Table of ContentsView AllTable of ContentsTreatable vs. CurableCancer TypesDisease SimilaritiesObstaclesTreatmentsFinding a Cure
Table of ContentsView All
View All
Table of Contents
Treatable vs. Curable
Cancer Types
Disease Similarities
Obstacles
Treatments
Finding a Cure
Some experts believe cancer may one day be curable, while others think it’s more likely we will learn to control it as a chronic disease rather than cure it outright. Either way, the many types cancer and the differences in those living with them will significantly factor into this effort, meaning there can’t be a one-size-fits-all approach to curing cancer.
Today, cancers that respond to treatment are not considered “cured” because there is always a potential they could come back. Instead, they are referred to as being in complete remission or evaluated as having no evidence of disease (NED), meaning there is no detectable cancer in the body.
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Even if a cancer cannot be considered 100% eradicated today, some can be effectively “cured” completely if detected early. Stage 0 cancers such asductal carcinoma in situ(DCIS) are, in theory, cancers that can be cured completely.
Oncologists (cancer specialists) will also refer to someone as “cured” if they hadacute lymphoblastic leukemiaas a child because the likelihood of recurrence in adulthood after successful treatment is low.
The following are types of cancer that are considered more “curable” based on five-year survival rates:
But there are important nuances to this, too.
For example, stage 1 to stage 3 breast cancers that areestrogen receptor positivearemore likely to recur five to 10 years after diagnosis than in the first five years. Sometimes recur even decades later.
These cancers may be more “treatable,” as there are more options for keeping them in check than there are for other cancers. But they are, in a sense, less “curable” than those that are not hormone receptor positive.
Durable ResponseIn some cases, the term “durable response” may be used when it appears long-term control of a metastatic cancer is possible or achieved. This is most common in stage 4 cancers that respond to treatment, with immunotherapy drugs appearing to improve the chances of durable response.
Durable Response
In some cases, the term “durable response” may be used when it appears long-term control of a metastatic cancer is possible or achieved. This is most common in stage 4 cancers that respond to treatment, with immunotherapy drugs appearing to improve the chances of durable response.
Different Cancer Types
Today, there is no one cure for cancer because cancer is not just one disease and every individual case is different.
There are hundreds ofdifferent types of cancer, from the all-too-common but highly treatable non-melanomaskin cancersto the rare and aggressiveMerkel cell carcinoma, a different type of skin cancer that’s often fatal.
Even when two cancers are the same tissue type, subtype, and stage, they may still have significant molecular differences that play a role in treatment options and outcomes.
Pharmacogenomics—knowing how a person’s genetic make-up influences how they respond to drugs—is still an evolving area of personalized medicine sciencce.
Further,cancer cellsoften find ways to escape both treatments and the immune system.
Will cancer be cured in 100 years?Because cancer is not just a single disease, it is unlikely that there will ever be a single cure for it. Instead, treatments for individual cancers are likely to evolve, making it possible for more people to acheive remission for longer periods of time or even permanently.
Will cancer be cured in 100 years?
Because cancer is not just a single disease, it is unlikely that there will ever be a single cure for it. Instead, treatments for individual cancers are likely to evolve, making it possible for more people to acheive remission for longer periods of time or even permanently.
Cancer isn’t one disease, but scientific advances are exploiting some of the similarities between different cancers in order to treat them.
Cancer cellsbegin as normal cells in the body, making them much more difficult to treat than other microorganisms. But the changes that cause this transformation, and the pathways associated with them, often overlap among cancer types.
Roughly 90% of cancer-related deaths are due tometastases(original cancers that spread to other parts of the body). The ways in which errant cells spread to regions they don’t belong are somewhat consistent among tumor types.
Shared Treatments
The immunotherapy drug Opdivo (nivolumab) and the targeted therapy drugVitrakvi (larotrectinib)are based on these discoveries and, therefore, work for more than one cancer type.
Opdivo (nivolumab)
This checkpoint inhibitor works to make cancer cells visible to the immune system, eliciting a response to fight them. It is approved for people with cancers including:
Vitrakvi (larotrectinib)
This targeted therapy drug works in some people with cancer who test positive for a genetic change calledneutrophic receptor kinase(NTRK) gene fusion. It may be used to treat people with:
Obstacles in Curing Cancer
Aside from the fact that cancer is not one thing, the continually changing nature of cancer, resistance to treatments, and other challenges continue to be roadblocks on the road to a cancer cure.
