Vim & Vigor - Summer 2019 - CH - 30

Devising a Treatment
Blueprint

A Change in Approach

30

SU M M ER 2019

PHOTOS BY GETTY IMAGES

In the field's greatest recent advance,
medical professionals are thinking differently about cancer, looking more broadly
at what drives a tumor's spread and
developing custom treatment sequences,
an idea known as precision medicine,
Schapira says.
With this method, a person's cancer is
tested to determine whether it would be
susceptible to a targeted therapy, which
uses drugs to interfere with molecules
involved in the cancer's growth. For
example, one type of treatment called signal transduction inhibitors blocks signals
inside a cell that can affect its functions,
including cell division and cell death, possibly killing cancer cells.
Lung cancer researcher Roy Herbst,
MD, PhD, describes the approach as targeting a cancer's vulnerabilities.
That new thinking and the therapies
it is producing are vital, because surgery,
radiation and chemotherapy sometimes
don't succeed, especially in advanced
cases, says Herbst, a member of the
American Association for Cancer Research
who contributes to the group's annual
Cancer Progress Report.

Every person's cancer is unique, and
treatment approaches and goals may
vary. For example:
* A person with a solid tumor in
the breast, colon or stomach might
need surgery to get rid of the original, primary tumor and high-energy
radiation waves to kill cancerous
cells that have spread.
* Someone with cancer that affects
the whole body, such as leukemia,
will need an all-over treatment,
such as chemotherapy. Other systemic options might include hormonal therapy or targeted therapy
to stop growth.
* A person with melanoma or a
certain type of lung cancer could
expect to have immunotherapy in
the care plan.
Whole-body treatments like
chemotherapy, which requires
several sessions of IV drug infusions, can sometimes be replaced
by treatments used over years to

maintain good health, such as hormonal therapy via oral medication,
Schapira says.
"We've made tremendous progress in both de-escalating or limiting
toxic treatments, because we now
know that sometimes they don't
work very well," she says.
For example, a 2018 study found
that chemotherapy does not help
many people in early stages of the
most common type of breast cancer.
Doctors now feel comfortable advising some breast cancer patients to
wait on chemotherapy, taking the
burden off people who felt they had
to try it to survive, says Schapira,
who treats breast cancer.
"Showing that you can accomplish
what you want using a hormonal
therapy, that is an absolute change
in the narrative," she says.



Vim & Vigor - Summer 2019 - CH

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Vim & Vigor - Summer 2019 - CH - Cover1
Vim & Vigor - Summer 2019 - CH - Cover2
Vim & Vigor - Summer 2019 - CH - Contents
Vim & Vigor - Summer 2019 - CH - 2
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