How long, seriously, before we have a cure for cancer?

[Stelios]

I read this (http://www.nytimes.com/2009/04/24/health/policy/24cancer.html?pagewanted=all) NYT article today which stated that, after having adjusted for increased population, the death rate for cancer has fallen a mere 5% since 1950. I found this pretty horrifying, and have been googling ever since to try and find some indication of where we, as a species, are in our war against cancer. Sadly, my google-fu is weak and I'm no closer to an answer than when I started. In my desperation, I turn to the Teeming Millions. How long, approximately, do you think we will have to wait until the war against cancer is won? I don't believe that victory need necessarily take the form of a "magic bullet" pill or inoculation. It could be that we win by incrementally improving our treatments until cancer becomes a non-fatal chronic condition, one that people simply have to live with. Roughly how long do you think it will be until we reach that point? For instance, I'm 29 years old. Is it reasonable to expect such a victory in my lifetime?

P.S. - I'm aware, of course, that the word 'cancer' denotes an enormous range of diseases, and that our progress against cancer has been enormously asymmetrical, with some cancers (ie. Testicular, or Hodgkins Lymphoma) having cure rates close to 100%, while other cancers like Glioblastoma Multiformae, or Small cell lung cancer, having death rates of close to 100%. I'm really asking about those cancers on which progress seems to have stalled, brain tumours, lung cancers and the like. Cheers.

[Exapno Mapcase]

Seriously, we don't know.

[janeslogin]

Which cancer?

[Covered_In_Bees!]

Which cancer?

You obviously didn't read the whole OP now did you? He was specifically asking about cancers we've made progress towards at least stalling the inevitable but have come to a standstill in said progress.

[Stelios]

Seriously, we don't know.

Not even a guesstimate? That makes me a sad panda :(

[thelabdude]

Many brain tumors can be cured on an outpatient basis. Try gamma knife. Also, they are now using proton beams generated by cyclotrons to fry certain tumors leaving other tissue spared.

Each type of cancer is different, and we have good methods for many. Early detection is still the key. I am infuriated my doctor ignored my symptoms for 2 years and now it likely will kill me.

[KarlGauss]

[hijack]
A few years ago I heard of an effort, sponsored and coordinated at a very high level of government/health research (possibly the NIH?) to have research physicists, inorganic chemists, etc,:

1. review the very questions being asked by cancer researchers (i.e. are the latter asking the 'right' questions)

and

2. from their perspective as physicists, etc, and despite them having no training or special knowledge about cancer, ask "out of left field" questions about cancer and cancer research, and identify hidden assumptions that cancer researchers may be using.

Anyone know about this? In particular, any follow-up?

[WarmNPrickly]

I read this (http://www.nytimes.com/2009/04/24/health/policy/24cancer.html?pagewanted=all) NYT article today which stated that, after having adjusted for increased population, the death rate for cancer has fallen a mere 5% since 1950. I found this pretty horrifying, and have been googling ever since to try and find some indication of where we, as a species, are in our war against cancer. Sadly, my google-fu is weak and I'm no closer to an answer than when I started. In my desperation, I turn to the Teeming Millions. How long, approximately, do you think we will have to wait until the war against cancer is won? I don't believe that victory need necessarily take the form of a "magic bullet" pill or inoculation. It could be that we win by incrementally improving our treatments until cancer becomes a non-fatal chronic condition, one that people simply have to live with. Roughly how long do you think it will be until we reach that point? For instance, I'm 29 years old. Is it reasonable to expect such a victory in my lifetime?

P.S. - I'm aware, of course, that the word 'cancer' denotes an enormous range of diseases, and that our progress against cancer has been enormously asymmetrical, with some cancers (ie. Testicular, or Hodgkins Lymphoma) having cure rates close to 100%, while other cancers like Glioblastoma Multiformae, or Small cell lung cancer, having death rates of close to 100%. I'm really asking about those cancers on which progress seems to have stalled, brain tumours, lung cancers and the like. Cheers.
If you think that statistic is horrifying, then this article (http://pipeline.corante.com/archives/2012/03/20/personalized_medicine_for_cancer_try_every_cell.php) should send you straight to the fetal position. Increasingly, the wisdom has become that even within certain types of cancer, the variation is enormous. There isn't one testicular cancer and one brain cancer, there are thousands of each kind. Now, according to this, the variation within each tumor is possibly very high.

