What Are Some of the Biggest Breakthroughs in Cancer Research?

By Janet Jenkins
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It’s a diagnosis that many of us fear for our friends and family as well as ourselves, but the sad fact is that an estimated one in three people will get cancer at some stage in life. Cancer can affect any part of the body and spread to many other parts of the body if it’s not treated.

Fortunately, many breakthroughs in cancer research and treatment have led to very successful outcomes that have extended lives and even completely eliminated the cancer. Discover more about this disease and how scientists and doctors are making incredible advances.

What Exactly Is Cancer?

Cancer occurs when cells start to change and grow abnormally, often at a very fast rate. This out-of-control growth leads to tumors and organ destruction that are detrimental to health. This can occur with the skin, organs, bones and other tissues.

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The problem becomes serious when the body’s control mechanism for the cells stops working properly. Old cells don’t die off as they should; instead, they mutate and grow into new, dangerous cells. This causes lumps or tumors that are sometimes visible and detectable by touch, although scans are often needed to detect the presence of a tumor and its size.

What Causes Cancer?

In some cases, a defect that is latent in your genes causes your cells to start to grow abnormally. This possible genetic connection to cancer is the reason doctors will always check your family history to see if a close family member has ever been diagnosed with cancer, particularly cancers that are more predisposed to genetic connections, such as bowel or breast cancer.

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Other biological factors contribute to cancer risk as well. For example, gender plays a role in testicular cancer, ovarian cancer and uterine cancer. Breast cancer can actually occur in both men and women, although women are more predisposed to develop it. Cellular changes naturally occur with age, which is why older people develop cancer more often.

What Are Some Important Statistics?

Some significant changes have appeared in cancer statistics in the past decade. For example, 2017 saw one of the sharpest one-year drops in cancer death rates ever recorded in the U.S. This was due in part to the amount of money and time put into research for the development of successful treatments for cancer. An estimated 3 million patients have survived cancer in the United States alone since 1991.

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The most significant advances have occurred in lung and melanoma cancer treatments, which formerly had high mortality rates. The largest decline on record in mortality rates for those cancers occurred between 2016 and 2017.

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Why Are Cancer Cases Increasing?

All of our increasing knowledge on the history of cancer discovery, detection, treatment and possible cures is helpful, but cancer diagnoses are still on the rise in the U.S. In fact, the Global Cancer Observatory estimates that approximately 11 million more people will be diagnosed with cancer worldwide before 2040.

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In 2018, the organization predicted the diagnosis of 1.8 million cases of cancer the following year, with 16,000 of those cases occurring in children. At the present time, although successful treatments of cancer are more likely, there continues to be a rise in diagnosed cases of various types of cancers in all age groups.

What's Behind the Rising Caseload?

Although those figures may sound alarming, part of the reason for the rise in diagnoses of cancer is because people are living longer, and the risk of cancer increases with age. It’s also easier to accurately diagnose people, thanks to greater awareness of cancer symptoms and better testing methods.

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So, just as cases of dementia and other diseases common in elderly populations have risen in recent years, cases of cancer have risen due to longer lifespans. The statistics behind it show a direct link between larger elderly populations and the increase in cases. Of course, lifestyle factors have also contributed to the increase in cancer.

How Has Screening Helped?

When doctors realized years ago that cancer could be in people’s bodies without them realizing it because there weren’t any symptoms, they worked to develop screening methods for cancer. These various tests are used to detect abnormal cells so cancers can be treated early for the best possible outcomes.

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The cervical smear test, known as the pap smear, was the first screening test to be introduced after a doctor researching menstrual cycles realized the tests could detect cervical cancer. Although he discovered this in the 1920s, most doctors were skeptical, so tests weren’t widely used until the 1960s. Mammogram screenings were developed in the 1960s and started to be recommended by physicians a decade later.

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How Has Detection Evolved?

After the introduction of cervical screening, the cervical cancer death rate in America declined by an amazing 70%. The 1970s also saw the introduction of imaging tests, which are still used today as one of the first steps in diagnosing many types of cancer.

