Science and technology against cancer: eight trends

As life expectancy rises and medical technology advances, the number of cancer cases is increasing. At the same time, mortality is decreasing due to new methods of diagnosis and treatment.

On February 4, 2000, at the World Summit on Cancer in the New Millennium, the Charter of Paris was signed to promote research, prevent cancer, improve treatment conditions and raise awareness. Since then, 4 February has been celebrated annually as World Cancer Day.

Trends, together with Yandex’s social program Help is Nearby, and oncology experts, talk about how new methods of diagnosing and treating cancer help to cope with the increase in the number of cancers.

The International Agency for Research on Cancer (IARC) estimates that one in five people in the world will develop cancer during their lifetime. Every eighth man and every eleventh woman dies of cancer. The UK National Health Service (NHS) is also pessimistic that one in two people will develop some form of cancer in their lifetime.

According to the World Health Organization GLOBOCAN 2020 database and The Lancet Oncology for the last 20 years (from 2000 to 2020):

  • the number of new cancer cases doubled from 10,1 million to 19,3 million;
  • The number of cancer patients living with cancer within five years of being diagnosed has also doubled, from 22 million to 50,6 million.

Why is the incidence of cancer on the rise?

The key reasons for the increase in the number of diagnosed cases are the improvement of early diagnosis and the aging of the population.

Age is the highest risk factor for most types of cancer. According to the US National Cancer Institute (NCI), the average age of patients at the time of cancer diagnosis is 66 years. 60% of cancer patients are 65 years of age or older.

The second reason for the growth is the ability of healthcare institutions to conduct effective cancer control activities – to identify patients in a stream. Cancer diagnosis is rapidly improving. Since about 2007, national screening and education programs have been launched in many countries.

The third reason is the environment in which people live and habits. The International Agency for Research on Cancer indicates a marked increase in cancer risk factors in developed countries, including Russia:

  • smoking;
  • unhealthy diet;
  • overweight;
  • lack of physical activity.

The burden on the healthcare system

An increase in the number of cancers means an increase in the demand for treatment. Given the high cost and duration of therapy for cancer, this significantly stimulates the development of drugs. According to a study by Knowledge Sourcing Intelligence, the global market for oncology drugs in 2019 was $200 billion. spending on health care will contribute to the growth of key players in the pharmaceutical market and cancer centers around the world.

According to a report by the Organization for Economic Co-operation and Development (OECD), the health and social care system of its member countries already employs more workers than at any time in history – about one in ten jobs is in health or social care. Charitable foundations are helping to cope with the growing burden on the healthcare system. For example, according to a study by the Need Help Foundation, in 2020 our country began to donate more to charitable organizations via the Internet, and this trend has continued for several years.

Maksim Kotov, Oncologist, Head and Neck Tumor Surgical Department, N.N. N.N. Petrova (St. Petersburg), spoke about the main trends in cancer treatment today:

1. Immunotherapy

Cancer immunotherapy is an artificial stimulation of the immune system. The immune system of white blood cells and the organs and tissues of the lymphatic system helps your body fight cancer naturally.

In 2013, the journal Science named immunotherapy for cancer treatment as a major scientific breakthrough. In this area, active scientific research and the expansion of the clinical use of immunooncological drugs, primarily immune checkpoint inhibitors, continue. In 2020, the US Food and Drug Administration (FDA) approved a number of new drugs for immunotherapy for certain types of cancer (pembrolizumab, atezolilumab, avelumab).

2. CAR-T therapy

The method of CAR-T cell therapy involves the introduction of the patient’s own T-lymphocytes with an attached chimeric receptor to recognize tumor cells. The American Society of Clinical Oncology (ASCO) has named CAR-T Cell Therapy as a major achievement of 2018.

Research into CAR-T therapy and the expansion of its use in clinical practice are ongoing. The US Food and Drug Administration (FDA) has approved CAR-T therapy for the treatment of mantle cell lymphoma.

3. Cancer prevention

In 2020, the FDA approved the human papillomavirus vaccine Gardasil for the prevention of human papillomavirus-associated head and neck cancer. Previously, the vaccine was approved only for the prevention of cervical cancer.

Another direction of prevention is the individualization of treatment based on the data of a genetic study – next generation sequencing (NGS). First of all, the identification of mutant variants of signaling pathway chains to improve the effectiveness of treatment. The FDA has already approved a number of drugs that target specific molecular genetic variants of cancer.

4. Oncoconsilium or tumor-board

Alexander Natroshvili, Head of the Extrabudgetary Department, University Clinical Hospital No. 4, Associate Professor, Department of Faculty Surgery No. 2, Sechenov University spoke about another trend:

Strategically, the most significant trend in recent years is the oncoconcilium (or tumor-board), which has already become routine, at which the most experienced surgeons, together with chemotherapy and radiation therapists, determine the optimal option and sequence of stages of treatment for a particular patient in accordance with modern international algorithms and protocols. .

5. Machine learning for cancer diagnosis

Another trend in cancer diagnosis is the use of machine learning algorithms. Developers “train” algorithms on arrays of images, teaching them to recognize anomalies associated with cancer and to distinguish from benign results. Over the past few years, many studies have been published confirming that machine learning-based analytics algorithms can improve the interpretation of screening mammograms and CT scans of the lungs.

