The Big "C" — Is Cancer Curable?

Advancement in basic science and medical technology has made cancer a curable disease for many patients. Approximately 40% of Americans will be diagnosed with cancer in their lifetime, but as of 2014, 1 in 22 Americans is a cancer survivor, which equals 14.5 million cancer survivors in the US, explained Joseph C. Alvarnas, MD, director of value-based analytics for the City of Hope.

“We’ve moved from an era where 10 drugs are treating 100 cancers to where 100 drugs may be used to treat what we would traditionally have thought of as 10 cancers,” Alvarnas said. “And over this time, there’s been an extraordinary evolution in our thinking. Our initial naïve belief that there was an inherent simplicity to cancer has actually yielded to a much more sophisticated deep seeded understanding of the inherent complexity of malignant disease and the need to understand this on a very, very deep, molecular level.”

He explained that there are limits to the therapies that currently exist, and to move forward the oncology world needs to more closely examine cancer at the molecular, genomic level. Therapy, Alvarnas said, must be driven by biology because cancer types have grown to all different shapes and sizes. Acute leukemia used to refer to only 1 disease type, but there now exists more than 30 different disease states under this umbrella. The same is true for lymphoma, which now has nearly 65 different disease states.

“In order to treat cancer more effectively, that level of granularity will increase because as you think about the human genomes, there are more than 20,000 genes in the human genome that culminate in 17,000 to roughly 21,000 proteins in the human proteome,” Alvarnas said. “That’s the scope of what we have to explore in order to fully move forward.”

He added that it’s not enough to simply understand these growing varieties of cancer types at the molecular level, but to then leverage this information when it comes to therapeutic decision making.