{"id":28152,"date":"2022-06-14T08:09:15","date_gmt":"2022-06-14T08:09:15","guid":{"rendered":"https:\/\/news.cancerresearchuk.org\/?p=24347"},"modified":"2024-11-03T15:13:37","modified_gmt":"2024-11-03T15:13:37","slug":"why-havent-we-cured-cancer-that-cancer-conversation","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/why-havent-we-cured-cancer-that-cancer-conversation\/","title":{"rendered":"Why haven\u2019t we cured cancer? \u2013 That Cancer Conversation"},"content":{"rendered":"
<\/div>\n

Lilly Matson  <\/strong><\/p>\n

Hi, and welcome to That Cancer Conversation. The podcast from Cancer Research UK that brings together the science and the stories behind cancer with me Lilly Matson. So here at CRUK, we don\u2019t want to shy away from the big questions. And this latest episode is definitely looking at a hard one. Why haven\u2019t we cured cancer? Now, this is something we get asked a lot. And to be totally, totally honest, there is no simple answer. So, to help us explore this idea of cure, and why at times, it can feel like quite a far off concept. We\u2019ve spoken to three wonderful experts. But before we get into the real nitty gritty, I think we should rewind the clock and look way way back.<\/p>\n

Alanna  <\/strong><\/p>\n

The earliest cancers I think we found in humans in ancient Egyptian mummies, so it really puts paid to the idea that cancer is a disease that comes along with industrialization, which a lot of people seem to have. And people have been identifying tumours for almost as long as they\u2019ve been practising medicine.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

You\u2019re listening to Dr. Alanna Skuse, a lecturer in English Literature at the University of Reading. Her work focuses on medical history, particularly how people thought about medicine and the body in the Renaissance and early modern periods. And when it comes to cancer, there\u2019s a lot of history to explore.<\/p>\n

Alanna  <\/strong><\/p>\n

Unfortunately, quite a lot of what we might otherwise know about cancer in the ancient world has been lost because in the ancient world, really the pioneers in medicine were all in the Middle East, and a lot of their records have been lost with burnings of the great library of Alexandria, which had a lot of their texts in.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

Some cases of cancer have actually been found in dinosaurs. But if we\u2019re talking about a human history, then the first identification of cancer as the word cancer comes from the ancient Greeks.<\/p>\n

Alanna  <\/strong><\/p>\n

So they use the term karkinos which translates in Latin to canker or cancer to describe a particular kind of tumour. And the word karkinos means crab, and they use the word for this kind of tumour because like a crab, the body of the tumour, they said is round and red, like the body of the crab, and then it has veins leading off of it, which are darkened, and they looked like the legs of the crab. And it was also like a crab, in that it grabbed hold of people really tightly and it wouldn\u2019t let go. So, in the Renaissance, the physician Alexander Reed said of cancer that \u2018whatsoever it claspeth with the claws it holdeth it firmly, so that it seems to be nailed to the part\u2019. That\u2019s very characteristic of how people talk about cancer.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

Right. So here, you\u2019re talking about texts from over 2000 years ago. But did these accounts differ from how we think about cancer now.<\/p>\n

Alanna  <\/strong><\/p>\n

So by the time of Hippocrates, which is about 400 BC, cancer is already quite well known. And ancient physicians knew that cancers could spread. Unlike other kinds of tumours, that\u2019s the big thing that differentiates them, and they knew that it could metastasize as well. But the main difference from today was that up until probably the late 18th century, doctors mostly diagnosed cancers that are near the surface of the body. So, for example, breast cancer, testicular cancer, skin cancer. They did know from opening people up after death, that it is possible to have cancer in other parts of the body, but because there\u2019s no real possibility for them of treating those cancers at the time, they didn\u2019t pay them that much attention. So in the 17th century\u2019s, century rather, people talked about cancer as being like an animal that ate the body of the sufferer. And partly this is an imaginative construct. That word crab is inherited from the ancient Greeks, but as well as being like a crab, people called cancer the wolf, because it ate up the person. And that was translated to practice. So some doctors would even apply raw meat to a cancerous ulcer, so that the wolf could feast on that for a while instead of eating the patient. But the cultural idea also influenced scientists who just got hold of microscopes on a large scale, so they started looking at tumours under magnification. And some of them concluded from what they could see that cancer was alive in an animate sense, that it was kind of parasitic. And we might now think of this as being quite silly, but it is massively influenced how we talk about cancer now. So we have a language for cancer that is much more adversarial than with other diseases. We\u2019re always talking about, we\u2019re going to kick cancer\u2019s butt, but we\u2019re going to battle cancer and so on. But we don\u2019t really talk in that way about, say, diabetes. And it\u2019s because of that idea that cancer is an enemy, that doctors also first decided that we should treat it very aggressively with poisons. So in the 17th century, doctors prescribe arsenic and mercury as treatments, which would hopefully kill the cancer before they kill the patient. And effectively, those were the first chemotherapies. The other thing to consider is that the adversarial narrative that we\u2019ve inherited from history, has, I think, fostered an environment in which heroic cures for cancer. So brand new drugs, brand new surgical procedures, are given far more emphasis than incremental improvements to existing therapies, or prevention of disease or early and accurate diagnosis, which are all things that could improve outcomes for people, but they don\u2019t have the same \u2018battling the beast\u2019 kind of resonance<\/p>\n

