Thanks to advances over recent years in both prevention and quality of life, and above all in scientific and technological knowledge, more than half of cancers are now cured, while many patients live for longer and with a good quality of life.
Yuval Noah Harari1 suggests that this century Homo sapiens could once again double the life expectancy of the species, and even overcome death at some unspecified point in the future. A less bold assertion would be to claim that we are witnessing the beginning of the end of cancer.
Advances over recent years in terms of prevention, lifestyle, nutrition, early diagnosis, the precision of diagnostic equipment, our understanding of the genome, molecular biology, improved understanding and surgical techniques, chemotherapy first followed by immuno-
therapy, biological medication, pharmaco-genomics, and more recently what is known as personalized or precision medicine, have offered substantial advances resulting in more than 50% of cancers being cured, while many patients live longer with a good quality life, and will often now die with cancer, but not because of cancer.
Precision medicine2-3 is a treatment that focuses on disrupting the changes that occur in cancer cells. Understanding how the cells grow and divide, and how they spread, means we can identify specific treatment targets for each patient and type of tumour, both at the time of diagnosis and during its subsequent evolution.
Over the following pages we set out two examples of how two common groups of tumour are tackled: breast cancer and lung cancer. These are tumours for which the tools available allow for the focused treatment referred to above, which is now available for those patients entrusting their care to our institutions and professionals.
Nonetheless, the price of these new treatments may limit access by all patients who need them, and even give rise to serious conflicts of interest, in which professionals place their interests ahead of patients’ needs4, as has been reported frequently in media coverage of cases that have provoked scandals. In any event, over the coming years we will see first the control of, and later victory over, the group of diseases that we generically refer to as cancer.