Khaas Baat : A Publication for Indian Americans in Florida
Health & Wellness

Cancer – What’s the Answer? Part II

Dr. M. P. Ravindra Nathan

By M. P. Ravindra Nathan,

Ever since Richard Nixon launched the “war on cancer” in December 1971, considerable progress has been made in our efforts to conquer the disease. And the legislation known as the National Cancer Act of 1971 helped strengthen the National Cancer Institute’s (NCI) efforts to conduct intense research and find a cure for this dreadful disease. Since then, we have achieved decisive victories on many forms of cancer. According to Dr. Vincent De Vita, professor of medicine at Yale Cancer Center and past president of American Cancer Society, “We are not only winning the war on cancer, but the deathof cancer is inevitable.” Welcome news, indeed.

Sometime in the early 70s, when one of my older patients developed cancer in the lung, he had to undergo extensive surgery followed by chemotherapy and radiotherapy and still succumbed to the disease within a short time. But now with our ability for early diagnosis and highly sophisticated combination therapy, the patient can expect either a total cure or get a much longer cancer free lifespan. One of the most important advances in our fight against cancer is the establishment of NCI – Cancer Centers program with several designated cancer centers all over the country. And they aim to bring the latest scientific discoveries to bedside cancer care. This has resulted in quicker diagnosis, better recovery rates and longer survival after cancer is recognized. 

In the past, when cancer of any organ is detected, we primarily discussed, “What are the chances for a five-year survival of this patient with the available treatment?” And if we could get the patient to survive beyond five years, that was considered a success. Things have changed drastically for the better now. Here are some new statistics. Breast cancer, quite common, had a five-year survival of only 75 percent about 30 years ago but now that has improved to 92 percent. Similar improvements are noted in many other varieties like prostate cancer, malignant melanoma, Non-Hodgkin’s lymphoma, bladder and colorectal cancer and a few others. Even the prognosis of cancer of the pancreas, perhaps one of the worst forms, seems to have improved. Some acute leukemias can be cured if caught early and properly treated. One case I know personally is that of the daughter of a doctor friend of mine who developed acute lymphatic leukemia at age 10, and was fortunate to receive state-of- the-art treatment and regular follow up from a cancer center, became disease free and continues to stay healthy at the age of 45.

Cancer is not just one disease or entity as we used to think before but research has shown it consists of many hundreds of diseases. Accordingly, our treatment plan also will need modification. With the introduction of ‘cancer genome project’ we achieved the ability to sequence the cancer genes, develop a cancer genome atlas and systematically explore the entire spectrum of genomic changes involved in human cancer. As per Dr. Francis S. Collins, director of National Institutes of Health, “Cancer occurs when changes in a cell’s genome or DNA instruction manual trigger uncontrolled growth. And the new drugs target such molecular changes – blocking the effects of a factor that promotes cancer cell growth or inhibiting the formation of blood vessels that feed the tumor.”

This has also opened up new and more effective therapies as well. Till a few years ago, we only had standard chemotherapy, surgery and radiation. And patients always dreaded chemotherapy because of its widespread side effects. These anticancer drugs were not selective enough just to kill the cancer cells. They also damaged normal cells and that is when the side effects come into play. Now, we have entirely new additional therapies consisting of ‘immunotherapy’ and ‘targeted therapy’ that seem to be revolutionizing the outcome. Different types of immunotherapy work in distinct ways, some help the immune system to stop or slow the growth of cancer cells whereas others assist the immune system destroy cancer cells or stop the cancer from spreading to other parts of the body. Immunotherapy treatments can be used alone or in combination with other cancer treatments.

Targeted therapies specifically zero in on the molecules in cancer cells thus stunting or stopping its proliferative growth; hence they are more effective than regular chemotherapy. Of course, we don’t rely on one drug or one form of therapy to treat any cancer. “If you want to cure advanced cancer, you need to combine three to four drugs that are individually effective to some degree,” says Dr. Vincent De Vita.

To be continued …

M.P. Ravindra Nathan, M.D., is a cardiologist and Emeritus Editor of AAPI Journal. For further reading, “Second Chance - A Sister’s Act of Love” by Dr. Nathan from Outskirts Press, can be found at www.amazon.com

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