Lilly Matson  <\/strong><\/p>\n

It is just such a cool thing to be researching. And as well as how we talk about cancer today, were there any other significant events or moments in history that have influenced what we know about cancer right now.<\/p>\n

Alanna  <\/strong><\/p>\n

So in the 18th, and 19th century, the number of diagnoses of cancer increased. And that\u2019s partly because people weren\u2019t so likely to die of the plague, so they lived long enough to get cancer. And it\u2019s partly because doctors became better at spotting cancer. And during this period, it also became evident that some groups of people were more likely to get cancer than others. So chimney sweeps who came into contact with carcinogens in soot, were getting cancer at a relatively high rate. And unfortunately, this led some people to draw the conclusion that cancer was actually contagious. And that had been a fringe belief in previous centuries. You do hear some people going right back to the medieval period, saying that cancer is actually a form of leprosy, but it now crops up in more force. It really contributed to the stigmatisation of cancer. So that even until very recently, we\u2019d say that people died after a long illness, instead of saying they died of cancer from a very early stage, certainly from the medieval period, cancer is believed to be a disease that mostly affected women. So that conception of cancer as being a female oriented disease, has carried through for good and bad, it means that today, breast cancer funding far outstrips research funding for other kinds of cancer. But it also means that cancer has been associated with particularly stigmatised times in women\u2019s lives, particularly the onset of menopause. Because it\u2019s such a universal experience, you look back to these diaries, or these letters to doctors that were written in 1600, and people have the same fears and the same hopes that we have today. Okay, so does knowing about the 18th and 19th century have anything to do with why we haven\u2019t cured cancer today?  Well we often imagine, I think that science is this sort of shining thing that sits completely apart from the rest of life. But if that was the case, science would not ever get things wrong, and it would always move in one direction, it would always be advancing. And in fact, we know that science often does advance knowledge, and it usually advances knowledge, but sometimes it throws up red herrings, or it goes back on itself, and, crucially, scientists only get the answer to the questions they ask. And scientists are human beings. So the questions they ask are influenced by cultural and political factors, what people want to see what governments want to fund, and looking at the history of medicine is an important reminder of this, and the history of cancer is particularly salient. Because so much of what we do around cancer seems to be influenced by rhetoric that we might not even know why we\u2019re using it. But it is really strong, this rhetoric of battling cancer or cancer being a kind of entity that we need to fight or defeat or kill.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

It\u2019s so true. And you know, that that language does still persists today. So I guess, kind of my final question for you is, from a historical perspective, and taking into account everything that we\u2019ve discussed and everything that you know, you know, why haven\u2019t we cured cancer yet?<\/p>\n

Alanna  <\/strong><\/p>\n

Perhaps the right question from a historical perspective is not why we haven\u2019t cured cancer yet, but why do people still die of cancer? Because of course, cure is a really important part of the puzzle. But the other part of the puzzle is preventing people getting cancer in the first place. And I suppose the third part actually is diagnosing it early enough that cures can be effective. And I think the historical narrative that we have inherited, really privileges cure, because of the way in which is posited cancer as an entity that is, apart from the human in which it is found, and is an enemy to the body. And that is a perfectly legitimate way of thinking about cancer. And it\u2019s very intuitive. And it\u2019s absolutely understandable that people will think about their cancer in that way. But it does privilege a search for types of medicine, that are heroic interventions, rather than the kinds of medicine that maybe are less, less flashy, less fashionable, if we like to use that, less appealing to funders, which is those investigations into what the risk factors are to cancer and how we can mitigate those, investigations into how we can diagnose people early enough that the cures we already have can be more effective. So that\u2019s the way in which I think history is most unhelpful to the ongoing mission to eliminate cancer.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

