Tech advances in cancer treatment

CANCER is a dreaded disease and the search for a “cure-all” continues to this day. Fortunately, there are treatments that have a good chance of “curing” certain types of cancer and new developments in cancer therapy is providing a fresh lifeline to suffering patients from all walks of life.

Last July 30, the latest advances in cancer treatment and care was the subject of a virtual regional press briefing “Understanding Cancer Advances in Treatment and Care,” hosted by Singapore-based Parkway Cancer Center (PCC). The virtual presser seeks to provide a firm understanding of cancer and its treatment modalities so patients and their loved ones could have a better appreciation of how to deal with the once “incurable” deadly affliction.

New frontiers in therapy

At the outset of the virtual presser, Dr. Ang Peng Tiam, medical director and senior consultant, Medical Oncology, PCC, told the audience that cancer treatment depends on a lot of factors like the type of cancer, where it is and how advanced it is, and that there is no one-size-fits-all therapy.

“Every cancer patient is different with a different cancer in a different site with a different genetics and spread. In which case, we apply patient-centric care,” Tiam said.

“With doctors and experts working together as professionals, treatment is no longer a one-man new show,” he added. “As such, new options and concepts in attacking cancer have come to light. Many doors and windows of opportunity that were once closed have been opened offering new hope to individual cancer patients where there was previously no hope at all.”

Tiam pointed out that multidisciplinary care and sub-specialization in oncology is one of the milestone changes in cancer treatment over the last 30 years. Others include technological advances in radiological intervention, advances in pathology through immunochemistry and genetic profiling, and newer options for treatment of local disease.

Advances in diagnostics

The diagnosis of cancer is a critical part of cancer prevention, treatment and care. Proper screening of cancer in its earlier stages enables the health care provider to offer initial interventions, reduce unnecessary expenses, or ineffective treatments and plan for personalized treatments.

Tiam said plain X-rays, CT scan and magnetic resonance imaging are still the first line of diagnostic evaluation. He also explained that the new trend in precision oncology has given rise to further developments in cancer diagnostics.

There’s a diagnostic evaluation through positron emission tomography in which a tiny amount of sugar tied to a radioactive substance is injected into the patient. The sugar then would go to where the cancer is and help the doctors to identify the type of cancer.

Another new development is radiofrequency ablation, an invention by a radiologist where high frequency ultrasound waves are generated to create heat that burns and kills the cancer without the necessity of the patient undergoing surgery.

Tiam also said that there is ongoing research leading to the development of many therapeutic agents, including cytotoxics, hormonal therapy, targeted agents, monoclonal antibodies and immunotherapy that would guide doctors on the best treatment that achieves positive results for cancer patients.

Cellular therapy

Cellular therapy is used to treat cancer in the blood. It uses blood cells in the body to hunt and kill infected cells to control the growth and spread of cancerous cells.

Dr. Colin Phipps Diong, senior consultant, Hematology, PCC explained, “CAR T-cell therapy is a type of cancer treatment in which a patient’s T cells, a type of immune cell, are changed in the laboratory so they would bind to cancer cells and kill them. Cellular therapy is all about harnessing the power of the T-Cell which could kill infected cells by themselves. Its use has advanced further and is approved in many parts of the world in contrast to tumor infiltrating therapies.”

Diong cautioned, however, that CAR T-cell therapy is not for everyone. He advised, “CAR T-cell therapy is only approved for B-cell lymphoblastic leukemia and diffuse large B-cell lymphoma, and not even for all cases. First line therapy is still chemotherapy and immunotherapy although CAR Tcells also come in where patients have become chemo-resistant.”

Proton therapy

This is cutting-edge cancer therapy that extends the capabilities of the radiation machine. Proton therapy uses the high-powered energy of protons (e.g., the positively charged companion of the electron in an atom) to treat cancer and cancerous tumors. It is precise, targeted and specific so the location of the tumor is a primary consideration on top of other factors.

It is said that 50 percent of all PCC’s cancer patients have received some kind of radiation therapy in their journey. Because radiation medicine is a common modality to treat cancer. It is not surprising that some are worried about its likely side effects of proton therapy such as possible adverse impacts on healthy cells.

Dr. Ivan Tham, senior consultant, Radiation Oncology, PCC, emphasized, “Radiation therapy like proton therapy could be used to treat many cancers in the body, but it is important to consult first and make sure that the therapy meets the needs of the patient. Proton therapy could be a powerful tool to deposit dose precisely where it is needed. As far as side effects are concerned, they would also depend on the radiation dose and the age of the patient.”

Tham also said proton therapy is not recommended for all cancer cases. Patients who are eligible to access proton therapy either have large tumors or deep tumors as in the case of a brain tumor. On the other hand, this therapy may not be a better option to chemo in cases of cervical cancer, brachytherapy and skin cancer.

The future

During the regional media briefing, the resource persons were one in delineating the shape of things to come in advanced cancer treatment and care. It’s precision in oncology where doctors are able to profile the molecular genetics of the tumor and identify actionable mutations to be able to provide personalized treatment and care to cancer patients.