Cancer was first recorded at the dawn of history and humanity has been suffering in a half-light of understanding for most of that time. Medical interventions have developed gradually as the disease was able to elude efforts to tame its malignant complexity.
The odds of surviving had the statistical skew that would scare even the most desperate of gamblers and it seemed the more we learnt, the more labyrinthine the foe became.
The burden is immense – 8.2 million people die worldwide annually from cancer according to World Health Organization figures – and its impact is personal and economic.
But a century of pioneering research has redressed the balance so that cancer’s innate ability to cloak itself and thwart therapies is not so effective; the game of medical hide and seek is being won by man.
Our ability to interrogate the core of a cancer, to strip back its disguises, has opened up a brighter world where talk of a cancer-free future is bold yet justified.
Cancer survival rates in the UK have doubled over the last 40 years with 50 per cent of adults diagnosed in 2010-11 expected to live ten years or longer
Survival rates have improved dramatically with patients able to live longer and with more fulfilling lives. Scientists can now engineer tailored treatments that outgun earlier blunderbuss techniques with short-lived action and debilitating side effects.
Cancer survival rates in the UK have doubled over the last 40 years with 50 per cent of adults diagnosed in 2010-11 expected to live ten years or longer.
“It is clear that we have made very good progress over the last 20 years and the exciting thing is that the pace is picking up as we know more about the molecular origins of cancer and how the body’s own immune system can react to it,” says Professor Peter Johnson, chief clinician for the charity Cancer Research UK.
“The numbers of people getting some types of cancer are falling thanks to reductions in smoking rates, although our ageing population means that overall numbers are increasing. People will unfortunately always get cancer, but our ability to diagnose, treat and help them to live with it or provide a cure is improving all the time.”
But advancements in healthcare design, government support and public health awareness are also key components in the fight against cancer.
“It is important to take a whole-system approach,” says Professor Johnson, who is also director of the Southampton Cancer Research UK Centre. “We are interested in the range of things we can do to prevent deaths from cancer. This includes reduction of alcohol and tobacco consumption, fighting obesity, better routes to diagnosis so we cut down the number of people presenting with cancer which has gone beyond the point of cure – something we do less well than some other countries – conventional therapies, such as surgery, chemotherapy and radiotherapy, and on to the new treatments.
“It is like the successful British Cycling mantra of optimising everything that can be optimised.”
The biggest buzz is the promise of immunotherapy – an approach that restores and steels the body’s immune system to fight off cancer naturally. In laboratories around the globe, the painstaking work of decoding cancer structures is paying dividends as scientists zero in on trigger points to switch off its defences.
Cancer Research UK, which benefits from £500 million of annual public donations, is a world leader clocking up 55,000 research hours each week in its labs, but Professor Johnson sees collaboration as the accelerator pedal in the race to beat cancer.
“We work very closely with partners in biotechnology and the pharma industry, and there is no doubt that we depend on each other,” he says. “The industry depends on the scientific research that Cancer Research UK funds to generate new ideas and targets for treatment, and our academic investigators depend on our partners in industry to develop treatments as quickly as possible.
“Successive governments have also played their part over the last 15 years by supporting science and technology and university and NHS research.”
In addition, the pharmaceutical industry has been pivotal with members of the Association of British Pharmaceutical Industry (ABPI) spending more than £3 million daily on cancer treatment research in the UK.
It believes that innovative medicines will get to patients quicker if clinical trials and the regulatory framework are redesigned to support early drug development.
“As new medicines become increasingly personalised, the research needed to bring these to patients becomes increasingly complex. Further collaboration between industry, research charities, academia and the NHS will be important to identify new targets,” says Dr Virginia Acha, ABPI research medical and innovation executive director.
“These medicines require molecular tests to identify patients who will respond to treatment. The development and delivery of these medicines raise logistical challenges for the NHS, industry and research organisations, including co-ordination of centralised databases, lab and diagnostic services.”