My speculation, is that this could help account for why cancers typically become resistant to the therapies that had been used on them in the past. Like bacteria, the ones that survive the first round are more likely to survive the second. There is enough variation within each tumor that some cells are inevitably resistant, and those cells continue to grow.

I predict that we will never cure cancer.

[KarlGauss]

If you think that statistic is horrifying, then this article (http://pipeline.corante.com/archives/2012/03/20/personalized_medicine_for_cancer_try_every_cell.php) should send you straight to the fetal position. But, as an accompanying editorial (to the original NEJM article) stated, it was of great interest (and possibly of great importance) that many of the different mutations in different parts of the same tumor involved the same genes; and that many of those genes normally play key roles in cell growth, differentiation, and signalling. In other words, the presence of such so-called convergent evolution (http://en.wikipedia.org/wiki/Convergent_evolution) in the tumor may be telling us which genes are most critical for the tumor's ongoing survival and proliferation, and hence which genes are likely to be good targets for repair or inhibition.

[WarmNPrickly]

I don't think I have access to that, but I certainly hope that's the case. From the looks of things right now, we could really use a breakthrough.

[dtilque]

I don't think I have access to that, but I certainly hope that's the case. From the looks of things right now, we could really use a breakthrough.

Well, we do get the occasional breakthrough. imatinib/Gleevec/Glivec (http://en.wikipedia.org/wiki/Imatinib) was one such. Prior to its development there was no really effective treatment for chronic myelogenous leukemia short of a bone marrow transplant. Now most patients can expect a normal life expectancy. It also can be used to treat a number of other cancers. But other mutations can crop up that produce resistance to imatinib, so they've developed some other drugs that usually work for them.

So that's one breakthrough. We'll need lots more like that.

[Senegoid]

Stelios -- Having read a certain other one of your threads, I wonder: Do you need an answer fast?

[benbo1]

1. my sister is a biochemical researcher, & she sez the only cure we'll have for cancer & other costly diseases (in terms of life, not $$$) is stemcell therapy. Unfortunately, at least as of recently, the best ones are the ones that come from aborted babies. Were they to have more to experiment with, she sez the prevailing consensus in the biochem research community is the most deadly ones (like pancreatic) could be manageable in 5 years. She analogized it to AIDS - a serious lifestyle adjustment, but no longer a death sentence.
2. Just watched this, & it's fascinating. Some cancers are stopped in their trax. The potential is promising. Well worth watching the hour.

http://www.pbs.org/wgbh/nova/body/cracking-your-genetic-code.html

[Rachellelogram]

Cancer is basically a catch-all term for a group of cells that are growing too fast. There are a LOT of different causes for this. There's probably not ever going to be a generic "cure for cancer," because cancer is not just one disease. Each responds differently to different treatments. It's intellectually satisfying to talk about a cure for cancer, as though cancer was a singular illness, but that isn't a medically-sound way to approach the question.

[Earl Snake-Hips Tucker]

I read an article some years ago (sorry, no cite, going from memory), and a doctor gave his opinion on a cure for *cancer. His opinion, based on what we know about cancers is that the most likely "cure" would be treating it as a long-term incurable chronic condition the same way we treat others such as diabetes and hypertension. I guess that's sorta what we do now, but so often the case is the cancer usually outwits the medication sooner rather than later.

*He was specifically talking about pancreatic cancer, and its miserable survival rates, but I think the same reasoning would apply to most others as well.

[Stelios]

Stelios -- Having read a certain other one of your threads, I wonder: Do you need an answer fast?

