Sometime today, about 325 people in our state will be told they have cancer. Weddings are about to be missed, reunions are about to be canceled and vacations postponed as medical appointments and procedures dominate their lives.
On a regular basis, my colleagues and I at the Cancer Prevention and Research Institute of Texas, or CPRIT, are asked when we’re going to find a cure for cancer. This is not an unreasonable question, considering that CPRIT supports more cancer research in Texas than any other agency, including the National Cancer Institute.
The good news is that after treatment, around two-thirds of people who develop cancer remain free of the disease for five or more years. The better news is that we are already curing some cancers – one person at a time, one discovery at a time – with new and evolving treatments. In fact, more than half of those diagnosed today will be cured of their disease.
The bad news, however, is that progress is frustratingly slow. This is due to the fact that cancer is not a single disease, but is made up of many diseases.
At last count, there were 17 different types of breast cancer alone, each of which may require a different treatment. This means it is unlikely that a single breakthrough cure is even possible. Furthermore, cancers have two distinct characteristics that make them hard to treat: They can spread to other sites of the body, where they are untreatable with surgery, and most cancers can change and become resistant to treatment.
Much of cancer research today is focused on finding cures. This is an important goal because more effective, less toxic treatments are sorely needed.
However, consider the impact of making progress on preventing cancer or detecting it in its earliest stage, when it is still curable. When breast cancer is detected early, 99 percent of patients are cured by today’s treatments. However, once it has spread to distant organs, the five-year survival rate drops to 24 percent.
Therefore, in addition to seeking new treatments for these advanced cancers, doesn’t it make sense to try to reduce their numbers by developing methods to detect them earlier and even prevent them altogether?
Prevention would have a much greater impact on reducing the burden of cancer in the population than curing a small subtype of advanced cancers. For example, discovering a cure for the most common type of lung cancer would eliminate 35 percent of the deaths from this disease, which would be a remarkable achievement.
However, eliminating tobacco use would prevent 80 percent of deaths from lung cancer as well as 30 percent of deaths from all cancers. While this is feasible for lung cancer and sunlight-induced skin cancer, where the causes are well-recognized, little is known about how to interfere with the development of other types of cancer or to detect them at their earliest stage.
Developing new, effective approaches for prevention and early detection of cancer will require much more research focused on these areas.
Unfortunately, these areas receive less attention and much less funding than the search for cures. This is why prevention and early detection are among CPRIT’s new priorities for research funding.
We challenge the research community in Texas to apply their considerable talent to addressing these critical areas in the hope that it will eventually reduce the incidence of and improve survival from all cancers, not just in Texas, but throughout the world.