Ultimately, what we know about cancer today, like with anything can\u2019t be removed from the past. But let\u2019s fast forward. What are some of the key challenges we\u2019re facing right now that mean we\u2019re not going to have a silver bullet, one-fits-all cure for cancer. To start, it\u2019s worth pointing out that there are over 200 types of cancer, and each one is treated individually and differently. If they need to be seen as 200 different diseases, what actually makes a cancer a cancer?<\/p>\n

Mariam  <\/strong><\/p>\n

There are some general inherent features that you could say all different types of cancers have, for example, the ability to grow uncontrollably, and the ability to spread from one part of the body to the other. But location is really important. At the very least, it\u2019s allowed us to, if you\u2019d like, categorise cancers. But also we see that the origin of a cancer can dictate the types of genetic changes that a cancer might have that\u2019s associated with it. For example, we know there are certain genetic abnormalities that are more common in breast as opposed to say lung cancer. And these changes based on location and genetic differences also determines the types of treatment that we can offer our patients.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

That\u2019s Dr. Mariam Jamal-Hanjani, a medical oncologist who treats patients diagnosed with lung cancer, and who is also a cancer researcher based at the University College London Cancer Institute. So as you heard her explain, there are some general features which can help us classify something as a cancer. But it\u2019s still an extremely complex disease. So looking beyond just the sheer number of different types of cancer, one thing that makes cancers so hard to understand, is the concept of cancer evolution.<\/p>\n

Mariam  <\/strong><\/p>\n

Over the last decade or so, I and many others in the field of cancer research have been looking at how cancers evolve and how they change, typically from the point of diagnosis and throughout the course of disease, in response to treatment that we give to patients. But also even outside of the context of treatment, the ways in which cancers might evolve, when, for example, they spread from the part of the body that they originate from, to other parts of the body and how that evolution is determined by either genetic abnormalities that are inherent or acquired within the cancer cell and the cancer cells, how the cancer cells interact, and that cross talk between cancer cells, how they interact with the cells in their surrounding environment and some of the structures. All of this plays a role in the way in which cancers evolve. But fundamentally, it\u2019s important to, to incorporate in the way we treat patients who have cancer, that cancers are not static.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

So if they\u2019re constantly changing over time. Does that mean that one part of a tumour can look different from another?<\/p>\n

Mariam  <\/strong><\/p>\n

They are very different, or how we phrase we phrase it as heterogeneous, within a tumour. So if you take a biopsy from one part of the cancer, and you look at how this differs from another part of the cancer, there will be many changes and many differences. And we see that these differences vary in degrees across different cancer types. So that\u2019s important too, some cancers are more evolved if you like, or evolve to a greater extent, than other cancers. So, cancers are made up of different populations of cancer cells, and they may have different properties. So cancer cells are very heterogeneous, and I think that\u2019s the complexity. But this is crucial in the way in which we treat our patients when a diagnosis is made. We have a biopsy, and based on that biopsy from a cancer, we decide how we can best treat our patients. When we do give treatment to our patients, in time, if sadly, that cancer relapses or progresses, then we need to be cognizant of the fact that the tumour or the cancer may have evolved again and evolved in response to having been treated. So it isn\u2019t always sufficient to rely on that very initial analysis or understanding of the cancer. So this this is one of the aspects of cancer evolution that we really work hard on and are trying to incorporate in the way in which we manage patients who are diagnosed with cancer, because we do need to understand the way in which the cancer evolves.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

So this means that while a treatment might work at certain point, further down the line, it might not be the case. And I guess this is something that makes treating cancer and finding a cure really, really challenging?<\/p>\n

Mariam  <\/strong><\/p>\n

I think you\u2019ve hit the nail on the head, why is cure difficult in the context of tumour evolution, and I think it\u2019s because we need to track evolution in the way that cancers evolve in time. And we can\u2019t do that if we\u2019re restricted to old biopsies, or if you think about as a biopsy gives you a snapshot of a cancer, and that snapshot will change in time. And if all our treatment and decision making for cancer care is based on a one time point biopsy, we will be missing information. So there\u2019s a lack of information there if we don\u2019t try to track the way in which these cancers evolve in time. And we need to do that because given that cancers evolve, and our patients are increasingly living with cancer, and thankfully, we have more and more treatment types and modalities to offer our patients, we need to be able to employ ways in which we can track cancer evolution so that we adapt the way in which we treat our patients accordingly.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