Cancers Change
There’s a tendency to think of cancer as an unchanging clone of abnormal cells, but that’s not the case at all. Cancer cells are continually changing and acquiring new mutations.
These new mutations may give rise to new characteristics of the cancer, such as the ability to spread more freely. Non-genetic cellular changes in cell behavior, called epigenetic changes, also occur.
Resistance
Changes in cancer cells mean that a tumor that responded to treatment at first has found ways toresist cancer drugsand continue to grow.
A significant amount of cancer research is focused on the growth pathway of specific tumors to identify other targetable places to halt their growth.
Many targeted therapies are able to control the growth of a tumor for a time beforeresistance develops. In some cases, next-generation drugs are available that allow people to stay ahead of this resistance, but tumors often change again.
Resistance also can transform a tumor into a completely different subtype of cancer. For example, someEGFR positivenon-small cell lung cancers may transform tosmall cell lung cancer, a much more difficult type of cancer to treat.
Cancers Enlist Help
Cancer cells often hide and adapt while enlisting help from normal cells in their surroundings.
Their secretions can’t be studied in a lab, further complicating researchers' ability to understand them.
Heterogeneity of Tumors
Not all cancer cells are the same, at the same time. They continually change how they behave and adapt in different parts of a tumor. This is calledheterogeneity.
Due to these changes, one part of a tumor may be sensitive to a treatment while another part of the tumor (or a metastasis) may be resistant.
Balance: Efficacy vs. Toxicity
Treating cancer means establishing a balance between what’s effective and its side effects. This balance is visible when addingimmunotherapy cancer drugsto a cancer treatment plan.
The immune system requires a balance between being overly active and attacking the body’s own tissues, and being underactive such that tumors grow unchecked.
The most common side effects of immunotherapy drugs include inflammatory disorders, while reciprocally, some medications for inflammatory diseases may raise the risk the cancer.
Chemotherapy can also cause cancer. While it may be part of a curative cancer treatment, it may cause a different cancer in the future.Likewise, radiation therapy can increase the risk of a secondary cancer.
Research Limitations
Most cancer drugs are first studied in the lab and in animal studies. What works in a dish in the lab (in vitro) does not often translate to effectiveness in the human body (in vivo).
According to a 2018 review, it’s thought that roughly 90% of cancer drugs that appear to be effective in lab studies fail to work when studied on humans in clinical trials.
The cost of research is also an influencing factor that cannot be ignored.
What is the hardest cancer to cure?Pancreatic cancer is thought to be one of the most difficult cancers to treat. This is because it is hard to detect early and is often diagnosed in the fourth stage, when treatment is more challenging. It is also in a hard-to-reach location, which makes it difficult to remove surgically or treat with chemotherapy.The five-year survival rate for people with this type of cancer is only about 13%. Pancreatic cancer accounts for around 8.5% of all cancer deaths in the United States.
What is the hardest cancer to cure?
Pancreatic cancer is thought to be one of the most difficult cancers to treat. This is because it is hard to detect early and is often diagnosed in the fourth stage, when treatment is more challenging. It is also in a hard-to-reach location, which makes it difficult to remove surgically or treat with chemotherapy.The five-year survival rate for people with this type of cancer is only about 13%. Pancreatic cancer accounts for around 8.5% of all cancer deaths in the United States.
Pancreatic cancer is thought to be one of the most difficult cancers to treat. This is because it is hard to detect early and is often diagnosed in the fourth stage, when treatment is more challenging. It is also in a hard-to-reach location, which makes it difficult to remove surgically or treat with chemotherapy.
The five-year survival rate for people with this type of cancer is only about 13%. Pancreatic cancer accounts for around 8.5% of all cancer deaths in the United States.
Treatments and Advances Toward a Cure
Progress in curing cancer may seem slow, but several advances in diagnosis andcancer treatmentare changing cancer care.
Targeted Therapies
Targeted therapies, while not a cure, can sometimes control a cancer for a significant period of time. Gleevec (imatinib) used to treatleukemiaand a few other cancers is a good example.
With second and third generation drugs for some types of cancer, some people—at least for a time—control their cancer as a chronic disease much likehigh blood pressureordiabetes.
The ability to identify gene mutations and rearrangements is expanding. Tests such as next-generation sequencing allow healthcare providers to examine many genetic alterations that may be treatable.
Immunotherapy
Sometimes a person may experience thespontaneous remission of cancer, even an advanced cancer. It’s now thought that the immune system may fight off a cancer in some cases.
