Treating cancer

Despite earlier diagnosis and better treatment, cancer remains one of the leading causes of death in Western-type countries. In fact, both cancer incidence and mortality rates have steadily increased over the years. Yet, cancer treatment has saved many lives, and continues to improve.

Surgery is the most important cancer treatment method and the key to survival, followed by radiation therapy. The latter's detrimental side effects have been reduced by a better comprehension of normal tissue tolerance to radiation and the availability of more powerful linear accelerators. The last major breakthrough with anti-cancer drugs came three decades ago: cisplatin significantly improves the cure rate for testis cancer. Immunotherapy has offered modest or little benefit, apart from a small proportion of patients with mestatic cancer of the kidney or melanoma. It has been suggested that gene therapy may follow the same path since it appears unlikely that one or a few genes transected into a few cancer cells will be able to reverse the malignant phenotype. The development of resistant cells at initial presentation or during relapse has undermined the use of chemotherapeutic drugs in the treatment of hematologic malignancies and solid tumors. Such acquired resistance to treatment also occurs in hormonotherapy and immunotherapy. Research has led to substantial advances in the understanding of the processes of cancer.