Editor's Letter

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Diana Swift
Editor-in-Chief
editor@canadian-health.ca

In our past two issues, we discussed screening tests for the early detection of cancer as well as ways to reduce your risk of malignant disease. Researchers hope eventually to be able to prevent almost 100% of cancers by controlling diet, lifestyle and environmental triggers, or by correcting flawed genes and blocking their protein products with drugs (see "Genetics 101"). In the meantime, while prevention and screening are paramount, the reality is that people who already have cancer need better treatments today. So for three years now, the venerable American Society for Clinical Oncology (ASCO) has saluted the past 12 months’ advances in cancer treatment — as well as in screening and prevention. Here are the six major achievements in the war on cancer that ASCO’s panel of experts highlighted for 2007.

Photo : Susan Ashukian

Preventive brain radiation in lung cancer

European researchers report that irradiating the brains of patients with advanced small-cell lung cancer cuts the risk that the cancer will spread to the brain by about two-thirds. It doubles the rate of those who survive one year with this disease, which, historically, has had a very poor outlook.

HPV and head and neck cancers

Two studies reported that the human papillomavirus (HPV), which is present in the vast majority of cervical cancers (see "Cervical Cancer"), was found in 72% of several types of cancers of the head and neck. Infection of the mouth with HPV has been strongly linked to these cancers, but somehow its presence prevents these tumours from spreading and is associated with better treatment outcomes. That suggests a preventive role for HPV vaccines against cervical cancer in these tumours as well.

An antibody for kidney cancer

Patients with advanced kidney cancer survived almost twice as long with no progression of their disease with the addition of bevacizumab to standard therapy with interferon. Bevacizumab is a monoclonal antibody (i.e., derived from cloning a single lab-engineered cell). It blocks angiogenesis, the formation of the blood vessels that tumours need in order to grow and spread. It targets vascular endothelial growth factor, a substance that promotes angiogenesis.

A pill for liver cancer

One large study found that therapy with the enzyme blocker sorafenib allowed patients with advanced primary hepatocellular carcinoma to live 44% longer. This is the first non-surgical treatment for this cancer, the most common type of liver tumour and the third-leading cause of cancer deaths around the world. It falls into the new category of targeted therapy, one that takes aim at proteins or faulty genes that promote cancer growth. Sorafenib, which inhibits cell growth and angiogenesis, also looks promising against kidney cancer.

MRI for breast cancer screening

Findings from several studies showed that magnetic resonance imaging (MRI) may be effective for screening women at high risk for developing breast malignancy (those with a family history of breast cancer or an existing tumour in one breast). MRI identifies areas of high blood flow, which can signal the presence of fast-dividing cancer cells, and may detect malignancies missed by mammography or physical breast examination. (MRI is not considered a replacement for mammography in women at average risk and is not always readily accessible.)

Decline in HRT use and breast cancer

Two studies reported that the recent significant decrease in the number of new cases of breast cancer in the U.S. appears linked to the declining use of hormone replacement therapy (HRT) by menopausal women since 2002 (see "Menopause Management," March/April 2007).

As April and Cancer Awareness Month approach, Canadian Health would like to take the opportunity to salute the dedicated researchers on the front lines of the cancer wars, in Canada and around the world.