So I\u2019d really love to discuss some of the ways that the projects you\u2019re working on, are helping to understand how tumours evolve. But before we do that, we\u2019re tackling all the big questions today and I\u2019ve got another one for you. What do you think the definition of cure is?<\/p>\n

Mariam  <\/strong><\/p>\n

I think this is a really difficult question to answer. And it\u2019s really hard for me to do this on behalf of my patients or patients in general, because I think it\u2019s down to them. Obviously, there can be a scientific definition, a clinical definition of cure. And, and generally this is considered as no detectable disease. Patients often think of this as being in remission. And I do think that increasingly, this is not particularly a helpful term. And the reason why is that many of the treatments that we now are able to offer our patients have allowed our patients to live with cancer. And I think perhaps, as opposed to cure, some of the things that I focus on, at least with the patients that I care for, is their quality of life, whether they have symptoms, as opposed to a scan, that is entirely clear. Of course, that\u2019s wonderful. And that\u2019s what I would like for every patient. But I do think that many of our treatments are now allowing our patients to live longer, but still with cancer that is perhaps inactive or what we term stable. So if the cancer is stable and not active, and our patients have a good quality of life that they should judge the quality of, and that they don\u2019t have symptoms and they feel well in themselves. I think that that is still something to aim for and is still an achievement on behalf of both scientists, clinicians and patients. So I find that a difficult concept, cure. Again, I think it\u2019s wonderful to strive towards a cure. And certainly it\u2019s a well known concept for the clinician scientists and the public. But I do think that there are other ways in which we can measure the success of a treatment and the management of a cancer.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

My understanding is that the term cure means different things to different people. So patients, healthcare professionals, statisticians, everyone has a slightly different definition. The word might typically be associated with a cancer disappearing and never coming back. But it\u2019s actually far more nuanced than that. And sadly, people\u2019s cancers do come back. For lots of the statistics we use at CRUK, we refer to cancer survival instead. Although the terms may be similar, cancer survival actually refers to the percentage of people still alive after a specified amount of time, often 1, 5 or 10 years after their diagnosis. So Mariam, you\u2019re a medical oncologist, but also a cancer researcher, and a number of the studies you\u2019ve been involved in are super, super groundbreaking and have greatly advanced our understanding of cancer, particularly cancer evolution. So I know of 2 studies that you work on the TracerX and PEACE studies that are both, you know, big deals in the world of research. Could you tell us a little bit more about them?<\/p>\n

Mariam  <\/strong><\/p>\n

Very briefly, TracerX is a study sponsored by Cancer Research UK, and we opened in early 2014. And there was some preliminary pilot work that justified and again, was the rationale behind setting a study like this up, we recruit patients who are diagnosed with a type of lung cancer called non-small cell lung cancer. And at the time of diagnosis, these patients are offered curative surgery, so their tumours are operable, which means that the intention of treatment early on, is to completely remove the tumour by surgery. And indeed, that occurs, but at the time of surgery, we are able to obtain tissue, and it\u2019s really important that we obtain tumour or cancer tissue that\u2019s fresh, and not just from one part of the tumour, but multiple parts. We talked about this, this variation or heterogeneity that\u2019s spatial. Well, this was one of the ways in which we wanted to try and understand this more by not relying on just a single biopsy, but obtaining multiple biopsies. We follow our patients up throughout at least 5 years. And we do this by collecting clinical data, seeing them in the clinic, monitoring them with scans and blood samples, always on the lookout that if unfortunately, their cancer returned, that we are then able to offer them treatment early. But also at that point, we approach our patients in the TracerX study and asked them, could we have another sample from the cancer that has returned. And so this has been the first prospective study worldwide of this magnitude looking at cancer evolution in the context of lung cancer. And it\u2019s allowed us to upfront say we\u2019re interested in understanding how cancer evolution impacts outcome in terms of survival and the likelihood of a cancer returning, but also how the different cancer therapies we give our patients might impact also cancer evolution. And at the point of the study in TracerX when the cancer has returned, and when sadly, our patients have developed stage four or metastatic disease, we also, if appropriate, will then discuss the PEACE study with our patients. Again, a study that\u2019s UK-wide and led and sponsored by Cancer Research UK, this is again, the first study of its kind in terms of its magnitude and ambition, where we\u2019re not just focused on lung cancer, we\u2019re focused on all types of cancers. And it\u2019s a research autopsy programme. So here, we ask our patients or their families and relatives whether they would be willing to donate samples after they die. So in this context, after the patient dies from their cancer, we perform post mortem tissue sampling, and that means that we collect tissue samples from all the sites in the body where the cancer had spread. And this is really helped us establish an unprecedented resource of both samples, tissue and blood. And it\u2019s been, it\u2019s been incredibly humbling. We we opened in 2016, we\u2019ve recruited over, I think, almost 350 patients, we\u2019ve done almost 200 research autopsies, where from every patient, we\u2019ve collected tissue, again, from multiple sites in the body, and again, trying to capture that aspect of cancer evolution by collecting multiple samples from every site where the cancer has spread. And what the PEACE study has allowed us to begin to look into which is incredibly fascinating and interesting, but important in understanding cancer is why does cancer spread? And how and also why have the cancer therapies stopped working? So how have these cancers developed the ability to become resistant to drugs? So really PEACE has allowed us to begin to investigate that the spread of disease, but also the development of drug resistance?<\/p>\n