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These tests include ultrasound or sonography, CT scans, magnetic resonance imaging — better known as MRI scans — and positron emission tomography or PET scans. Before these types of scans were available, cancers were usually diagnosed by surgeons cutting into the body and looking at the lumps to see if they were cancerous.

The Next Frontier of Screening

Although cancer screening methods have already become more accurate, available and affordable over the past few decades, the future of screening continues to evolve. Genetic tests designed to detect changes in your genes that could predict cancer will be more readily available within the next decade as healthcare becomes increasingly personal.

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Personal monitoring and testing will allow for more precise diagnoses, personalized treatments and specific monitoring. Every person is different, and that means every cancer treatment needs to be different too. Genetic testing is one vital component of this shift.

The Most Common Surgical Response

Surgery to remove cancer is still common, particularly with the more tumorous types of cancers. However, much less of the affected area is removed in surgery, and the surrounding tissue is treated with medication or radiation therapy. Some surgical procedures have also evolved into less invasive procedures, which significantly speeds up recovery.

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Fiber optic tools and miniature cameras are used to look inside the body, and cancer removal can be done using small tools manipulated through tubes. This can be done through the abdomen or chest. Endoscopic instruments can also be used to remove tumors through the throat, colon or bladder through natural openings like the mouth and anus or urethra.

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The Future of Cancer Surgeries

Like many other advancements in cancer treatment, the future of surgical options for cancer is on target to become less invasive and more specific. Laser treatments, where lasers are used to cut through tissue or vaporize tumor cells, are becoming more commonplace for cancers of the voice box, skin, liver and other organs.

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Additionally, cryosurgery, which uses liquid nitrogen to freeze cancerous cells and kill them, is a promising surgical option for early stages of cancer. Both cryosurgery and laser treatment may sound like futuristic, sci-fi concepts, but they are very real, and they will save countless lives.

Radiation Therapy

When x-rays and radiation were first introduced to the medical world, they were used for diagnosis and therapy for cancer. The powerful rays would kill cancer cells, but after they started to be used at the beginning of the 20th century, scientists discovered they both coil also cause cancer.

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Radiation is still used, with measures being taken to minimize any potential harm. For example, intraoperative radiation therapy is used at the time of surgery and targets nearby tissues directly once the cancer is removed. It’s most commonly used in pelvic, abdominal and recurring cancers.

Radiation Therapy in the Future

Like so much of modern medicine, radiation therapy is moving toward a more personalized approach. Newer technologies are allowing tumors to be exposed to higher doses of radiation with a narrower, higher intensity in delivery.

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This allows the radiation to effectively attack the tumor without affecting the surrounding tissue as much as traditional radiation therapies in the past. Additionally, 4D scans of organs and their movements are allowing this hyper specific, hyper effective radiation therapy to be used on organs that traditionally were too mobile in their functioning for radiation to be used safely.

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Chemotherapy

Chemotherapy involves a chemical cocktail that targets and kills mutated cancer cells. Unfortunately, it can be quite harsh on the body and causes side effects of its own, such as sickness, lethargy and hair loss. However, in many cases its benefits outweigh the temporary negative conditions.

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It was first developed from an agent that was used to treat mustard gas victims in war. Aminopterin, a compound related to folic acid, was found to block the chemical reactions needed for DNA to replicate and mutate. Aminopterin was developed further into a drug called methotrexate, which is used in chemotherapy today.

The Future of Chemotherapy

More advanced monitoring technologies are revolutionizing chemotherapy treatments. The changes have the potential to make chemotherapy even more effective in battling multiple types of cancer.

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These new technologies allow treatment teams to precisely monitor the concentration of chemotherapy drugs in the bloodstream of a patient. Real-time monitoring will allow greater flexibility in treatments, as the concentration of drugs can be more consistently maintained or adjusted. This will help minimize the less comfortable side effects of chemotherapy treatments, while allowing for the treatment to become even more precise and effective.

Hormone Therapy

As early as the 19th century, discoveries were made about the potential role of hormones in cancer treatment. Dr. Thomas Beatson at the University of Edinburgh experimented in 1878 on rabbits and found that the breast was "held in control" by the ovaries. When he removed the ovaries of breast cancer patients, he found that the condition improved due to the change in estrogen levels in the body.

