will die from the disease.

It’s not all bad news, however. The number of people living beyond a cancer diagnosis reached nearly 14.5 million in 2014, NCI data suggest, and that number is expected to rise to almost 19 million by 2024. Furthermore, advances in treatment on various fronts are helping people afflicted with cancer not only live longer but also enjoy a higher quality of life during and after treatment.

Progress is being made even in cancers that are particularly difficult to treat or that have traditionally had the highest death rates. As an example, pancreatic cancer is diagnosed in nearly 50,000 people in the United States every year, and less than 10 percent of whom survive more than five years past their diagnosis. Pancreatic cancer is typically treated through a combination of surgery, radiation and chemotherapy, but advances in technology have shown promise in dealing with the disease more effectively using pharmacological treatment. In addition, physicians have also made significant strides in detecting signs of recurrence.

In a genome-sequencing study of the malignancies and blood of more than 100 patients with pancreatic cancer, scientists with Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore found that at least one-third of the patients’ tumors have genetic mutations that may someday help guide precision therapy of their disease. Also, results of blood tests to detect DNA shed from tumors predicted cancer recurrence more than half a year earlier than standard imaging methods. Furthermore, the study suggests that genomic sequencing of patients’ tumor samples may identify mutations that match the target of certain clinical trials or drugs that are more precisely appropriate for these patients.

This is just one example of the ways in which technology has helped the area’s leading cancer-treatment centers provide the best possible outcomes for patients. Technology such as intensity-modulated radiation therapy and image-guided radiation therapy enable medical professionals to target cancer cells with radiation more precisely and effectively, while reducing exposure to healthy tissue.

If surgery is required to treat cancer in certain areas of the body—the head and neck, the kidneys, the colon, etc.—some area medical centers offer minimally invasive robotics-assisted surgery via the da Vinci Surgical System. Surgeons trained to use the system gain a three-dimensional view of their surgical field, offering the potential for enhanced visualization and precision and, as a result, improved surgical results. For the patient, the use of robotics-assisted system in surgery can yield benefits such as less bleeding and scarring, shorter hospital stays and quicker recoveries. 

More Weapons
Technology aside, the medical community is also turning with increasing frequency to a resource that many believe has been underutilized till recently: the innate powers of the human body’s immune system. Rather than killing cancer cells directly with chemotherapy or radiation, often leaving the patient vulnerable and damaged as a result, the latest treatments in immunotherapy are designed to boost the body’s natural ability to battle foreign substances, including cancer cells.

The versatile nature of the human immune makes it an increasingly attractive weapon in the war against cancer. The system is highly mobile, able to hunt down cancer cells wherever they may be in the body, meaning it can be effective in treating cancer upon diagnosis but also helpful in limiting the likelihood of recurrence. Addition, the immune system is scalable, meaning it can amplify its response to attack advanced cancers, and adaptable, meaning it can evolve to fight cancer cells, whose unstable nature makes them well equipped to outsmart conventional treatments. It also has a tremendous capacity for memory, meaning it can learn to battle cancer cells for the duration of a person’s life.

The question comes down to harnessing the immune system’s power.

The human immune system produces large quantities of antibodies, or proteins that adhere to specific proteins known as antigens. Antibodies circulate in the body until they find and attach to these antigens. Once attached, they can recruit other parts of the immune system to destroy the cells containing the antigen. Researchers have learned how to design antibodies that specifically target a certain antigen, such as one that is found on cancer cells, according to the American Cancer Society.

In order to make an antibody, researchers must first be able to identify the correct antigen to attack. Because each cancer is unique, the successes have yet come across the board but have shown to be effective in treating forms of breast and stomach cancer, as well as certain types of leukemia. Over the past couple of decades, the U.S. Food and Drug Administration has approved more than a dozen antibodies for use in treating cancer, while clinical trials continue to be done of newer antibodies.

An article in the May issue of the New England Journal of Medicine detailed a recent study that underscores the promise of immunotherapy. The act of combining immunotherapy treatments and giving two checkpoint-inhibitor antibodies at the same time has shown to extend the effective and lasting responses—i.e., progression-free survival—for patients with untreated metastatic melanoma, or skin cancer.

Although progress continues to be made on many fronts in the battle against cancer, the war is far from over. Those who need help, however, now have more increasingly effective resources—and more promise that they will be able to one day call themselves “survivors”—than ever before. 


Treatment, Care, Compassion
As seen in the names listed below, the Philadelphia area has a number of exceptional health care centers and skilled medical resources devoted to helping people overcome their battles with cancers of every sort. Fox Chase Cancer Center, for example, ranked 19th among the nation’s top 50 hospitals for cancer care in U.S. News & World Report’s Best Hospitals 2014-2015 rankings.

Cancer Treatment Centers of America at Eastern Regional Medical Center
215-537-7400 | cancercenter.com/eastern

Einstein Health Care Network
800-346-7834 | einstein.edu/cancer

Fox Chase Cancer Center
888-369-2427 | fccc.edu

Penn Medicine Abramson Cancer Center
800-789-7366 | penncancer.org

Sidney Kimmel Cancer Center at Thomas Jefferson University
888-955-1212 | kimmelcancercenter.org

St. Mary Medical Center
215-710-2000 | stmaryhealthcare.org/cancer