The future of cancer treatment
We speak to a Mediclinic oncology surgeon and an oncologist about the future of breast cancer treatments.
Most early breast cancers will not benefit from chemotherapy according to Dr Ettienne Myburgh, an oncology surgeon at Panorama Mediclinic. The treatment itself has a risk of about 2-3% of life-threatening complications, whether during treatment or even years after. ‘In essence, if we know that someone is not going to benefit from chemo, we shouldn’t be exposing them to it,’ he says.
Dr Myburgh says that with the accumulation of cancer data internationally, oncologists are able to personalise the treatment of each individual patient. ‘I think the ideal is really to move away from standard guidelines of how to treat breast cancer towards treatment that is specifically appropriate for the patient sitting in front of us – personalised medicine.
‘It’s not just a matter of saying we’ll have chemo or not, or we’ll have radiation or not – it’s also saying what exact type of chemo or what exact type of radiation that patient should have,’ he adds. Learn more here.
Dr Omondi Ogude, a medical oncologist at Sandton Oncology Centre, also believes that in the next 10 years genetics is the way forward, but he adds a focus on the immune system.
‘We’ve moved from trying to actively destroy the cancer to looking at how we can get the immune system to do this,’ Dr Ogude explains. ‘We know that a lot of patients who develop cancers of any form often have abnormalities in their immune system, where it doesn’t actually recognise abnormal cancer cells.’
He adds that cancer cells are quite intelligent and are able to disguise themselves from the immune system. ‘Advances would mean therapy where the immune system is activated so it can fight these cells,’ he says.
In the next 10 to 12 years, Dr Ogude predicts a greater shift in focus from examining cancer on an anatomical level (breast cancer is only called ‘breast’ cancer when that is where the cancer originates) to a purely genetic level. ‘There are about 80 different mutations that drive a genetic risk for cancer, all of which can combine in their different permutations to result in cancer,’ he says.
Dr Myburgh agrees. ‘In the next 10 years, we will probably see personalised medicine and gene therapy coming onto the market, and chemotherapy would only be used very sparingly for breast cancer in very specific situations,’ he says.
He hopes that gene therapy – which is currently being developed – will be able to fix defective genes in people, thereby preventing the development of cancer. ‘In existing cancers we might be able to fix the genes in the cancer itself, causing the cancer cells to either die or revert back to normal tissue. That is the dream,’ concludes Dr Myburgh.