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Fast forward a few hundred years, and this connection with hormones and cancer led to hormone therapy. This type of treatment includes the use of drugs like tamoxifen and aromatase inhibitors to alter hormone levels in the body.

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How Hormone Therapy Has Advanced

New classes of hormone therapy combination drugs have revolutionized the way certain cancers are fought. Research focusing on understanding how hormones influence cell growth has led to many new drugs for cancer treatment. Among the new drugs are CDK4/6 inhibitors. CDK4 and CDK6 are enzymes that jump start cell division. CDK4/6 inhibitors are drugs designed to fight the cancer cell growth.

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Abemaciclib, palbociclib and ribociclib are CDK4/6 inhibitors that have been approved by the FDA for breast cancer treatment. They are used in combination with traditional hormone therapy to treat metastatic breast cancers.

CAR T-Cell Therapy

Immune system strength is vital for preventing and fighting many types of diseases. If your immune system can detect and respond to cancer growth in time, it can slow it down or even stop it entirely. In the 1980s, researchers in America investigated this concept with T-cells, which are a type of immune system cell.

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When these cells were genetically modified — later called CAR T-cells — they became a new effective way to help the body fight cancer. Boosting a person’s whole immune system has been particularly effective in treating forms of leukemia.

CAR T-Cells' Promising Future

While so much of the future of cancer treatment is hyper specific, CAR T-Cells' future actually involves a broadening scope. What does that mean? The treatment method is so promising that researchers are hoping to expand it to a broader range of cancer types and treatments.

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As medicine overall becomes more personalized, CAR T-Cells' adaptability offers a lot of new, effective options for treatment. Just this past year, researchers discovered a new T-cell, MR1, that could possibly be even more effective on more cancers than the T-cells currently in use.

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A Significant Success Story

After immunotherapy in the form of CAR T-cell therapy had been developed for a few years, rapid positive responses were recorded. In 2012, after government funded trials, the Children’s Hospital of Philadelphia said that almost 90% of children and adolescents with a certain type of leukemia had a total and fast response to treatment with CAR T-cells.

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The results led to the American Food and Drug Administration calling CAR T-cell therapy an official "breakthrough" in 2014. The therapy was praised for being an ideal treatment solution for certain types of cancer.

What Are Other Immunity Related Therapies?

Links to cancer and the immune system actually go back to the 1960s, when it was first recognized that both B-cells and T-cells worked to fight off diseases. The drug rituximab, which was FDA approved in 1997, was the first immune treatment that targeted a specific cancer cell protein for lymphoma.

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In 2011, the FDA approved two new drugs, ipilimumab and vemurafenib, which hailed another breakthrough for treating metastatic melanoma. As a result, melanoma death rates have declined by 7% a year for people aged 20 to 64 and by 5% to 6% percent a year in people aged 65 or older.

Can Robots Fight Cancer?

Another amazing breakthrough is the use of robotics in order to fight cancer. The Auris Monarch robotic platform was approved by the FDA in 2018. This groundbreaking new tool uses a combination of robotics, software, data analysis and endoscopy to help combat lung cancer, which has the highest cancer death rate in the U.S.

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It can investigate and treat lung cancer in its early stages and stop it from spreading at its usual fast rate. The therapy is hailed as being more accurate, with lower risk of complications than other types of therapy.

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Robots Are Revolutionizing Medicine — But Should They?

Robotic surgeries have become increasingly common within our healthcare industry, for good reason. They offer greater precision and dexterity than their human counterparts, and when they are properly operated, they can be just as safe and effective as their human counterparts.

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However, the FDA in recent years has put the brakes on some robot surgeries. Although data is still being gathered, it appears that minimally invasive cancer removal procedures completed by a robot could have higher rates of cancer resurgence. Researchers are not yet sure why this happens, but the studies involved have raised some red flags.

