Cancer Answers:  The Latest Treatments - Part 1

F ifty years ago, a cancer diagnosis was seen as a death sentence. Now, however, thanks to the latest technology and research development, we have the tools that will help us beat cancer. For example, one of the most talked-about new treatments comes in the form of a tiny pill called STI571. Initially found to be effective in treating leukemia, this amazing "magic bullet" targets only cancer cells, and is currently being trialled on patients who have other types of cancer.

    For the past two decades, we have all seen enormous changes in the approach to what was at one time thought of as an inevitably fatal disease. Before 1977, 83 percent of young men diagnosed with testicular cancer were dead within one or two years. Today, the cure rate is about 90 percent. Childhood cancer such as leukemia and brain cancer have a similar decrease. Thirty years ago, 85 percent of children under 10 years who were diagnosed with these cancers died within a year to two. Now the cure rate is 85 percent.

    The completion of the Human Genome Project has created opportunities undreamed of 25 years ago. Cancer is the result of genes that have been damaged. New technology allows medical researchers to examine the human genome in one hit, and can identify people who are susceptible to cancer, determine how well an individual will respond to a certain treatment, and even identify the specific agent that caused the cancer. The future will also see individually tailored treatments and prevention strategies. A recent discovery that a small amount of DNA can be found in the blood may mean we can screen for cancer using a simple blood test.

    Researchers at the Queensland Institute of Medical Research (QIMR) have been conducting trials of a cancer vaccine. Initially developed to treat melanoma, the technique involves harvesting cancer cells, inserting specialised immune cells and then reinjecting them to stimulate the patient's own immune system to fight the cancer.

    The core of the experimental treatments are based on cellular immune therapy - using the cellular components of the blood to stimulate the immune system. Researchers say that this treatment is experimental and should not be seen as an alternative to standard treatments. As with all new therapies, the vaccine must go through various phases of human trial, and may not be widely available for some time.

    This disease is the second most common cause of cancer death in men, especially men over 45. Current treatments for prostate cancer include radiotherapy and surgery, but the end result largely depends on a speedy diagnosis. As scientists begin to understand the mechanisms of this disease, there may be more targeted treatments in the future.

    Researchers at QIMR and University of Queensland is currently investigating a new diagnostic test using seminal fluid, which is believed will be more accurate than the PSA blood test available today. Researchers are looking at specific genetic markers for prostate-cancer cells in this fluid, and hopefully this will allow them to develop an earlier and more accurate diagnosis.
FIVE YEAR SURVIVAL RATE: Variable, but about 80-85 percent. A steady improvement since 1989.

    There have been no major recent breakthroughs or developments but, rather, small improvements in how lung cancer is treated. There's one form of treatment that cures lung cancer and that's surgery. But fewer than 30 percent of sufferers are considered suitable for surgery, either because the cancer has spread too far for an operation to be of any help, the type of cancer is small-cell carcinoma, or the patient is unfit for surgery because of other diseases related to smoking.

    The aim of current research is to get more patients to surgery, researchers are seeing an interest in CT scan screening to provide earlier diagnosis.
FIVE YEAR SURVIVAL RATE: 13 percent. Only very slight improvement over 20 years.

Twenty years ago, treatment for bowel cancer included surgical removal of the colon, and most patients living for the rest of their lives with a colostomy bag. Today, improved techniques allow surgeons to attach the small bowel directly to the rectum, and most people avoid the colostomy.

Researchers are now looking into the screening for colon cancer using a test that can detect microscopic traces of blood in the faeces. It shows that this test can reduce deaths from colon cancer by about 20 percent. People with a strong family history of bowel cancer can now undergo genetic testing to establish with almost total accuracy whether they are at risk of developing the disease.

Researchers at the Newcastle's Hunter Medical Research Institute in NSW recently stopped colon cancer-cell growth in a test tube by using two compounds obtained from vegetables such as broccoli and Brussels sprouts. Experts have

known for some time that cruciferous vegetables have a protective effect, but the dosage could be influenced by factors such as cooking methods or the freshness of the vegetables. Researchers think that it may be possible to protect by giving a precise dose in capsule form.
FIVE YEAR SURVIVAL RATE: About 60 percent. Up to 10 percent since 1980.

Besides the new breast cancer drugs, the latest research includes the development of a surgical technique that is currently being trialled, known as the SNAC (Sentinel Lymph Node Biopsy versus Axillary Clearance) trial. This new technique will allow surgeons to effectively check whether cancer cells have spread to the lymph glands.

    This method will show if the dancer has spread by testing a sample of one lymph node. If there are no cancer cells present, it won't be necessary to remove the axilla (armpit glands). This will improve the quality of life for the patients by avoiding lymph edema, an unpleasant side effect of the surgery.
FIVE YEAR SURVIVAL RATE: 84 percent. Up to 10 percent since 1989.