Saturday, September 11, 2010

Learning from Curable Cancers

This week's edition of Newsweek has a fascinating article called "Curing Cancer: What Treatable Tumors can Teach Us about Improving the Odds in the Deadliest Cases."

It reports on work that researchers are doing on the types of cancers that result in the most fatalities, turning to some of the cancer success stories for models for how to handle the ones that are still causing so many problems.

For example, there's a much better cure rate for ALL (acute lymphoblastic leukemia) in kids than in adults, and it's better among kids who are treated by pediatric oncologists than those treated by adult oncologists. This is because the pediatric oncologists are more likely to blast the kids with mega-doses of a bunch of different drugs -- as much as the kids can tolerate. Adult oncologists tend to take a try-one-till-it-stops-working approach. I think that's fascinating. It makes a lot of sense, and certaining in Follicular NHL, the more aggressive treatments (like R-CHOP, a combination of 5 drugs) results in a greater likelihood of a lasting remission. Of course, the single-agent, hold-off-on-the-hard-stuff approach has its place, too. But there's some speculation that a guns-a-blazin' approach might offer a chance of a cure, too: R-CHOP followed by RIT, for example. That's a whole lot of initials to deal with.

Another example involves the kind of personalization that's becoming much more common, where a precise genetic mapping of the individual's cancer cells helps determine which treatments will be successful. This would mean that treatment is determined by genetic markers, rather than body part: there are a whole bunch of different lung cancers, not just one type, and knowing which gene mutation caused which type of lung cancer could make a big difference in outcome, where time and money isn't wasted on something that they know won't work.

It's not new, all of this information, but I like to read it again. And I like to read quotes from researchers who are excited about what they're doing and say things like "I feel like I've seen the future."

Bring it on.

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