ONCOLOGY
Dr Nick Plowman Clinical Oncologist
AT THE FOREFRONT OF ADVANCES IN CANCER TREATMENT Everyone knows there have been advances in cancer, but most people are unaware of the truth behind the discoveries of recent years, from which cancer sufferers will benefit. Exceedingly few know the optimal order of various treatment options that are best for individual people. Indeed not all experts agree themselves! The baseline shifts. What is clear is that there are now more cancer treatment options, and that all-important cancer prevention programmes are no longer confined to cervical screening, faecal blood testing and mammography, but are often based on genetic predisposition and ‘high-risk screening’ individuals (for example, low-dose CT on the lungs of heavy smokers) and even blood testing for circulating ‘cell-free’ mutated DNA fragments – a signature of cancer.
For established cancer, the staging of the disease is paramount. Not only do we now have advanced anatomic imaging (notably CT/MR), but also functional imaging, notably PET scanning (often more sensitive for diagnosing the extent of the cancer) and where the individual characteristics of particular cancers can be used for specificity (a good example being PSMA-PET scanning for prostate cancer). In cancers that grow slowly over time and spread to distant sites (‘metastasise’) later in their natural history (eg cancers of the head and neck, such as larynx, mouth, pharynx), regional treatment for early cases – predominantly surgery and radiotherapy – is attended by high cure rates. Advances in surgery usually hit the press, but advances in radiotherapy are often overlooked. The introduction of charged particle beam radiotherapy ▸
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