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Last Updated: Wednesday, 9 February, 2005, 11:27 GMT
When will we beat cancer?
By Tom Geoghegan
BBC News Magazine

Cancer graphic
The death from cancer of BBC journalist Ivan Noble at 37 showed there's still a long way to go in treating the disease. But there have been huge strides in the last 10 years, and experts predict more good news.

One in three of us will get cancer at some point in our lives, according to Cancer Research UK.

No other disease grips us with the same fear and some people feel defeated by it as soon as they are diagnosed.

But should they? There has been great progress made in prevention and treatment, with further developments in the pipeline offering glimpses of hope.

For a start, stopping some cancers from happening in the first place is now more likely.

"The 'cause' of cancer is actually very complex," says Mark Matfield, a scientific consultant at the Association of International Cancer Research, based in Fife.

Dr Mark Matfield
For some cancers, like childhood leukaemia, we are virtually at a cure today
Mark Matfield
Association of International Cancer Research

There are several factors in the cause "and they are the result of interactions between our heredity - our personal genetics - and the environment we live in, such as sunlight, chemicals, diet and viruses.

"Even when we clearly identify preventable causes of cancer like smoking and obesity, there is a whole separate battle to persuade people to change their lifestyle to eliminate them."

Tobacco was identified as causing cancers in the 1950s, which led to a public health campaign that is growing more prominent by the year.

The number of smokers and lung cancer sufferers has subsequently fallen but the message on obesity, which can cause bowel cancer and post-menopausal breast cancer, has been less productive.

'A third cured'

Treatment has had huge leaps forward. Fifty years ago, surgery was the only weapon but now there is radiotherapy and drugs.

"Although we only really cure about one third of cancers, in about another third, we have been able to significantly prolong the length and quality of patients' lives," says Dr Matfield.

The rate of progress will continue to accelerate, he believes, and although cancer will always be life-threatening, we may be able to defeat that threat in most cancers in 30 to 50 years.

Such advances have saved the lives of many and given hope to the people such as two-year-old Albie Haynes and her family.

Albie, centre, with family PIC: CANCER RESEARCH UK
The Haynes family have Albie home PIC: CANCER RESEARCH UK
In 2003, the toddler was diagnosed with cancer in her uterus, which then spread to her kidneys and formed a 22cm tumour.

Years ago, she probably would not have survived much longer, but intense chemotherapy has helped her walk and she's now back with the family in Kent, at the start of a long road to recovery.

"We are just thankful she is at home with us," says her mother Lesley.

In other areas, new drugs such as Tamoxifen are benefiting breast cancer sufferers and earlier diagnosis of many cancers has increased survival rates.

And child leukaemia is "virtually at a cure", according to Dr Matfield, with survival rates up to 90% thanks to chemotherapy used in combination with bone marrow transplants.

MOST COMMON CANCERS
Breast
Lung
Large bowel
Prostate
Bladder

Source: Cancer Research UK
Genetic technology has improved cancer research fundamentally and could yet revolutionise it, but Dr Matfield says the suggestion that humans could one day be implanted with a chip to detect mutating gene cells was "fanciful".

A huge stride in eliminating the side effects of radiotherapy is on the way too, says Richard Sullivan, head of clinical programmes at Cancer Research UK.

"Radiotherapy is a relatively blunt tool and in the last five years we've started to do something quite unique - killing the cancer without damaging other tissues, a sort of painting by numbers using computer power."

But it is not all good news. Treatment has not been as effective as hoped in lung and brain cancers, because they resist it or tend to be detected at an advanced stage.

Controlling cancer

Lung cancer is very difficult to study because when it is removed, it falls apart or is attached to healthy tissue, says Dr Sullivan, and brain cancer is complicated by its unique siting.

Radiation
Radiation will soon be able to isolate the cancer cells
The progress with vaccines has also been slow, although there is a reasonable prospect of a working vaccine for cervical cancer.

Perhaps we need to change our mindset from always looking for "a cure" to getting the cancer under control, says Ian Davis, an oncologist at the Ludwig Institute for Cancer Research.

"We always used to measure success or failure by how much we could make the cancer shrink or go away, but sometimes it just sits there and if it does that and behaves itself then it might be the next best thing. It won't kill you but it's a chronic illness you can live with."

Hence treatments under trial are aimed at slowing down the rate at which cancer cells divide, rather than killing them.

Mr Davis also sees psychological fillip from these medical advances, believing that patients who think positively are better able to recover.

"There are reasons for optimism, it's a very exciting time and we are making progress. We wish it could be faster but we're moving forward."


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