War Against Cancer Turning to 'Smart' Weapons

Treatments targeting pathways of disease beating out chemotherapy

WEDNESDAY, Sept. 29, 2004 (HealthDayNews) -- The war on cancer in the 21st century is becoming one of guerrilla tactics rather than saturation bombing, with "molecularly targeted" drugs replacing wholesale chemotherapy in many cases.

This new approach, experts say, is resulting in patients who can live longer, productive lives despite their diagnoses.

"The emphasis in cancer has shifted from broad observation to zeroing in on what we think is important in the biology of tumor cells," said Dr. Owen O'Connor, of Memorial Sloan-Kettering Cancer Center's Department of Medicine in New York City.

One tactic -- called biologic therapy -- helps the body's own immune system fight cancer by using drugs to interfere with uncontrolled cell growth. It can also act indirectly to help healthy immune cells control cancer, or assist in the repair of normal cells damaged by other forms of cancer treatment, O'Connor said.

Biologic therapy is the latest cancer-fighting tool, joining such earlier approaches as tumor-removal surgery, chemotherapy and radiation, he said.

O'Connor was one of five experts who spoke Tuesday about the state of cancer research and treatments at a conference in New York City.

In the past 15 years, scientists have discovered just how complex the biology of cancer can be. And they've been able to develop drugs that target the individual components of cancer growth. The increase in the number of U.S. Food and Drug Administration-approved drugs in the last decade has meant there are more medicines to help manage the disease in a wide variety of patients, O'Connor added.

This new approach isn't the "magic bullet" cure that doctors used to discuss. But it's a more realistic assessment of how best to deal with the disease, O'Connor said.

"Historically, we've held cancer to the standard that all patients with the disease have to be cured, something that we haven't had with other diseases. The objective now is to recognize that treating cancer as a chronic disease -- like heart disease, emphysema or asthma -- is just as laudable a goal," he said.

Along with this recognition of the chronic nature of cancer comes the necessity to help patients and their families adjust to the new paradigm of cancer care, said another speaker, Diane Blum. She is executive director of CancerCare, a non-profit organization in New York City that assists cancer patients.

More effective cancer treatments have meant that people are spending less time in a hospital, they're living longer with the disease, they have access to far more information about their disease, and they have many more treatment options. All of these are signs of progress, she said.

"But with extended survival, people have to know what they can expect in terms of chronic health problems," Blum said, such as fatigue and cognitive impairment.

"Further, more information is a wonderful thing. But we need to help people figure out how to use it," she said, particularly in sifting through the available information to know what is relevant to a particular person.

Then there's the issue of cost, especially for those without insurance. For these patients, the cost of extended medical care can be prohibitive, Blum said.

But for those who have faced a cancer diagnosis and have benefited from the new medicines, life is sweet indeed.

Gene Grassi, a 50-year-old woman from Long Island, N.Y., was diagnosed seven years ago with multiple myeloma, a cancer of the bone marrow. But she took the drug Velcade from 2001 to 2004 while participating in a clinical trial, and she credits it with having kept her alive beyond her expectations.

"You know I'm here seven years after my diagnosis," she said.

The conference was sponsored by Millennium Pharmaceuticals Inc., the maker of Velcade. The company on Wednesday asked the U.S. Food and Drug Administration to approve broader use of Velcade for multiple myeloma based on successful clinical trials of the drug.

More information

For more on clinical trials of cancer treatments, visit the National Cancer Institute.

SOURCES: Owen O'Connor, M.D., Ph.D. Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York City; Diane Blum, executive director, Cancer Care, New York City; Gene Grassi, cancer patient, Long Island, N.Y.; Sept. 28, 2004, Cancer in 10 Years conference, New York City
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