Cancer continues to cause an immense amount of death and suffering. Because the major risk ractor for cancer is age, we can, unfortunately, expect an ever-increasing number of cancer patients in the near term. Preventing cancer remains a major goal of cancer researchers worldwide. But, even if every cause of cancer were identified and eliminated tomorrow, cancer would continue to be a, if not the, major cause of death in Western societies for the foreseeable future (because of the 15-20 year lag between cancer initiation and its manifestation as clinically apparent disease). Yet, due to the remarkable achievements of cancer biologists worldwide—not least at The Princess Margaret—there is more hope than ever before.

The cancer medicine of the future will look dramatically different than the cancer medicine of today—and it will be unrecognizable from the cancer medicine that preceded the dawn of molecular oncology in 1976. First, using molecular diagnostics and ever-improving imaging devices, we will detect tumours of ever smaller size. We will remove them—especially when they are located in sensitive areas—using robotic, image-guided therapies that exact far less tissue damage and side effects. Many times, these operations alone will be curative.

The pathologists ‘microscope’ of the future will be a DNA sequencer. With that tool, tumours will not be diagnosed only as ‘breast cancer’ or ‘colon cancer’. Instead, we will determine the complete spectrum of genetic and epigenetic abnormalities in each tumour. That will allow doctors to pair that molecular diagnosis with specific targeted therapies that find the Achilles heel of each tumour. Not only will we target the bulk tumour cells, we will make sure we kill the tumour-initiating cells as well, extirpating the ‘roots’ as well as the’ leaves’ of the tumour. If targeted agents alone won’t do the job, we will know how to mobilize—or remobilize—the immune system, so that it more effectively eliminates the tumour and/or prevents tumour recurrence. Indeed, we will know how to intelligently combine targeted therapies and immunotherapy to yield maximal patient benefit.

To those outside the trenches of the fight against cancer, this vision may seem like science fiction. But it is no exaggeration to state that for most of the goals outlined above, the future is now. We know the enemy. He is formidable. To finally defeat cancer will take hard work, and a lot of it, and it will require substantial additional investment by government, industry and private philanthropy. But the tipping point in the fight against cancer is at hand, and we at The Campbell Family Cancer Research Institute are committed to one goal: CONQUER CANCER IN OUR LIFETIME.

Dr. Ben Neel, Research Director
Ontario Cancer Institute and
The Campbell Family Cancer Research Institute
Princess Margaret Cancer Centre/UHN
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