Oh, Christ I hope not! :D As far as I know, I'm currently big C free. That said, I am a pack a day smoker, so that may only be temporary. Although, I must admit, I'm mighty curious as to which thread you were referring to. Was it this (http://boards.straightdope.com/sdmb/showthread.php?t=644814) one by any chance? If so, rest assured my current troubles are caused by a minor genetic condition that is pretty inconvenient, but not dangerous. But thanks for your concern, anyway.

[Chronos]

Quoth benbo1:

1. my sister is a biochemical researcher, & she sez the only cure we'll have for cancer & other costly diseases (in terms of life, not $$$) is stemcell therapy. Unfortunately, at least as of recently, the best ones are the ones that come from aborted babies.Only for a very stretched definition of "aborted babies". By the time a pregnancy is far enough along that you could have what most people consider an "abortion", the stem cells have already differentiated into bone cells, muscle cells, nerve cells, etc., and you can't get much that you couldn't also get from an adult. Embryonic stem cells come from extra fertilized eggs at fertility clinics that don't get implanted. Now, admittedly, some folks do use a definition of "abortion" that's broad enough to encompass extra eggs at a fertility clinic, but that's not the usual usage.

[brazil84]

I read this (http://www.nytimes.com/2009/04/24/health/policy/24cancer.html?pagewanted=all) NYT article today which stated that, after having adjusted for increased population, the death rate for cancer has fallen a mere 5% since 1950. I found this pretty horrifying,

Seems to me it's not as bad as it sounds, since dramatic improvements elsewhere necessarily increase the death rate for cancer.

Anyway, your question is necessarily speculative, but I am more optimistic than most. I predict that within 20 years, you will be able to test yourself for most kinds of cancer very easily, that it will be a matter of downloading a "test for cancer" ap to your phone. And that extremely early-detected cancers will be able to be zapped pretty easily with some kind of radiation gun.

[Mijin]

I read this (http://www.nytimes.com/2009/04/24/health/policy/24cancer.html?pagewanted=all) NYT article today which stated that, after having adjusted for increased population, the death rate for cancer has fallen a mere 5% since 1950.

The article says that it is adjusted for age, population etc, but I still don't quite get what that means. We're living much longer now, and for most cancers the incidence increases with age.
Even if we had successful therapies for many cancers I'd still expect it to be the reaper's tool of choice for many of us. Is there a statistician / epidemiologist in the house?

ETA: Or, what brazil84 said.


My speculation, is that this could help account for why cancers typically become resistant to the therapies that had been used on them in the past. Like bacteria, the ones that survive the first round are more likely to survive the second. There is enough variation within each tumor that some cells are inevitably resistant, and those cells continue to grow.

I did some oncology modules as part of my master's and we were taught about this as an observation (i.e. it wasn't considered speculative).

[Surreal]

Has medicine ever "cured" anything? I'm not aware of any diseases that have actually been cured.

If, at some point in the future, medicine actually succeeds at curing something it probably won't be cancer.

[Rhythmdvl]

Can't get to the article at the moment; could someone clarify the OP?

What does "death rate for cancer has fallen a mere 5% since 1950" mean? That for the most part, someone who is diagnosed with cancer today has the same basic prognosis as their grandfather did 60 years ago? That lifespans are similar? That if given a choice between the two technologies someone with a thing for the 1950s is going to be just as well off being treated by a doctor/hospital with 1950s technology and training?

Advances in imaging and detection alone make me think I'm grossly misinterpreting the statistic.

[scr4]

Has medicine ever "cured" anything? I'm not aware of any diseases that have actually been cured.

There are numerous diseases caused by bacterial infection that are cured by antibiotics.

[Rigamarole]

Has medicine ever "cured" anything? I'm not aware of any diseases that have actually been cured.

If, at some point in the future, medicine actually succeeds at curing something it probably won't be cancer.

Yeah, this. My vote is for "never". I hope, and would love to believe that's not the case, but given the vast amounts of research, time, and money that have been poured into it already, I'm not holding my breath.

[Billdo]

Has medicine ever "cured" anything? I'm not aware of any diseases that have actually been cured.

