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As cancer treatment advances, patients and doctors push back against drugs' harsh side effects

11 Comments
By CARLA K. JOHNSON

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Unlike in other diseases, cancer drug development has focused on finding what’s called the “maximum tolerated dose.”

Historically cancer has been a category of different diseases that required aggressive treatment so patients could survive, but thanks to advances in medical science the situation right now is very different, and patients are cured every day from different kinds of cancer, that means that the treatments can replace part of that aggressiveness with faster detection, better drugs or more localized therapies. It may seem risky for some people but if this results from patients suffering much less for the same benefit then it is the only ethical thing to do. Specially when the treatments themselves come with risks for the health.

Another consequence on this change of paradigms in cancer is that more and more doctors become confident in declaring their patients cured as well, a patient that is treated with the best dosage to minimize their problems and can be declared free of the disease is proof of the huge advancement in treatments that has been achieved.

https://pubmed.ncbi.nlm.nih.gov/31436897/

https://pubmed.ncbi.nlm.nih.gov/28244479/

Recognising a cancer patient as cured represents an opportunity to improve their quality of life.

-1 ( +3 / -4 )

A lot of hype here.

While treatment is a lot better for people with stage 3 or better cancer, stage 4 cancer is typically terminal.

Cancer type also matters a lot, while breast snd lung cancer have a lot of targeted options, cancers such as CRC have very few treatment options other than chemo, with targeted therapy only working in ~5% patients, and a dry pipeline

0 ( +0 / -0 )

Cancer is so difficult and scary. My post-cancer treatment required a range of drugs but none gave me any side effects.

Others are taking stronger drugs with side effects.

3 ( +5 / -2 )

Through a program called Project Optimus, the FDA is pushing drugmakers to include more patients in early dose-finding trials to get better data on when lower doses can work. 

Although as of today there is still no cure for cancer, the FDA is helping by pushing these drugmakers, and by approving various treatments.

-1 ( +2 / -3 )

Although as of today there is still no cure for cancer, the FDA is helping by pushing these drugmakers, and by approving various treatments.

There is no cure for a whole category of diseases because that makes no sense (as much as not having a single cure for "infection"), but fortunately for many types of cancer there is definitely a cure, and as the article clearly explains this can be reached with less aggressive treatments and this is the current trend.

As mentioned in the references, the focus of the experts in the field now is about letting patients know they have been cured.

Recognising a cancer patient as cured represents an opportunity to improve their quality of life.

3 ( +4 / -1 )

The advances in cancer treatment are, to me, mind boggling. One of my sons in law had stage 4 cancer, and was given a 2% chance of living for five years. He was also offered a new therapy which they said had shown a 30% chance of a beneficial outcome. He took the chance, and now, 7 years later, they cannot detect any cancer in him. I call that amazing.

Both my parents died from cancer, after suffering during the best attempts by medical personnel to help them. Many years later, and my wife was treated for a large tumor in her brain. What was impossible decades ago, is standard today, and my wife is well and fine, or at least enjoying her life.

5 ( +5 / -0 )

 my wife is well and fine, or at least enjoying her life.

Nice. That is a happy thing.

2 ( +3 / -1 )

Whaddya know?

Science works!

2 ( +2 / -0 )

Trends towards announcing that cancer cures exist / almost exist / kind-of-exist surface occasionally, especially at budget time. Mostly because the advances in novel treatment compounds and radiation therapies (e.g. Proton therapy) have been so pronounced. And research for further advances is also pronounced.

Making for some cancers, a possibility of recurrence after a number of years to be low enough so that risk of death becomes similar to that for the general population.

But this can be somewhat misleading for patients and their families.

Your oncologist can help. There are appropriate ways to use the word “cured” in aclinical and communicative setting, that highlights a positive potential impact of the word on patients, while opening an important discussion towards less-than-optimal likely outcomes

Altogether a delicate matter.

If any of this applies to you or a loved one, I wish you all the best for a best possible outcome.

Some resource materials:

Understanding Cancer Prognosis, NIH/NCI, https://www.cancer.gov/about-cancer/diagnosis-staging/prognosis. (June 17, 2019).

Remission, cancer-free, no evidence of disease: What’s the difference? MD Anderson, https://www.mdanderson.org/cancerwise/remission--cancer-free--no-evidence-of-disease--what-is-the-difference-when-talking-about-cancer-treatment-effectiveness-and-results.h00-159460845.html, (May 12, 2021).

Potential for Cure by Stage across the Cancer Spectrum in the United States, February 06 2024, Cancer Epidemiology, Biomarkers & Prevention, https://aacrjournals.org/cebp/article/33/2/206/733924/Potential-for-Cure-by-Stage-across-the-Cancer . (Please note both the Author Disclosures and Acknowledgments sections for conflicts information).

0 ( +0 / -0 )

There is no cure for a whole category of diseases because that makes no sense

If you don't understand the difference between cancer and other diseases--whoaaa boy.

As it stands now, there is no cure for cancer. But there are cures for other diseases--which is still irrelevant to the fact there is no cure for cancer according to the experts over the whole entire world.

-1 ( +1 / -2 )

If you don't understand the difference between cancer and other diseases--whoaaa boy.

Cancer is not a single disease, it a category of diseases, that is why it makes as much sense to think there is a single cure for the whole category as to think the same for others such as infections or deficiencies.

There are many cures for different kinds of cancers, you even commented on an article explicitly talking about one of them already.

-1 ( +0 / -1 )

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