The Future of Medicine Is Genomic

As science advances, certain techniques that were once thought to be impossible have become quick, affordable and accessible. One of the emerging practices is genomic sequencing, or the mapping of your personal DNA genome. Once thought of as the stuff of fantasy, genomic sequencing can now be accomplished, relatively affordably, in just a few hours.

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Knowing the entirety of your genome will allow doctors in the future to personalize cancer treatments based on your DNA. Certain medications work better for one person's genetic sequencing, for example. Knowing these differences will be crucial to saving even more lives.

Personalized Care and Personalized Cures

With the growth of personalized care, genetic testing and genomic treatments comes the growth of personalized immunotherapies. This is a huge advancement, especially for particularly challenging cancers.

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Brain cancer and prostate cancer are two cancers that have proven particularly difficult for doctors to treat with immunotherapies. So far, they have proven resistant to these otherwise very effective treatments, but doctors believe myeloid cells, a type of immune cell, could hold the key to increasing the efficacy of these treatments. Therapies involving myeloid cells will hopefully offer a promising future for treating and eradicating these more resistant cancers.

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The Future Is Bright

As seen throughout this article, there are many reasons to be optimistic about the future of cancer detection, diagnosis and treatment. Although no single cure for cancer is ever likely to exist — cancer is an all-encompassing term for a variety of cell mutations that must all be treated differently — there are a variety of approaches that are continuing to make significant differences.

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One sign that some of these advancements are already working is the largest drop in the cancer death rate in U.S. history in 2016. With that kind of progress, just imagine what 2026 might look like.

Future Challenges

Unfortunately, despite their many successes, scientists still face many challenges in their quest to conquer cancer. The sedentary lifestyles and unhealthy diets of many people around the world have contributed to an increase in certain types of cancer. These habits cause inflammation and metabolic and hormonal problems, which can all lead to cancer.

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Particular cancers linked to obesity and inactivity include colorectal, liver, kidney, pancreas, uterine and breast cancers. Based on this data, it shouldn’t be surprising that rates for these cancers are much higher in recent decades. Alcohol consumption is also a significant factor, not just in liver and pancreatic cancer, but also for breast and testicular cancer.

Leading Drug Breakthroughs

In recent years, lung cancer has gone from a death sentence to something that has a much improved survival rate. One of the main reasons for this is due to groundbreaking drugs, which are either used with surgery or chemo or on their own. They include nivolumab and pembrolizumab, which specifically target squamous non-small cell lung cancer.

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However, many of these breakthrough drugs can take between 10 and 20 years to make it from conception to development and actual use. That obviously means there has to be constant funding in order for scientists to continue their research and prove the efficacy of drugs in order for them to be approved for use.

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Main Focus for Further Breakthroughs

Due to the success of hormone therapy, continued development of this research is also helping doctors learn how to prevent these cancers from forming if someone is genetically predisposed to it. Therefore, different medications with fewer side effects are being tested. This type of precision medicine aims to identify the genetic make-up of different cancer cells carefully so that the ideal treatment drugs can be chosen.

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Leaps and bounds continue to be made in surgery, particularly in terms of robotics and the use of even more minuscule tools. Operated by specialist surgeons, these tools could eventually eliminate the need for invasive and lengthy operations.

What's Next in the Research Pipeline?

With every passing year, new treatment and detection methods for cancer are discovered and developed. Many of these focus on ways to use genetic testing and manipulation to halt or reverse deadly cellular changes. Others take a look at how certain medications or radiations block mutations in these cells, without changing or harming other tissues around them.

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Many of these changes mean that diagnoses of cancer are no longer automatically seen as a death sentence, and cancers like pancreatic cancer and metastatic melanoma will soon be as treatable as standard chronic diseases.

How Important Are Donations to Research Breakthroughs?

In order to help with the early detection, treatment and successful removal of all types of cancer, important research must continue. The future of such life-changing treatments depends on how well doctors and scientists are funded.

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This funding comes from government budgets and valuable charity donations. Numerous charities are dedicated to cancer research and treatments, and they have been the driving force behind many of the breakthroughs we've seen so far. Their assistance enables scientists to figure out what connections have not been made yet, what equipment could advance treatment, what medical avenues should still be explored and more.

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