How about Smallpox (http://en.wikipedia.org/wiki/Smallpox), which has been eradicated through vaccination.

[KarlGauss]

Has medicine ever "cured" anything? I'm not aware of any diseases that have actually been cured.
Hodgkin's Disease (http://www.wikicancer.org/page/Hodgkin%27s+lymphoma+-+prognosis). Childhood acute lympoblastic leukemia (ALL) (http://leukaemialymphomaresearch.org.uk/information/childhood-leukaemia/acute-lymphoblastic-leukaemia/prognosis). (for neither is the cure rate 100%, I admit) . I will simply note that both Hodgkin's and ALL, diseases of young adults and kids in particular, used to be pretty much death sentences. Maybe you'd like to ask a HD or ALL survivor, or their parents, if medicine has ever cured anything.

HD and ALL are just two diseases. There are many other examples of cancer cures (again, I admit not at 100%, but there are lots of surgical cures of some lung or GI cancers, retinoblastoma . . .)

ETA: Oh, you mean 'eradicated'?

[DSeid]

[hijack]
A few years ago I heard of an effort, sponsored and coordinated at a very high level of government/health research (possibly the NIH?) to have research physicists, inorganic chemists, etc,:

1. review the very questions being asked by cancer researchers (i.e. are the latter asking the 'right' questions)

and

2. from their perspective as physicists, etc, and despite them having no training or special knowledge about cancer, ask "out of left field" questions about cancer and cancer research, and identify hidden assumptions that cancer researchers may be using.

Anyone know about this? In particular, any follow-up?
Of course the problem is that no one knows in advance what the "right" question will be. A physicist or chemist has no better idea than does a molecular biologist.

The problem inherent in the "war on cancer" model is thinking of it as an engineering problem, like building a vehicle that can go to the moon. It is not an engineering problem; it is an issue of expanding basic understanding of the processes and much of the greatest progress has occurred as "happy accidents" while looking for something else. (See this book (http://www.amazon.com/Happy-Accidents-Serendipity-Medical-Breakthroughs/dp/1559708190) by that name.) From discovering the cancer treating utility of nitrogen mustard as a result of a wartime bombing of Bari Harbor causing a covered up exposure in the water, to the accidental discovery of cis-platinum just because platinum was chosen to use a wire because it was thought to be inert, to the exploration of deaths in chickens leading to the concepts of retroviruses and oncogenes, to the vinca alkaloids being discovered looking for something to help control blood sugars, to the accidental discovery of folic acid antagonists (methotrexate), and so on and on. (Really a very fun book!)

The engineering approach has its applications, but broadly support research in all quarters, making sure that the scientists doing so are not so narrowly focused so that a lucky accident can land next to a prepared mind ... this is where the big breakthroughs will come from. By its nature unpredictable.

[Beable von Polasm]

June 14th, 2055.

[TimeWinder]

As far as I know, I'm currently big C free. That said, I am a pack a day smoker, so that may only be temporary.

You'll then be delighted to know that in your case we've ALREADY got a cure for lung cancer -- stop smoking, and you'll never get 90% of them.

[Beable von Polasm]

You'll then be delighted to know that in your case we've ALREADY got a cure for lung cancer -- stop smoking, and you'll never get 90% of them.

You can start to relax 5 years after quitting, and breathe a sigh of relief after 10.

Or start smoking pot. It's so chock full of carcinogens that researchers are dumbfounded there's no apparently correlation to lung cancer. That leaves but one explanation -- something in it counteracts the carcinogens.

[Surreal]

Hodgkin's Disease (http://www.wikicancer.org/page/Hodgkin%27s+lymphoma+-+prognosis). Childhood acute lympoblastic leukemia (ALL) (http://leukaemialymphomaresearch.org.uk/information/childhood-leukaemia/acute-lymphoblastic-leukaemia/prognosis). (for neither is the cure rate 100%, I admit) . I will simply note that both Hodgkin's and ALL, diseases of young adults and kids in particular, used to be pretty much death sentences. Maybe you'd like to ask a HD or ALL survivor, or their parents, if medicine has ever cured anything.

