India’s biggest challenge will be how to make it affordable and accessible for millions of its people when technologies continue to revolutionize cancer care, says expert.
Globalization, growing economy, aging population and changing lifestyle could push India to the threat of a tsunami of chronic diseases such as cancer. This warning was sounded by leading oncologist Dr. Jame Abraham, Chairman, Department of Haematology and Medical Oncology, Cleveland Clinic, Ohio, USA, who said that these factors are making it imperative for the country to embrace technology-driven medical techniques to prevent the health catastrophes in an effective and affordable manner.
Cancer vaccines for prevention and treatment, expansion of Artificial Intelligence & data digital technology, and cancer diagnosis from liquid biopsies are among the six trends that will reshape cancer care in this century, he added.
The other three trends are use of genomic profiling, evolution of gene editing technologies and next generation of immunotherapies and CAR T cell therapies, Dr. Abraham, wrote in the Manorama Year Book for 2023. According to him, digital technology, information technology and telehealth will narrow the gap between patients and specialists. This will also potentially enhance the availability of experts’ care in remote parts of our country, including rural setting where majority of our population lives, he added.
India’s biggest challenge will be how to make it affordable and accessible for millions of its people when these technologies continue to revolutionize cancer care, Dr Abraham added.
Cancer burden seen rising worldwide
As per the Globocan estimates, the cancer burden worldwide is expected to be 28.4 million cases in 2040, a 47% rise from 2020, due to demographic changes. This may escalate by increasing risk factors associated with globalization and a growing economy.
An estimated 19.3 million new cancer cases and almost 10.0 million cancer deaths occurred across the world in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer while lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers, reveals the report.
Dr Abraham said that cancer vaccines are an exciting research area having the potential to immunize people against various cancers. Researchers have developed amazingly successful mRNA COVID-19 vaccines. The fact is mRNA-based cancer treatment vaccines have been tested in small trials for more than a decade, with some promising early results.
Highlighting the role of cutting-edge technologies, he says computers using Artificial Intelligence (AI) can recognize variations in pattern from normal to abnormal in the biopsy, much more accurate than the human eye. These technologies will demand radiologists and pathologists to be more efficient and accurate.
Genetic profiling or testing at an early age to detect the abnormal gene can find breast and colon cancers in their earliest stage. “In a futuristic society, genomic testing will be widely used, like monitoring blood pressure or cholesterol, to identify high risks and find targeted treatments to kill cancer cells specifically. By doing testing in the population or high-risk individuals will allow doctors to intervene before the cancer happens,” he said.
Treatment needs to be very aggressive
Noting that scans, mammograms, colonoscopy or a pap smear are currently used for cancer diagnosis, Dr Abraham says by the time the tumor is detected, it can be too late. “Hence, the treatment needs to be very aggressive. The emerging liquid biopsy technologies will help detect cancer from a drop of blood, before it can be detected by a scan or it manifests as a lump or an ulceration.”
Genome or gene editing is an area of research seeking to modify genes of living organisms and use it to treat genetic or acquired diseases. Gene therapy holds promise for treating cancer, cystic fibrosis, heart disease, diabetes, hemophilia, sickle cell disease, and AIDS.
Another trend in cancer treatment is of immunotherapies, which, in combination with chemotherapy, have resulted in complete disappearance of tumor in several cases. It is now a standard treatment currently in many parts of the world. Scientists are also using CAR T cell therapy, in which T cells are isolated from a patient’s blood and modified in the laboratory to specifically attack cancer cells.
Dr. Abraham cautioned that when novel technologies are developed to prevent and treat cancer, the focus on cancer prevention cannot be ignored. Most common causes of cancers are still tobacco, alcohol, diet and infections. Policies for tobacco and alcohol control have to be a national priority, he added.