Lilly Matson  <\/strong><\/p>\n

I mean, wow, I\u2019ve really not ever heard of kind of any study like it. It\u2019s such such amazing work that you do, and of course entirely, you know, selfless of patients. So why are studies like this so important in helping us understand cancer in its entirety?<\/p>\n

Mariam  <\/strong><\/p>\n

You know it\u2019s almost working backwards, if you like, because at the point of us performing these autopsies and incredibly altruistic of our patients, incredibly selfless because they know they will not benefit. And yet they are willing to donate their bodies and their samples after they die because they know that there is the possibility that future generations of patients will benefit. And it\u2019s incredibly important to understand metastatic or advanced stage four disease because that is the number one killer in patients diagnosed with cancer. And sadly, despite huge efforts and significant advances in our abilities to diagnose cancer early on, to prevent even the development of cancer, we still see an overwhelming number of patients who come to the clinic and who sadly are diagnosed with advanced disease. So first of all, we really must try and understand what might be the differences in our patients who develop advanced disease compared to those who develop very early stage disease, and we diagnose them sooner rather than later. What is it about cancers in terms of the genetics, the environment in which they exist, the way in which the patient\u2019s body interacts with a with a cancer and the immune system that dictates or allows for a cancer to spread. Because it is indeed that spread to different parts of the body, that means our patients survival is impacted that they die sooner of their cancer. And also, when patients have advanced metastatic disease, it is tougher to treat in terms of the likelihood of response to cancer therapies. So it\u2019s incredibly important to understand the processes and the biology of cancer spread. But also, we know that, sadly, in many cancers, drug resistance is inevitable, and being able to collect tissue and blood is allowing us to look at cancer cells that have developed the ability to become resistant. And not just to one type of cancer treatment, but to multiple. And so it\u2019s crucial and important to do the autopsy work because it\u2019s allowed us to access tissue from patients in whom otherwise it really would be impossible.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

So what\u2019s next? What more do we need to know in order to bring us closer to this concept or idea of cancer cure?<\/p>\n

Mariam  <\/strong><\/p>\n

I do think the fact that cancers evolve, and that they change in time, in response to cancer treatments, and the complexity in which cancer cells interact with each other, and the environment in which they exist, is a huge challenge. In terms of the way in which we understand cancer and the way in which we we treat patients, it does mean that there is a real need to track these changes, and adapt the way in which we treat our patients. But this needs, this needs structure. It needs logistical consideration, it\u2019s difficult for for patients, but it doesn\u2019t, it doesn\u2019t mean that it isn\u2019t something we can\u2019t incorporate. And I think studies like TracerX, hopefully, will make that increasingly obvious. So whilst it is a challenge, I think it\u2019s a challenge that that we can take on.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

Absolutely, I mean, without a doubt. But for you, as a scientist, as an oncologist is cure something you\u2019re still striving for.<\/p>\n