HD and ALL are just two diseases. There are many other examples of cancer cures (again, I admit not at 100%, but there are lots of surgical cures of some lung or GI cancers, retinoblastoma . . .)

ETA: Oh, you mean 'eradicated'?

By "cure" I mean a treatment that brings about a full recovery from a disease in nearly all of the patients who are treated. What constitutes "nearly all" is debatable but I certainly wouldn't consider a 35% mortality within 5 years indicated in your first cite to be "cured."

[Wesley Clark]

No idea. However assuming medical progress continues to grow rapidly, there is no telling (more scientists on earth, more money spent on research, more productive research, etc all combining). I don't know if I believe in Kurzweil's theory of exponential growth, but I'm sure medical science will be many times more productive 50 years from now than it is today.

As a WAG, 50-150 years from now. But no idea within that wide window.

[The Second Stone]

Has medicine ever "cured" anything? I'm not aware of any diseases that have actually been cured.

If, at some point in the future, medicine actually succeeds at curing something it probably won't be cancer.

Well it has cured the death of evil. Dick Cheney would be dead in two years without his heart transplant.

Medicine makes life solitary, poor, nasty, brutish and much longer than in the days of blood-letting and humors. So take heart. Literally. Or is that figuratively?

[bordelond]

What are the current thoughts on the future use of nanobots in fighting cancer? Way too far out to give serious thought right now, or something our great-great-grandchildren might see?

[WarmNPrickly]

Nobody that knows anything about the current state of nanotechnology seriously talks about nanobots at all, much less curing cancer with them. Carbon nanotubes are barely making it in even experimental forms of commercial product, and what products they are being used in are as a bulk material.

In order to make useful nanobots we need to figure out how to manufacture one, figure out how to scale that manufacturing by 10^6, and figure out how to power them. We are exponentially closer to commercial fusion power than we are to nanobots. They are just barely making a molecular motor, and last I heard it was mostly a series of reactions on a molecule that pivots. It takes several days to react and isolate the product from each reaction.

[Machine Elf]

For an extremely interesting history of humanity's long struggle against cancer, I highly recommend The Emperor of All Maladies: A Biography of Cancer. (http://www.amazon.com/The-Emperor-All-Maladies-Biography/dp/1439170916/ref=sr_1_1?ie=UTF8&qid=1338818656&sr=8-1) The author is an oncologist, and he covers everything from the ancient Egyptian's understanding of it ("there's nothing you can do"), up through the development of surgical techniques, the evolution of chemotherapy from chemical weapons, the understanding of causes/risk factors, the battle to get adequate research funding, changing public attitudes toward cancer, and so on. I'm 2/3 of the way through, and it's been fascinating.

[robert_columbia]

I, for one, feel a bit worn out from the endless cancer research fundraising that has been going on since I was a child. "Race for the Cure"? You've been racing for 30 years and we've given you millions, what's taking you so long? Sometimes I wonder how much cancer fundraising really advances our understanding of cancer and how much actually goes to buying researchers a new beach house and spiffier BMW's.

[Telemark]

Sometimes I wonder how much cancer fundraising really advances our understanding of cancer and how much actually goes to buying researchers a new beach house and spiffier BMW's.

Seriously? Is that where you are letting your frustration take you?

[Chronos]

I highly doubt there's any area of research, at all, where beach houses and BMWs are the norm for the researchers.

[Buck Godot]

I, for one, feel a bit worn out from the endless cancer research fundraising that has been going on since I was a child. "Race for the Cure"? You've been racing for 30 years and we've given you millions, what's taking you so long? Sometimes I wonder how much cancer fundraising really advances our understanding of cancer and how much actually goes to buying researchers a new beach house and spiffier BMW's.

Just so you know that that money hasn't been entirely wasted, I've attached a a link (http://www.guardian.co.uk/science/2010/jul/12/cancer-survival-rates-doubled)to show how far we've come.

