Why experts rarely talk about ‘curing’ cancer anymore

There has never been a better time to be hopeful about cancer. There has never been a time when both the prevention and treatment of different types of cancer were the best. And with more and more of us experiencing what appears to be real honest-to-God cures, it’s time to retire the concept of “the cure for cancer.”

“In an unprecedented 100% of rectal cancer patients in a small immunotherapy clinical tria, the cancer was gone after immunotherapy.”

Last fall, Cleveland Clinic launched a clinical trial of vaccines with the ultimate goal of preventing triple-negative breast cancer in high-risk patients. In late May, the City of Hope cancer care and research center in Los Angeles and Australian biotech company Imugene announced their first-ever clinical trial of a cancer-killing virus in patients with advanced tumors. And then, earlier this week, amazing news came out of Memorial Sloan Kettering—an unprecedented 100% of rectal cancer patients in a small immunotherapy clinical trial had their cancers “disappear after immunotherapy—without the need for the standard treatments of radiation, surgery, or chemotherapy” – a trinity so terrible to endure that they are known to patients as “slash, burn and poison”.

Is the long-awaited cure we’ve been waiting for just around the corner? Unfortunately, it’s not that simple – because cancer is anything but simple.

“The cure” is a phrase that is thankfully less common than it was in 1969, when cancer researcher Sidney Farber ran a full-page ad in the Washington Post challenging the president; “Mr. Nixon: You can cure cancer,” the ad read. Just a decade ago, the New York Times asked, “Is the cure for cancer in you?”

While the rhetoric has since become more nuanced, the phrase refuses to disappear completely. There are initiatives like the Susan G. Komen “Race for the Cure” and Wacoal’s “Fit for the Cure”. There are biopharmaceutical companies making vague claims about a ‘universal cancer treatment’. And there are loose headlines in the mainstream media, such as The Telegraph’s recent musing about whether “the cure for cancer” is in your gut. At the very least, when the Biden administration announced the relaunch of the Cancer Moonshot plan earlier this year to “end cancer as we know it,” they at least changed the goal to add a few words about ” improving the experience of living with and surviving cancer’.

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I sometimes carefully describe myself as healed. After receiving a rapidly fatal diagnosis of metastatic melanoma and entering an innovative clinical trial of immunotherapy, I have not presented any evidence of disease in ten years. But I’m careful to try to make it clear that mine healing was not the healing.

Cancer is not one thing. They are more than a hundred things, more than a hundred variations on a theme of uncontrolled cell growth, all with their own specific expressions. There are four types of breast cancer, four types of melanoma. Like dr. Jonathan Chernoff, Chief Scientific Officer at Fox Chase Cancer Center, explained: “It turns out that cancer is a general term. There are many different types of cancer in different tissues that work in different ways. They are not all caused by the same mutations and they not all will respond to the same type of treatment.”

Genetic variations in all of us make each cancer a unique experience. Some treatments work well for some people and not at all for others. I didn’t have the correct BRAF mutation for vemurafenib, a treatment that was FDA-approved just days before I was diagnosed with stage 4. Is vemurafenib an effective treatment for a specific type of cancer? Yes. Would anyone call it “the cure” for cancer? Of course not.

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Along with the really exciting prospect that more people can say they had, past tense, cancer, and even more to never get it, there must be room to think beyond all-or-nothing. Healings are great; I should know. And progress in one cancer can often point to hope for treatments for others. Immunotherapy, for example, was the dark horse of oncology. Today, it’s an approved protocol for dozens of cancers, with clinical trials for even more — like MSKCC’s promising rectal cancer trial — now rippling. There have been incredible recent breakthroughs, even in deadly cancers like pancreatic.

But those breakthroughs will continue to be highly customized propositions for the foreseeable future. As a researcher once helpfully explained to me, you don’t get a comprehensive cure like penicillin for something as complex and variable as cancer. Frankly, the idea of ​​many effective options and treatments, rather than one panacea for the second leading cause of death in the US, is pretty amazing.

As we continue to make progress in eradicating cancer, we can also make room for: to live with it† For certain patients, cancer is no longer a death sentence, but just a condition they can meet. Some people’s tumors simply cannot be completely eradicated. For them, the phrase ‘stopping the progression’ can be just as beautiful and hold as long and bright a future as ‘cure’. Given the often invasive and arduous nature of the treatment and the toll it can take on the human body and psyche, the goal of a flawless scan is far less meaningful than a healthy overall quality of life anyway.

“Future cancer therapies will not win by a simple cancer-killing strategy,” the authors of a 2020 article wrote in the journal Cancers. Instead, “We would probably benefit more patients overall by turning cancer into a manageable chronic disease, rather than just focusing on finding a complete ‘Holy Grail’ cure.”

This is a mindset worth adopting, even for those of us outside of the research world. It would mean that a diagnosis would not come with a presumptive assumption that we are “fighting” cancer. It would mean that one small word would not become the umbrella term for such a complex experience. It would mean in this breathtaking age of science that the story shifts from a war against a single enemy to a story of incredible hope, for millions more living, breathing people.

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