For example, the Botkin.AI platform is the first software in our country using artificial intelligence technologies for analyzing medical images. The platform was developed by the Russian company Intellogic and is fully used in medical institutions of the Yamalo-Nenets Autonomous Okrug and the Chelyabinsk region for diagnostics, as well as by the Moscow Health Department for research work.

Polina Pilyus, radiologist, medical consultant at Intellogic:

Botkin.AI quickly provides information about the presence of malignant neoplasms of the lungs on chest CT. The radiologist does not need knowledge of AI, the doctor receives the results of the AI ​​analysis in an understandable format for him according to the standard parameters that are used when describing the conclusions of the studies. The difficulty of using Botkin.AI is that the program has its own interface, and the specialist must first spend some time learning. Also, AI analysis is limited to specific pathologies and does not provide information about the presence of other diseases.

6. Patient support and information projects

Cancer patients are at high risk and during the pandemic were forced to limit their social activities more than ordinary people. The problem was especially acute for those who just found out about their diagnosis – this is not only stress, but also the need to decide on a treatment plan. Therefore, online educational projects and online communities of mutual support have become more relevant than ever.

Alexander Natroshvili:

The main problem with medical groups in social networks and instant messengers is to separate the “wheat from the chaff”. A lot of false information and outright charlatanism. It is very difficult for a patient to understand, especially when he has just learned about the diagnosis and is in a state of stress. In order to prevent all sorts of “specialists” recommending dubious methods of “treatment” from leaking into the group, high-quality moderation and constant participation in discussions of doctors of a truly expert level are needed. My priority is two Facebook groups – “Find your doctor” (there is a subgroup “Oncology”) and “Cancer is curable.” I have been reading for more than a year, participating in discussions in both, and I can recommend them with a clear conscience.

7. Early diagnosis

Screening can help doctors detect and treat several types of cancer early, before they cause symptoms.

Checking for cancer (or abnormal cells that could become cancer) in people who don’t have symptoms is called screening.

According to the US National Cancer Institute, screening tests can not only be beneficial, but also lead to early diagnosis. That is, a screening test shows that a person has a tumor, but this tumor would not harm the person. The treatment of such cancer is called overtreatment.

For example, a new study by researchers at the International Agency for Research on Cancer (IARC) analyzed thyroid cancer rates in children and adolescents aged 0-19 from 49 countries. Salvatore Vaccarella, IARC scientist and lead author of the study, explains that in recent years, the incidence has increased rapidly in many countries, and early diagnosis is likely the main reason for this increase. Increased surveillance of the thyroid gland and the introduction of ultrasound has led to the discovery of indolent non-lethal tumors that exist in the thyroid gland in healthy people of all ages, including children and adolescents.

The problem of early diagnosis is relevant for different types of neoplasms. Today, overtreatment is being avoided by recommending screening based on statistics. For example, it is recommended to be screened only from a certain age. However, this approach is not the optimal solution, and the problem of overtreatment points to the potential for advances in diagnostic methods.

8. Reduced mortality

Despite the dynamics of the growth of oncological diseases, the development of technology and the constant decrease in the death rate from cancer around the world indicate that the chances of not dying from cancer are increasing every year:

  • USA: 29% decrease in mortality (2,9 million lives saved) over the past 30 years;
  • UK: Decrease in mortality by half in 40 years.

oncologists are also talking about significant improvements in cancer treatment.

Alexander Natroshvili:

In recent years, major changes have taken place in the system of oncological care in the Russian Federation. I can say without exaggeration that a number of clinics work in accordance with the latest international standards for the diagnosis and treatment of oncological diseases. Modern equipment and, most importantly, brilliant specialists provide a high level of care for patients with cancer. If we talk about the surgical stage, there are many world-class oncosurgeons in the country.

charitable foundations helping cancer patients

Funds participating in the Help Nearby project:

On February 4, 2021, on World Cancer Day, the Nastenka, Dobry Dom and the Leukemia Foundation joined the Help Nearby program, in which the AdVita and Zhivoy funds already participate.

To help these and other funds, it is enough to enable the “Rounding” option in Yandex Go. It works like this: the cost of the trip is automatically rounded up to a multiple of ten, for example, 191 rubles – up to 200, 234 rubles – up to 240. The difference goes to pay for trips for wards of charitable foundations who need help with movement. You can also make a donation on the Help Nearby website.

  • “Alive” is a fund to help seriously ill adults aged 18 to 60 years. In addition to raising funds for treatment, the foundation is engaged in systemic projects, for example, translating guidelines for oncological diseases.
  • AdVita – helps patients with oncological, immunological and hematological diseases. The Fund pays for treatment, provides household, social, informational support.
  • Leukemia Foundation – helps adult patients with oncological diseases of the blood system.
  • “Nastenka” is a fund for helping children with cancer and other serious diseases. The foundation also helps families of patients and hospitals.
  • Dobry Dom, a social hotel for children with cancer, provides free housing for children who come to Moscow for treatment.

Information, support and educational projects

  • Just Ask is a free reference for people with cancer. You can apply from any region and in any situation. Qualified experts will answer questions within a few days.
  • Profilaktika Media is an educational project of the Not in Vain Foundation about evidence-based medicine and oncology. Launched in 2018. The materials on the site are intended for cancer patients and their loved ones.
  • Clear Morning is a hotline for cancer patients. Free and around the clock you can get the help of a psychologist and a lawyer in medical law.

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