The new approach, Barai said, is more like a “GPS guided bomb.” “You want to hit the particular building while causing minimal or no collateral damage,” he said. The new drugs are also much more lethal. Using another war analogy, Barai compared them to missiles with nuclear warheads.
He expects cancer treatment to become more targeted, in the form of genomic editing, where immune cells would be genetically edited to kill cancer cells. He predicts the treatment will be in wide use in 20 years, transforming cancer care.
Another promising advancement in cancer treatment is immunotherapy, where drugs stimulate the patient’s immune system to fight the cancer.
Dr. Janet Retseck, a medical oncologist with the Porter Physician Group, explained that cancer cells put the brakes on healthy immune functioning.
“What these drugs do is take these brakes off and allow the immune system to recognize cancer cells as something foreign or bad and destroy them,” she said.
She said immunotherapy has been most effective against melanoma and renal cell cancer but is expanding into breast, prostate, bladder, head and neck cancers.
“We’re all very excited about immunotherapy,” she said. “I’ve heard stories of people who had been ready for hospice, at the end, taking immunotherapy, and the cancer vanishing, being able to go back to regular daily activities. That’s why we do this.”
Cancer screening is also becoming more accurate. One advancement is 3-D mammograms.
“Those are good at unveiling cancers in breasts with dense tissue,” said Dr. Chadwick Mills, a diagnostic radiologist with Franciscan Health hospital in Crown Point.
He expects the diagnostics to continue to advance.
“Just in the time since I started medical school, I’ve seen the technology rapidly improve,” he said. “Do I think there’ll be a new technology that will replace mammography? I do.”
He predicts the next forefront in diagnostics will be molecular imaging, which provides detailed pictures at the molecular and cellular levels.
Cancer treatment is increasingly being customized to each patient.
Dr. Mohamad Kassar, an oncologist with Community Healthcare System, brought up the case of a middle-age woman with an aggressive form of breast cancer that had spread to her liver.
“She was very disturbed about her diagnosis,” he said.
She got a second opinion at a hospital that recommended palliative chemotherapy, predicting that she had no chance of living past a couple of years.
She went back to Kassar, who chose to be aggressive with dose-dense chemotherapy, which delivers chemo in shorter intervals than the traditional version, as well as beam-directed radiation. She is now in remission.
“We are getting smarter now in the way we treat cancer,” he said. “We are not going to provide the same recipe to everyone with cancer.”