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Shaping the Next 50 Years of Cancer Care
By Mothaffar Rimawi, MD, Professor and Executive Medical Director of the Dan L Duncan Comprehensive Cancer Center
Over the past several decades, tremendous strides have been made in cancer research, bringing ever-improving therapies and better outcomes. From advances in imaging to genomics to immunotherapy, new discoveries continually improve the way we treat cancer. Research from the American Cancer Society shows these innovations led to a 33% decrease in overall cancer mortality rates since 1991. We’ve come far, but we have a long way to go to reach our ultimate goals.
While we’re all working toward a world in which cancer can be cured for all patients, the smaller victories we make along the way are just as important. Rather than focusing only on reaching a massive breakthrough discovery, we must strive to make as many incremental improvements along the way as we can to improve the lives of cancer patients and save as many lives as possible today.
We can’t imagine where cancer treatment will be in 50 years, as science and technology evolve at such a rapid pace. But it’s not unreasonable to predict that multiple improvements in cancer treatment will occur during the next half century, resulting in therapies that are increasingly more effective and more easily tolerated.
Here at the Dan L Duncan Comprehensive Cancer Center (DLDCCC) at Baylor St. Luke’s Medical Center, our teams work tirelessly to ensure that several decades from now, we’ll be able to look back and take pride in how far we’ve come.
Personalizing Cancer Treatment and Prevention
In the coming years and decades, we’re likely to uncover both more therapeutic targets and more agents for those targets, leading to a precision oncology approach so nuanced that every patient will receive an individualized cancer treatment plan. This will pave the way to personalized therapies that yield better outcomes and significantly lower the treatment burden on the patient, with fewer side effects and better quality of life.
We’re already finding ways to optimize treatments, with surgeries becoming less invasive and radiation more precise. I anticipate we will continue to move from chemotherapy that affects so many cells to an increasingly precise approach. Two ways this can be achieved are:
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Molecular profiling: We have made significant advances in profiling tumors, from genomics and transcriptomics to, more recently, proteomics and kinomics. In 50 years, we could have even more sophisticated ways of monitoring tumor cells and interrupting their processes, and these methods could become mainstream and very accessible.
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Artificial intelligence: We are just starting to understand the complexities of cellular processes and how to alter them through physical, thermal and chemical methods. With 50 more years of discovery and the ability of artificial intelligence to analyze patterns and neural networks, I believe we should be able to determine how particular pathways affect tumors and use the information to design and deliver individualized treatments.
Even when a particular type of cancer can’t be cured, we seem to be on the verge of thinking of that cancer as a chronic disease people can live with. I think we’ll soon be able to predict how tumor cells develop resistance and adapt our treatment plan accordingly to inhibit tumor growth. HIV has shown that it’s possible for a disease with a high mortality rate to become a chronic condition people can live with to normal life expectancy. Twenty-five years ago, this was inconceivable. I believe we can achieve this with cancer as well.
Similarly, I believe personalized care will lead to personalized prevention as we look for ways to anticipate each person’s individual risks for cancer based on:
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Genetic factors
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Environmental factors
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Lifestyle, including what we eat and how much we exercise
We will continue to strive to better identify people at risk for particular types of cancer and determine how to mitigate their risk.
Moving the Needle at the Dan L Duncan Comprehensive Cancer Center
As an NCI-designated Comprehensive Cancer Center that is part of the Baylor College of Medicine, the DLDCCC is in a unique position to make a significant impact on cancer research. We continually seek breakthroughs, big and small, in cancer prevention, diagnosis and treatment, through:
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Basic research that strives to understand cellular mechanisms, one molecule at a time, one pathway at a time
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Translational research that applies the latest discoveries to specific pathways and brings findings with good outcomes to the clinic setting to improve patient care
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Clinical trials that collect samples directly from enrolled patients and use them for extensive molecular profiling, precision analytics, and DNA and RNA sequencing in our search for patterns that define pathways to improved care
Our research initiatives span numerous cancer types and therapies. We are leaders in genomics and proteomics, pioneering the science that led to optimal hormonal therapies and immunotherapy using CAR T cells.
We are dedicated to discovering new ways to shape the future of cancer treatment and prevention while making the same high quality of care accessible to everyone as costs go down. In 50 years, we hope to look back and again see how far we’ve come. Together, we can continue to get closer and closer to reaching our ultimate goals.