Breast, bowel and prostate cancer survival rates have shot up, as have those for non-Hodgkin's lymphoma and leukemia. The study, for Cancer Research UK, compared data on 10-year survival rates of patients diagnosed with cancer in 1971-72 with the expected survival rates of those diagnosed in 2007. On average it found that 45.2% of cancer patients are now expected to survive at least 10 years, compared with 23.7% in the 1970s.

As far as how the resources are being used, they are much more likely to be spent on expensive pieces of equipment, reagents, and patient expenses than lining the researchers pockets. Most researchers I know could probably earn much more money in private practice, but prefer the intangible benefits that arise from working to solve a difficult problem that affects many peoples lives.

Looking into the future, over the last 10 years we have started getting together the tools to really understand the molecular basis for cancer. This is the electrical engineering equivalent of having just invented the micro-processor. It will take some time to figure out what it all means but there are already clinical trials that are evaluating therapies that will target precisely those things that make a cancer cell malignant. This will result in fewer off target effects making the treatments have fewer side effects.

Cancer can be very tricky so a blanket cure for all cancer types probably won't probably be found in our life time, but even in the next 10-15 years I expect there to be a dramatically rapid improvement in prognosis.

[Buck Godot]

Anyway, your question is necessarily speculative, but I am more optimistic than most. I predict that within 20 years, you will be able to test yourself for most kinds of cancer very easily, that it will be a matter of downloading a "test for cancer" ap to your phone. And that extremely early-detected cancers will be able to be zapped pretty easily with some kind of radiation gun.

It probably won't work exactly this way. In most cases to test for cancer you will need to have a test sample that contains cancer cells. This will mean either that you have a biopsy taken at the site of that cancer, or else your cancer is so metastatic that cancer cells are pervasive in your body. So I think a test for cancer will not be an over the counter procedure. Also I think that the new treatments for cancer are more likely to be chemical rather than radiation in nature. But overall I share your optimism.

[Chronos]

It probably won't work exactly this way. In most cases to test for cancer you will need to have a test sample that contains cancer cells. This will mean either that you have a biopsy taken at the site of that cancer, or else your cancer is so metastatic that cancer cells are pervasive in your body.Or you have some means of testing in situ without cutting a biopsy out of the patient, like any of the current medical imaging techniques. Or you test for some chemical secreted from the cancerous cells, similar to how we use PSA to screen for prostate cancer.

[AaronX]

Maybe the solution isn't a cure, it's to put the rapidly dividing, immortal cells to good use?

[Buck Godot]

Or you have some means of testing in situ without cutting a biopsy out of the patient, like any of the current medical imaging techniques. Or you test for some chemical secreted from the cancerous cells, similar to how we use PSA to screen for prostate cancer.

I actually thought of PSA as an exception when I wrote that but I don't think that most other cancers secrete proteins to the extent that Prostate cancer does, the other case where there could clearly be a test is leukemia in which case a blood test would certainly work. As far as the imaging techniques go, they can indicate the presence of a tumor but not wither or not it is malignant, and in anycase not something that you could do yourself at home from a kit, like we do home drug tests. What you will (and actually are able to do) is to get semi complete gene sequencing to see if you are at high risk for certain cancer types, and as time goes on this information will be come more accurate and more complete.

Disclaimer: I'm not a biologist, and from my work am probably biased in the direction of genetic tests that require tissue (much like benbo1's sister is probably biased in favor of stem cells), so someone may come around and set me straight.

[danewilson77]

Many brain tumors can be cured on an outpatient basis. Try gamma knife. Also, they are now using proton beams generated by cyclotrons to fry certain tumors leaving other tissue spared.

Each type of cancer is different, and we have good methods for many. Early detection is still the key. I am infuriated my doctor ignored my symptoms for 2 years and now it likely will kill me.

Sorry to bump an old thread. This may be my only post...but thought it was worth it...to post pictures of my daughters before and after gamma knif brain surgey. MRI's are 6 months apart. Good stuff.

http://i1015.photobucket.com/albums/af278/nicee46/Family/Surgery/IMAG0762-1-1.jpg

[chargerrich]

You kind of answered your own question IMO. We have not cured "Cancer" in much the same way we have not cured "Colds". There are so many variants, causes and treatments that science is in fact curing 100s of diseases.

