Cancer has been hitting the front pages again, and it can be difficult from the headlines to judge whether it is good news or bad.
We seem to lurch from a game-changing new treatment one day to reports of rising rates the next – most recently, alarming news about the increase in global incidence of cancer among the under-50s.
So, what is going on? Are we on the verge of dramatic breakthroughs thanks to new drug combinations or immunotherapies that offer the promise of a cure for some cancers? Or are we, like Canute, trying valiantly to hold back a rising tide of cancer swelled by unhealthy lifestyle choices such as poor diet and lack of exercise?
First, let’s acknowledge the bad news. It’s true – cancer cases have increased in recent decades in younger people. It’s likely that there is a combination of factors driving this trend, including obesity and physical inactivity, but the exact reasons remain elusive. Dealing with a surge in cases will be a challenge for an already under pressure NHS and reversing this trend will largely depend on efforts to prevent cancer through understanding and tackling its causes.
But for all that, I am firmly of the view that our efforts to defeat cancer are paying off. This is a battle that we can win, and indeed are already winning.
We can see from another set of figures that death rates from cancer, as opposed to cases, continue to come down – among the under-50s and across the board. We are seeing the benefits of rapid improvements in diagnosis and treatment – driven by exciting progress in cancer research.
But the improvements we are picking up in survival statistics so far are just the start. I am hugely heartened by the advances we are seeing and optimistic about the future for cancer patients.
Technologies used to study cancer have never been so advanced – we can see the disease in unprecedented detail, and reading DNA has never been so fast and cheap. We are rapidly uncovering new knowledge of how cancer changes and evolves as part of a complex ecosystem, exposing its weaknesses and revealing potential new routes to treatment.
This sophisticated understanding is in turn driving innovation in many aspects of cancer care. Smarter and faster diagnostics promise drastic improvements in early detection – advanced blood tests can now detect cancer DNA in the bloodstream, and artificial intelligence (AI) is revolutionising our ability to analyse complex scans to spot subtle abnormalities that could signal cancer. Treatments are rapidly advancing, with personalised drug regimens, based on genetic testing, targeted drugs, tailor-made immunotherapies and state-of-the-art radiotherapy that delivers radiation beams precisely to tumours.
There has been a huge increase in the number of new cancer drugs approved in the last decade. Many of these are so recent that we are yet to see their true impact on survival rates. Capivasertib, for example, is an exciting new breast cancer drug, which is being assessed for potential approval by US drug regulator the Food and Drug Administration (FDA). It was developed in the UK following a programme of fundamental science and drug discovery in our labs at the Institute of Cancer Research.
Capivasertib is just one of many new targeted cancer drugs that are on the cusp of entering the clinic, or have already become available.
Immunotherapy is the biggest breakthrough in cancer treatment in the last 15 years. In 2008, just one in 20 patients with advanced melanoma survived for five years – now approximately half do, and immunotherapy has played a major role in that.
In the pipeline are even more exciting immune-targeting therapies – cancer-killing viruses that selectively wipe out cancer cells and vaccines tailored to patients’ individual cancers have shown promise in phase II trials and may soon become a reality. These advances hold the potential for curing more patients and reducing side effects through smarter treatments.
Through cutting-edge radiotherapy techniques and schedules, we’re also reducing the number of treatments that patients need and have advanced our ability to target radiation more precisely to the tumour so that we can reduce side effects.
But for all the exciting discoveries we’re seeing in cancer research, more work is needed to turn that progress into better effects on patients. It’s still much too difficult to be able to provide access to the latest drugs, diagnostics and technologies on the NHS.
We need the NHS and its companion organisations to put in place systems that can rapidly make available the most innovative treatments with the potential to have the greatest impact on the lives of patients. And we need to do much better at providing patients with access to clinical trials offering the latest treatments.
Despite leading the world in research against Covid-19, post-Brexit challenges and loss of the EU medicines regulator threaten UK clinical trials.
Pharmaceutical companies are increasingly looking elsewhere to run clinical trials due to the excessive administrative burdens and costs they face in the UK. This is a huge loss to the economy, but it also means UK patients risk losing access to the most exciting and innovative medicines available through trials.
I have great hope for the future of cancer treatment, and I am confident that the UK will play a major part in that. The fundamental scientific discoveries we are making today will generate new and more efficient targeted therapies. With improved funding for cancer research, support for clinical trials that cuts red tape and a robust cancer plan for the NHS, we will see substantial improvements in early cancer diagnosis, and the emergence of ever kinder, smarter treatments that mean many more people survive the disease.
While cases of cancer may be rising, we’ve never been more prepared to detect and treat it.
