Anyone suffering from cancer today can have hope. Survival rates for many types of cancer have increased significantly in recent years. A look at the numbers from the Center for Cancer Registry Data at the Robert Koch Institute (RKI) shows:
For many tumor diseases, we speak of a “cure” when the patient has survived for five years without a relapse and there is no longer any detectable tumor activity, says Susanne Weg-Remers from the German Cancer Research Center in Heidelberg. However, there are exceptions, such as breast cancer, where the tumor can return even after more than ten years. “So that can vary.”
Better chances of survival thanks to new forms of therapy
But why is it that the chances of survival continue to increase? In addition to improved early cancer detection and preventive examinations, according to Weg-Remers, molecular tumor analysis has played a crucial role in recent years. Tumor tissue is specifically examined for specific changes at the molecular level. “The doctors can identify the Achilles heel of the tumor, so to speak,” says the expert.
Cancer occurs when one or more cells in the body begin to divide and multiply uncontrollably. “In most cases, it is not a single change in the genome that is responsible for this,” she says. “Several changes come together that change the growth behavior of the cells.” For example, there is sustained cell proliferation, no longer responds to stop signals from the environment and ingrowth into surrounding tissue. Ultimately, metastasis occurs – cancer cells migrate via the blood or lymphatic system to other areas of the body and settle there.
“Cancer is very complex. There are many different biological mechanisms that can play a role and that could theoretically be attacked with targeted drugs.” Molecular tumor analysis shows which mechanisms play a role in the cancer of a particular patient. “In many cases, very individual treatment options can be found, for example through a targeted drug or an immunotherapy that works precisely against a specific ‘Achilles heel of the tumor’.”
“Surgery, radiation therapy and chemotherapy remain the three important pillars of fighting cancer”
The progress is particularly clear in certain tumor subtypes of lung cancer or black skin cancer. “There are now patients for whom one would have said ten years ago that they actually have no chance of survival. Thanks to new therapies, long survival or even a cure is possible for individual patients.”
However, the expert emphasizes: “Molecular diagnostics and treatment with targeted drugs as well as immunotherapy are two drug approaches that have become more important in recent years, especially for patients with advanced cancer. However, the classic treatment methods – surgery, radiotherapy and chemotherapy – remain the three important pillars of fighting cancer,” says Weg-Remers. “In many cases they continue to be the prerequisites for having a chance of recovery.”
mRNA vaccination against cancer as a potential cancer cure?
There are also some therapies that are currently being tested in clinical studies, says Weg-Remers. The mRNA vaccination approach is “very interesting”. “Here we are testing a vaccination against cancer with the aim of activating the body’s own immune system and fighting the tumor cells.” There are initial study data that indicate that the principle can work. “But of course a lot more research still needs to be done.”
She also hopes that there will be improvements in tumor types that are still difficult to treat. These are tumors of the liver, bile ducts or pancreas. “The problem here is that these tumors only cause symptoms when they are relatively advanced. There are also no good early detection tests yet. There’s definitely still a need.”
Weg-Remers does not yet see that cancer will be completely curable in the foreseeable future. “Because cancer is simply very insidious and heterogeneous in its growth. This means that tumor cells can still change even during therapy.” It can happen that a tumor is temporarily kept in check by medication, but the cells become resistant after a certain time. “They change and can bypass or compensate for the biological mechanism that the drug controls.” A relapse then occurs. “So the challenge will continue to exist.”
Cancer prevention has “very high and as yet unexploited potential”
Weg-Remers, on the other hand, sees “very high and as yet unexploited potential” in cancer prevention. “We know that around 40 percent of all new cancer cases in Germany can be traced back to avoidable risk factors,” she emphasizes. “If everyone became aware of the importance of cancer prevention and made just a few lifestyle changes, we would have a real chance of preventing many new cancers.”
Cancer prevention measures include:
Avoid obesity, no smoking, little alcohol, avoid UV radiation, regular exercise (regardless of obesity), vaccinations (against HPV and hepatitis B), and avoid harmful substances, such as fine dust and radon
“I think there is still a lot to do, but my observation over the last ten or 20 years is that we are making step-by-step progress in the early detection, diagnosis and treatment of cancer,” says Weg-Remes. “And yes, there are more and more cancer survivors!”