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ASCO 2014: Dr. Nilesh D. Mehta


ASCO 2014 : Dr. Nilesh D. Mehtastethoscope20140604154222_l


The scientific and research communities have received several accolades for the breakthroughs achieved over the last decade. However, one fact remains and sticks out like a sore thumb – 1.6 million Americans will be diagnosed with cancer this year, and the number of new cancer cases will increase by nearly 40% by 2030. One of every four deaths in the United States is caused by cancer. While the research has brought newer treatments to the forefront, our federal funding for cancer research is at the lowest point in decades. This certainly does put a lot of pressure on the scientific community and researchers.

The 50th Annual American Society of Clinical Oncology meeting was held at McCormick place in Chicago during the month of June.  During the last five decades, the landscape of cancer management across the spectrum has changed significantly. Whether this pertains to surgery, radiation, chemotherapy, hormonal therapy or the personalization of therapy, research and application of innovative ideas has been the driver for our success in cancer management. Our understandings of basic facts of cancer have improved over the last few decades and this has helped us treat patients in a better manner. Utilizing screening techniques with mammogram in breast cancer detection have vastly improved with newer machines and technology. Realizing the genetics of this disease was crucial and this led to the identification of BRCA1 and BRCA2 genes. Now, for certain high-risk patients and their families, we can offer this test to screen for breast cancer and other cancers. MRI also has become an important modality of screening in this high-risk group of patients.

Besides screening techniques, physicians also found the additional option of risk reduction when we entered an era of chemoprevention in 1998. It became clear that taking tamoxifen for five years reduced the incidence of estrogen receptor (ER) positive breast cancer by 50% in women at increased risk of developing this dreaded disease. Nearly 20% of breast cancer patients over-express HER2 gene which allows physicians to tailor therapy with trastuzumab. Chemotherapy plus traztuzumab was found to prolong survival in patients with HER2-overexpressing tumors. It was once erroneously but widely believed that more surgery is better. This also applied to removal of lymph nodes from the axilla in breast cancer patients. But, one major trial ACOSOG 20011 revealed similar survival and local surgical outcomes when less aggressive surgical techniques were used.

In addition to breast cancer news, this meeting had  good news for patients with prostate cancer, lung cancer and lymphoma. More oral drugs are likely to be utilized in the near future with lesser side effects which conventional intravenous chemotherapy is known for.

In summary, we have come a long way but still miles to go before we can reach the cure for cancer. The scientific community will need governmental support with grants for research to fund various projects throughout the country. In an era of diminishing research funding, this certainly presents as an ongoing challenge. Let us hope that our future continues to be as bright as our recent past research has led us to believe.