Cancer Care Advances in 2007 Offer Hope

TUESDAY, Dec. 18 (HealthDay News) -- Advances in breast cancerscreening and new treatments for liver, kidney, head and neck and lungcancers are among this year's most important breakthroughs in cancer care,the American Society of Clinical Oncology says in a new report.
However, while treatment is improving the lives of many cancerpatients, flat federal funding for research and clinical trials threatensto stall future progress, the report added.
"Overall, this is a very hopeful picture," said Dr. Julie Gralow,director of breast medical oncology at the University of Washington Schoolof Medicine and Fred Hutchinson Cancer Research Center in Seattle, and anexecutive editor of the report. "We have made advances and there is hopethat we will make more advances as we enter this new molecular-targetedtreatment era."
But, Gralow added, funding for cancer research has reached a criticalpoint.
"The only way we get new drugs approved, the only way we can studywhat's better or worse for patients is to do clinical trials," she said."But where we have really struggled in the past seven years is inreductions in federal money for clinical trials."
Among gains cited by the ASCO report, titled Clinical CancerAdvances 2007: Major Research Advances in Cancer Treatment, Prevention,and Screening, is the first systemic treatment for liver cancer. Alarge study found that patients who took the targeted therapy sorafenib(Nexavar) for advanced liver cancer lived about 44 percent longer,compared with patients who didn't get the therapy. This is the firsteffective non-surgical treatment for liver cancer, the report said.
In a similar vein, treating kidney cancer with bevacizumab (Avastin)along with standard treatment nearly doubled patients' progression-freesurvival.
The report also noted that this year, based on findings from severalstudies, new guidelines recommend for the first time that MRIs can beeffective in screening the 1.4 million U.S. women at high risk for breastcancer. MRIs are still not yet recommended for most women as a breastcancer screening tool, the report added.
Other important news: Two studies this year confirmed that thesignificant drop in breast cancer rates is linked to fewer menopausalwomen taking hormone replacement therapy, following the 2002 Women'sHealth Initiative finding that uncovered the connection.
"It's quite clear in breast cancer that we have had steady reductionsin deaths due to breast cancer over the last decade," Gralow said. "Wehave metastatic patients living longer."
Also, two studies this year showed that the human papillomavirus (HPV),the virus present in almost all cervical cancers, may play a role in headand neck cancers. HPV was found in 72 percent of several types of head andneck cancers and, interestingly, the presence of the virus was linked tobetter treatment results.
These findings suggest that the new HPV vaccine, which is recommendedfor 11- and 12-year-old girls to prevent cervical cancer, may prevent headand neck cancers, but more research is needed, the report said.
Also, for the first time, researchers found that "whole brain"radiation therapy, given to patients with advanced small cell lung cancer,reduces the risk of the cancer spreading to the brain by about two-thirds.This treatment was able to double the one-year survival rate, according tothe report.
But the report's editors expressed concern that budgets for the U.S.National Institutes of Health and the U.S. National Cancer Institute havenot changed in four years. This is the longest period of flat funding forcancer research in U.S. history, the report said.
To address this problem, ASCO is calling for substantial increases ingovernment funding that, at a minimum, would keep pace with inflation inmedical care.
"This has really been a decrease in funding, which has had an impact onthe number of clinical trials and the number of patients enrolling intrials," Gralow said. "It's really a wrong message."
The report also calls for public and private insurers to cover thecosts of patients in clinical trails. Some insurers don't cover clinicaltrials because they are classified as "experimental." But some states havepassed legislation or have agreements that require health plans to pay forroutine medical care for patients in clinical trials. The report urgesmore states to do the same, and for Medicare to continue to coverpatients' costs in clinical trials.
Dr. Otis Brawley, chief medical officer at the American Cancer Society,applauds the progress in the fight against cancer, but adds that muchremains to be done.
"These are important advances," Brawley said, citing those gainscontained in the ASCO report. "But, I admit when I say that, it's a shamein many of those diseases we are talking about prolonging people's livesby months, sometimes weeks. We shouldn't rest on our laurels. We stillneed to do a lot of work."
Brawley agrees that more money is needed for research. The flatNational Institutes of Health budget "is negatively affecting our effortsto try to do better than improving survival by two or three months," hesaid. "Progress is slower than it could be. You delay findingssubstantially by not making the investment in clinical trials."