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Pathways to Discovery: Summer 2013

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U.S. Cancer Death Rates Continue to Drop

The latest national statistics show that the overall death rates from the most common cancers are declining steadily. This news is encouraging not only for patients, but also for the doctors and researchers whose careers are devoted to reducing cancer’s devastating effects.

“Cancer death rates have fallen consistently for a decade now, so it’s clearly a trend and not just a blip,” said Michelle M. Le Beau, PhD, Arthur and Marian Edelstein Professor of Medicine and director of the University of Chicago Medicine Comprehensive Cancer Center (UCCCC).

By the Numbers
A report issued by the National Cancer Institute (NCI) stated that from 2000–2009, cancer death rates fell by 1.8% per year among men and 1.4% per year among women. Cancer mortality rates among children also decreased by 1.8% per year. The 5-year relative survival rate for all cancers diagnosed between 2002 and 2008 is 68%, up from 49% in 1975–1977, according to the American Cancer Society. The NCI estimates that there are over 13 million cancer survivors in the U.S. today.

“Cancer is gradually changing from a disease you die from to one you live with,” said Dr. Le Beau.

Improvements in Prevention, Early Diagnosis, and Treatment
The decline in cancer death rates reflects significant progress made over the past few decades in cancer prevention, early diagnosis, and treatment. In some cases, cancer death rates have fallen due to public health measures. For example, cigarette smoking among adults 18 years of age and older decreased by half, from 42% to 21% between 1965 and 2004.

In other cases, death rates have fallen due to scientific research that has translated into improvements in all aspects of cancer care.

Researchers are using systems-level science to analyze the interactions between vast networks of genes, the environment, and other factors in an effort to map the causes of cancer, predict cancer risk, and design personalized prevention and treatment approaches. The UCCCC is applying these strategies to high-risk individuals through its Cancer Risk Clinic. These patients include both cancer survivors with a high risk of recurrence and individuals with a family history or personal genetic profile that make them more susceptible to the disease.

UCCCC experts have made major contributions to screening and diagnosis by discovering new approaches to detection and improving computer technologies that aid radiologists in analyzing images. For example, computer-aided diagnosis, pioneered by Professor of Radiology Maryellen Giger, PhD, is allowing physicians to use enhanced magnetic resonance imaging (MRI) scans, rather than a biopsy, to determine whether a common breast lesion (ductal carcinoma in situ) is invasive.

Studies focused on the molecular underpinnings of cancer have facilitated the development of targeted therapies. For example, crizotinib is a drug that targets the mutated anaplastic lymphoma kinase (ALK) protein. Ravi Salgia, MD, PhD, professor of medicine, was among study authors who found that the drug can halt or reverse the growth of lung tumors in more than half of the patients with the genetic abnormality.

Research has also improved the precision of radiation therapy so that it selectively targets the tumor, without causing damage to surrounding healthy tissue. Everett Vokes, John E. Ultmann Professor of Medicine and Radiation Oncology, and Daniel Haraf, MD, MS, professor of radiation and cellular oncology, and colleagues pioneered a combined chemotherapy and radiation treatment that has improved survival and has become the standard of care for head and neck cancer in the U.S.

Also encouraging is the progress made in pediatric cancer. The 5-year survival rate for all childhood cancers combined has increased from 58 percent in the 1970s to more than 80 percent today. The improved survival rate is due to significant advances in treatment.

Susan L. Cohn, MD, professor of pediatrics, said, “Pediatric cooperative group clinical trials and translational research studies have played an integral role in the development of more effective, less toxic therapies for pediatric cancers.”

Our Best Defense
Despite the progress made in the past several decades, investments in federal funding for cancer research have been on the decline since 2003. Automatic budget cuts created by the sequestration are further endangering life-saving cancer research.

“It’s important to acknowledge the remarkable progress we have made with cancer,” Dr. Le Beau said. “As a nation, we must place a high priority on investing in biomedical research––it is our best defense against cancer.”

Sources: The American Association for Cancer Research Cancer Progress Report 2012, American Cancer Society Facts and Figures 2013, and the NCI Annual Report to the Nation on the Status of Cancer, 1975–2009