This is diametrically opposed to say AIDS/HIV which is - generally speaking - a single disease that can be targeted.

I for one believe AIDS will be cured before cancer and would add that AIDS has diverted billions of dollars in research money that might have gone to cancer research.

Not really an answer I know, but my thoughts on the subject anyway. ;)

[Iggy]

There are techniques in development that could be generally applicable to a variety of cancers.

Basic research has led to the understanding that many cancers express cell surface proteins that are not generally expressed in healthy cells.

Researchers have figured out how to make antibodies to those cancer specific cell surface proteins.

Now the clever part... researchers have figured out how to attach a powerful chemotherapy drug to that antibody. This combined antibody drug conjugate (aka immunoconjugate) allows targeted use of more powerful chemo drugs than could otherwise be tolerated.

Seattle Genetics has already brought a drug to market using this process. Adcetris targets CD30+ lymphomas and Large Cell Carcinomas.

Conceptually this approach should work with other cancers. 1) Researchers identify unique cancer cell surface proteins. 2) Researchers design an antibody to the cancer cell surface protein. 3) The antibody is incorporated in an antibody drug conjugate.

This approach requires a rethinking of cancer. It is not about breast cancer, colon cancer, or lung cancer. Instead it is about which unique cancer cell surface proteins are expressed in a given tumor (almost*) regardless of where in the body it is. So think in terms of whether a patient's cancer is positive for CD30, CD15, CD40 or whatever other cell surface protein and then choose treatment accordingly.

It is still early in the use of this process, but there is hope.


*downside is that antibody drug conjugates are large molecules and may not easily pass the blood-brain barrier.

[HoneyBadgerDC]

Several years ago I read of a treatment where geneticaly engineeered antibodies could be armed with radiactive isotobes and sent directly to cancer cells. Delivering a much higher dose of radiation directly on target with highly reduced levels overall, this sounded very promising as a treatment that could be custom fit to each patient and cancer potentialy, any more word on this?

Sorry Iggy, I posted before I read your post.

[Smeghead]

Several years ago I read of a treatment where geneticaly engineeered antibodies could be armed with radiactive isotobes and sent directly to cancer cells. Delivering a much higher dose of radiation directly on target with highly reduced levels overall, this sounded very promising as a treatment that could be custom fit to each patient and cancer potentialy, any more word on this?

Sorry Iggy, I posted before I read your post.

This is an important and promising method of treatment, but it's unlikely to become a "cure". Any tumor is going to have a heterogeneous population of cells. Some will have the protein targeted by the antibody, some won't. The ones that don't may survive and reexpand into a new tumor. I was just reading a paper about this a few months ago. Really, the more we look, the more complicated cancer is. Within a single patient, different tumors may be made up of vastly different cells, and within a single tumor, there may be many types of cells. The paper I read specifically identified a very small population of cells within a tumor that seem to function as protectors - sort of "master cells" that keep the whole shebang moving along. I forget the details. But it just reiterates the point that's been made several times already: It's really unlikely that we'll ever find a specific treatment that cures all cancers, or even one that will completely wipe out all cases of one kind of cancer.

[Learjeff]

The problem is that every cancer is unique, because it's a series of mutations that thwart the body's very robust anti-cancer mechanisms. Every cancer is arguably "more unique" (if you'll forgive the expression) than the person who has it, who might be a twin.

For a great book on the subject (though, from 2001, so not quite up-to-date), see Evolution - An Evolutionary Legacy (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1281537/) by Mel Greaves.

We won't be able to prevent cancer, but we will find more and more effective ways to treat many types of cancer, as well as predicting it better and detecting it earlier, and stopping it before it metastasizes. IMHO our best bets will be finding out ways to stimulate our own immune systems to fight it -- but that will require significant per-patient engineering.