The immune system knows how to fight cancer with powerful cells such asT cells. Unfortunately, cancer cells have discovered the ability to suppress that immune response so that cancer cells can grow unchecked. Immunotherapy drugs work to empower the immune system instead.
Immunotherapy drugs known ascheckpoint inhibitorsmake cancer cells visible to the immune system. These drugs can result in durable responses in advanced cancers like melanoma, but they don’t work for everyone. Future research may find ways in which more people will respond.
One notable finding is that the diversity of gut bacteria (the gut microbiome) relates to how well checkpoint inhibitors work.Research into ways to increase diversity of the gut microbiome is needed to see if these drugs can be effective for more people.
Adjunct TherapyImmunotherapy in combination with radiation treatment can sometimes improve control due to the abscopal effect. Cell death from radiation activates immune cells that then attack tumor cells far away from the site where radiation was delivered.These combined therapies with an added oradjunct therapymay improve outcomes.
Adjunct Therapy
Immunotherapy in combination with radiation treatment can sometimes improve control due to the abscopal effect. Cell death from radiation activates immune cells that then attack tumor cells far away from the site where radiation was delivered.These combined therapies with an added oradjunct therapymay improve outcomes.
Nanotechnology
Nanotechnology is a way of detecting and treating cancer at the molecular level using nanoscale devices. These are very small, between 100 and 10,000 times smaller than a human cell.
Scientists hope one day these tiny devices will be used to detect cancer at the earliest possible stage. Nanoscale devices can also be used to deliver targeted therapies directly to cancer cells and to help guide surgeons during tumor removal.
Cancer Vaccines
The same mRNA technology that was used to create COVID-19 vaccines is also being tested for cancer treatment. An mRNA cancer vaccine could target specific proteins found in cancer cells and be individualized for a person’s specific type of cancer.
In theory, these vaccines will be able to help the immune system learn to recognize the cancer cells as invaders so they can be eliminated.This technology has been used in clinical trials with mixed and sometimes disappointing results.
Treatment of Oligometastases
Treatment of these areas with methods such asstereotactic body radiotherapy(SBRT) with a curative intent may sometimes eradicate these rogue tumors, allowing a cancer to again be controlled.
The Future of Finding a Cancer Cure
There are many approaches both already available and in the works that promise to improve cancer care and perhaps, one day, a cure. For example, some people respond particularly well to certain treatments.
Researchers want to know why a rare person might respond to a treatment. One example is theEGFR inhibitor Iressa (gefitinib), which was limited 20 years ago to only people with non-small cell lung cancer who responded well.
The evolving understanding of the role ofEGFR mutationsin some lung cancers (between 10% and 20% of non-small cell lung cancers) led to expanded drug approval in 2015, for people with specific EGFR-related changes.
While two main types of EGFR changes account for 85% of those identified, researchers continue to work on more rare types, likeEGFR exon 20 insertion mutations.
Other research priorities that may change the way “cure for cancer” is understood include:
New genetic discoveries also may lead to prevention or early detection of cancers, as well as treatment options.Genome-wide association studiesare studies that look at people with and without a disease and then look for changes (called single nucleotide polymorphisms) in the entire genome that may be associated with the disease.
What About CRISPR?Gene editing (CRISPR-Cas9) is certainly advancing the science that could aid in treatments, but it’s unlikely that gene editing alone could be acurein the near future. More potential could be seen in the use of CRISPR to edit cells in the immune system to better fight cancer as with strategies likeCAR-T immunotherapy.
What About CRISPR?
Gene editing (CRISPR-Cas9) is certainly advancing the science that could aid in treatments, but it’s unlikely that gene editing alone could be acurein the near future. More potential could be seen in the use of CRISPR to edit cells in the immune system to better fight cancer as with strategies likeCAR-T immunotherapy.
Summary
While cancer can’t be cured, that’s not how oncologists and cancer experts think about a successful treatment. They refer to it ascomplete remission, allowing for the fact that cancers can recur. They also describe it as “no evidence of disease” that, in some cases, may prove permanent.
Advances in cancer treatment aren’t the same as a cure, but they are helping people to live longer with a cancer diagnosis—sometimes even with the hope of managing it as a chronic disease.
Evolving research continues to deliver more personalized care, including immunotherapy and targeted therapy drugs. New understanding about cancer and its treatment already informs cancer care and offers options that weren’t possible even a few years ago.
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