Mariam  <\/strong><\/p>\n

I think if if the pandemic itself taught us that \u2013 we saw how diverse communities: scientists, clinicians, pharmaceutical companies, the public and media, so many different disciplines came together in a real strong, collaborative effort, all with the same aim in mind. And I think that that is true across clinicians and scientists in the field of cancer research, we all want to aim for cure, we all want a world in which cancer no longer exists. In setting up the TracerX and PEACE studies, our our biggest advocates have been our patients. For example, with the autopsy work initially, I had some anxieties and I was concerned about how we would approach our patients because there is still a real stigma around discussing death with patients. And really, they have been our biggest supporters. And they\u2019ve really rallied the research and they\u2019ve rallied the study and they\u2019ve championed this study and they\u2019ve opened our minds and hearts. And it\u2019s allowed us to strengthen the relationship that we have with our patients. And I think it\u2019s been incredibly important to learn from them and studies like TracerX and PEACE, these are the research that\u2019s derived from these studies. It really is the legacy of our patients. And that really will be ongoing, I hope for decades to come.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

There are lots of serious challenges that we come up against when treating cancer from cancer evolution and drug resistance, to access to samples and funding, at times it can feel overwhelming. Will a cure for cancer ever be a reality? Well, it\u2019s important to remember exactly how far we have come.  While there\u2019s no one size fits all answer to curing cancer, we have made real progress. It\u2019s not only that we no longer perform operations with raw meat because cancer is thought to be a wolf, but in the 120 years that the charity and its forerunners have been investigating cancer research alone, we have significantly improved outcomes for people with cancer. Even in the last 40 years, survival has doubled thanks to research into more effective and gentle treatments, improving diagnostic techniques and campaigning for policy change. And who better to tell us about some of the amazing international achievements in cancer research and collaborative successes than our chair, Sir Les Borysiewicz.<\/p>\n

Borys  <\/strong><\/p>\n

If there\u2019s one thing we\u2019ve learned over 120 years of research, it\u2019s the sheer complexity that cancer poses. Our ideas of cure mostly stemmed from infectious diseases, which was originally my clinical specialty. And here we would get a pneumonia, we can give an antibiotic, we clear out the bugs, and the person can, is cured because the bugs are all dead. Cancer is much more difficult, because it comes from within us and changes in our own cells. And that\u2019s why controlling it is not so simple as giving an antibiotic and merely clearing the bacteria. And that\u2019s why cure has to be considered very carefully as to what we mean when we talk about cancer. And for that reason, we use a 10-year timeline to say that people who\u2019ve survived 10 years or more, are virtually certain to be clear of their cancer, and can be considered cured to all intents and purposes.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

And what do you personally think are some of our biggest achievements in the field of cancer research?<\/p>\n

Borys  <\/strong><\/p>\n

There have been many, many advances some over the whole 120 years we\u2019ve been researching, something over the last 20 years where Cancer Research UK has been in existence. However, the real opportunity to me in the field that I have been engaged with happened last November. I have been particularly interested in a condition called cervical cancer, which has afflicted so many women over so many centuries. We now know that this cancer is caused by papilloma virus, and a vaccine against papilloma virus was shown by Cancer Research UK investigators to be virtually preventing cancer in all women really, who have received the vaccine, particularly in early years of life. That has been so successful, that for the first time in history, the WHO, the World Health Organisation, have declared the possibility of eradicating cervical cancer by 2050. Now, I won\u2019t live to see that, but that is a huge milestone. This disease has been a scourge of women over centuries. And here we are, in the 21st century, looking to the time when it\u2019ll be gone, it\u2019ll be consigned to the history books. Now, I have 2 daughters, and I think that should mean the world to them. And my granddaughters, in particular, may never need to even read or to be taught about cervical cancer, and the screening procedures that we undertake today. So so much excitement in what can be done for the patient, how it can be diagnosed early, and now increasingly, how we might even be able to prevent it happening at all.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

It is a truly truly amazing achievement to be involved in. And so aside from seeing the potential eradication of a cancer, such as cervical cancer, what have we learnt about the disease that is so fundamental to the improved treatments and outcomes that we\u2019ve seen in recent years?<\/p>\n

Borys  <\/strong><\/p>\n

Firstly, our basic understanding of what is going wrong in the cancer cell so that we can tackle it at the root cause of the problem. Secondly, the fact that treatments are being better employed, we can look for instance, at the huge improvement in survival for breast cancer, that is testimony to earlier diagnosis, better use of the treatments that we know work, and more and more treatments coming alongside the accepted forms of treatment. And lastly, we\u2019re also getting better at delivering cancer care to patients. At the moment, we are tragically have a huge backlog of individuals waiting for cancer treatment, and I know the NHS will work hard at it. But overall, we are being able to deliver those treatments, with fewer people missing out because of where they live. And hopefully, we will stop all of the inequalities so that everyone who has a cancer can get access to the optimum treatment for their disease. So that\u2019s why I\u2019m optimistic we\u2019re moving not just in one small area, but right across the board, in improving cancer survival.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

