Can advanced-stage cancer be cured? Check the latest developments

Feb 2023:

Three to five years ago, it would have been impossible to imagine a Stage 3 lung cancer patient living a normal life. However, contemporary targeted cancer therapies have made the impossible a reality. A 35-year-old man with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC) became asymptomatic after three months of treatment with the targeted drug lorlatinib. This feat is just one of the numerous advancements in cancer treatment over the past five years.

Cancer is currently regarded as one of the most infamous noncommunicable diseases worldwide. It is currently the third leading cause of death, but by 2030, it is projected to be the leading killer. According to the International Agency for Research on Cancer (IARC), the global cancer burden has increased to 19.3 million cases and will result in 10 million cancer-related deaths by 2020. The population is projected to increase by 47%, or to 28.4 million, by 2040. Statistically speaking, according to IARC findings, one in five people develops cancer during their lifetime. In India, the proportion is marginally better, at one in nine individuals. But still unsettling.

Surgical procedures, radiation therapy, chemotherapy, targeted therapy, hormonal therapy, cancer vaccines, and immunotherapy are currently available as cancer treatments. Again, these can be classified as the surgical and medical management of the disease.

There have been numerous innovations and breakthroughs in both fields over the past five years.

Surgical management: Robotic surgery and keyhole surgery have emerged as major advances in the treatment of cancer. In India, there has been a significant increase in oncorobotics and robotic oncology surgery over the past two years. India has become one of the leading countries in the use of robotics for cancer treatment, particularly in the fields of gynecological and urological cancers, due to the adoption of robotic surgery by prominent institutions. Reduced functional loss and mutilation of patients’ bodies has resulted in a significant reduction in recovery time. This has not only increased surgical precision but also decreased recovery time significantly.

Medical management—About a decade ago, chemotherapy was the only known cancer treatment, but in the last 5 to 7 years, there have been significant advances in radiation, immunotherapy, and targeted therapy.

The use of advanced radiotherapy techniques in India, such as intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT), has significantly improved cancer treatment. The process damages DNA and inhibits the division and growth of cancer cells. Immunotherapy, which involves a more targeted and concentrated treatment of cancerous cells, has helped even Stage 4 cancer patients live longer and with a higher quality of life. It is known that these therapies are effective against over 30 types of cancer, including breast cancer, lung cancer, prostate cancer, and even genetic cancers. Targeted therapies are small-molecule drugs that have been genetically engineered to inhibit targets on cancer cells. They are administered orally and are effective against chronic leukemias, myelomas, lung cancer, and breast cancer. On multiple occasions, these medications have not only controlled the disease but also cured it.

In terms of advancements, cellular therapies and living drugs are gaining prominence. On the premise that the body’s own immune cells can recognise and destroy cancerous cells, immune cells are extracted, multiplied, and genetically modified in a controlled environment before being used as a treatment. Innovations in this field, known as Chimeric Antigen Receptor T-cell (CAR-T) therapy, are anticipated to alter the dynamics of cancer treatment. Under the Make in India initiative, such drugs are currently being developed and tested at Tata Memorial Hospital and IIT Mumbai.

The fact that India is producing innovative CAR-T drugs is a source of immense national pride. In addition, they will help reduce the cost of treatment by a tenth or more. Indeed, affordability and accessibility continue to be two of the greatest obstacles cancer patients face today. In light of the fact that 70 to 80 percent of our population lacks access to diagnostic testing and targeted therapies, initiatives such as these provide cause for optimism.

Obviously, the process of discovering new drugs is expensive and difficult. To create a conducive and supportive environment, the country should incentivize innovation and promote collaboration with leading research institutions. In addition, we need a robust regulatory framework, more government programs like the Pradhan Mantri Jan Arogya Yojana (PMJAY), and a greater number of new cancer hospitals and centers in Tier-2 and even Tier-3 cities. This will make cancer treatment more affordable and widely available, allowing us to win the war against this disease.