Future Of Cancer Treatment: Using Technology To Find Care
Cancer is a group of diseases characterised by abnormal and uncontrolled growth of cells which has potential to invade and destroy surrounding normal tissues and spread to other parts of body through lymphatic system or blood. It can affect any part of body.
Cancer incidence is on rise across the world in all geographies and ethnicities. According to WHO, cancer is one of the leading causes of death worldwide, accounting for nearly 10 million deaths in 2020.
A lot has changed in last few decades in cancer research and treatment. Besides achieving higher cure rate, focus is now on the better quality of life with less side effects of treatment. Many cancers can be cures if detected early and treated effectively.
Use of technology in cancer cure can be seen in many different ways. It can be better understanding of tumour biology, better cancer specific imaging, targeted therapy and immunotherapy, minimal access surgeries for appropriate indications, highly conformal Radiation treatments, tumour treating fields (TTF).
Cancer Biology or more specifically molecular biology can be key to identify the exact mutation that has caused cancer and gives us potential to correct it at that level. Biologists are now working on how to break down these molecules and rebuild them using gene editing tools.
The noble prize in chemistry in 2020 has been awarded to Emmanuelle Charpentier and Jennifer Doudna for gene editing tool. Next generation sequencing can identify these mutation and many targeted therapies are now available for that particular actionable mutation. Based on certain characteristics of the tumour now cancer vaccines or immunotherapy can potentially change the cancer treatment. These kind of treatments enhances immunity to fight the cancer cells.
Cancer specific imaging which includes PET CT, PET MRI, with cancer type specific Radioactive ligands can help to locate the cancerous tissues inside the body which otherwise would have missed in routine imaging. MRI spectroscopy and perfusion imaging does the same job for brain and few other organ systems. this helps in accurate staging and response assessment for particular treatment and guides cancer clinicians in taking decisions in various aspects of treatment.
Radiation therapy for cancer make use of high energy ionising radiation directed towards cancer cell which in turn damage the cancer cell DNA. This is probably the treatment which has evolved with time by many folds. The present generations of Linear Accelerators are capable of delivering highly conformal Radiation with Cone Beam CT image guidance to accurately locate the tumour. Small tumours or limited metastasis can be effectively ablated by high dose of Radiation in few fractions. These treatment protocols are rapidly evolving and hold promising future as they have less side effects and short treatment time.
MR-LINAC is a new Radiation delivery system which makes use of MRI for better tumour localisation. CyberKnife is Robotic Radiation therapy delivery system which uses real time tumour tracking using various algorithms. FLASH is a new concept under development which delivers radiation extremely fast at ultrahigh dose.
TTF or tumour treating fields are mild alternating electrical fields that are placed around the tumour. the TTFs are applied using FDA approved transducer arrays Orthogonally placed around the tumour area. The precise mechanism at molecular level is not fully understood yet however preclinical studies shows disruption of cell division leading to cancer cell death. Its approved for treatment of high grade brain tumour and various trials and going on for other cancers.
The future of cancer treatment using technology is promising. Use of personalised and precision medicine with better understanding of tumour biology and cutting edge technology in all other treatment modalities working in synchrony promises pain free cancer treatment journey with high cure rates.