We really have come such a long way. But it doesn\u2019t end there, as we know. So what are you hopeful that the future might hold?<\/p>\n

Borys  <\/strong><\/p>\n

So I\u2019m excited about so many things as to where cancers going. Continuing improvement in all aspects, earlier diagnosis, can we get better technologies to have simple tests that people will be able to have at home or in a general practice surgery or in screening centres that are not invasive, very easy. Secondly, I think the making drugs that are not just effective, but increasingly have fewer side effects, nearly every patient I talked to cancer will recount how difficult going through chemotherapy and radiotherapy is, and we want to make those treatments kinder, but still just as effective, if not more effective than what we have today. I think new forms of treatment are going to come along as well. The ones that I\u2019m particularly interested in, obviously, from my own background, is how we harness the body\u2019s defences to actually tackle cancer. This brings a vision of potential cancer vaccines. So individualising care, and individualising treatment going forward, I think is going to be hugely important. And then lastly, I do remain optimistic that we will get better at being able to deliver cancer. I think one of the things we all think about and worry about is inequalities in getting access to cancer care. So in the United Kingdom, we would hope that we can deal with this right across the board through the NHS, and we work closely in partnership with the NHS. It\u2019s not perfect at the moment. But we hope to continue that improvement.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

So cancer inequalities, other unfair and avoidable differences in cancer incidence and outcomes across society. And so when we talk about progress in cancer research, we\u2019re not just talking about the UK, but how cancer impacts people across the world.<\/p>\n

Borys  <\/strong><\/p>\n

When I think of the cancer burden in the world as a whole, and we think of those who have no access to radiotherapy, virtually no access to chemotherapy, in poorer parts of the world. That is something we do have to put right. That\u2019s something that I believe we all have a responsibility to also push that agenda. This isn\u2019t just a UK problem, it\u2019s an international and global problem, especially when we bear in mind that 1 in 2 of us is going to experience cancer as we go forward.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

So you\u2019ve spoken about collaboration being a huge part of searching for answers in cancer research. So what does collaboration mean to you?<\/p>\n

Borys  <\/strong><\/p>\n

I\u2019m very proud to be chairman of Cancer Research UK. I mean, if you think about an organisation that\u2019s 20 years old, we fund close to certainly over half and close to 60% of all cancer research in the UK. And as a charity, we can be very proud of what has been achieved. But that could not be achieved without all of the volunteers who help and support us without the many patients who give their very precious time to participate in trials to enable research to go forward. This isn\u2019t just about the scientists and the clinicians, and others. This is about everyone working together. Because without the volunteers without the patient\u2019s participation, we could not do what we do. And that is absolutely essential because this work must go forward. If we\u2019re to ensure that cancer can be consigned, if not totally to the dustbin of history, it can actually be consigned to such a way where people will treat cancer as just an illness that they would encounter during their lives, but go forward with the confidence of knowing that it will be managed and that they can continue to look forward to a full healthy and active life.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

So we\u2019ve asked all our guests what cure means to them, but is cure on the horizon? Is it going to ever be a reality?<\/p>\n

Borys  <\/strong><\/p>\n

Yes, we go for cure, complete eradication in every single case if we can manage it. If we can\u2019t, then the next best thing is to actually ensure people can live a full and normal life with good quality of life. And that cancer becomes just another condition which we can cope with. So, you know, we have to look to a future. We have a future is bright and optimistic, but we cannot drop our guard for 1 minute.<\/p>\n

Lilly Matson  <\/strong><\/p>\n

So that\u2019s it for this episode of That Cancer Conversation. As always, we were produced in the cancer Research UK digital news team, and our music today came from Poddington Bear. If you\u2019ve listened this far, and would like to learn a little bit more about any of the topics discussed in this episode, links are available in the show notes. To make sure you\u2019re the first listen to our next episode, be sure to subscribe on Apple podcasts, Spotify, or wherever you get your podcasts. I\u2019ve been Lilly Matson. Thank you so much for listening, and I\u2019ll catch you next time.<\/p>\n

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