ANY cell in the body can form a cancer as long as it can divide. Genetic changes can be inherited or acquired. While all copies of cells should be the same, " mistakes " or mutations may occur, especially with increasing age. Most of these mutations are corrected by DNA repair.


However, with some genes, uncorrected repair eventually results in purposeless cell division or cancer. If the cancer spreads to other parts of the body, the cells continue to divide and new mutations appear.


Understandably for a disease which kills ~9 million people worldwide in a year, second only to heart disease, there is hope that " one day cancer will be cured ". Three quarters of such deaths occur in low- and middle- income countries such as the Philippines.


First, the good news . Many cancers ARE now highly treatable, with either long term survival or complete cure. People in whom cancers are diagnosed early, either by screening or when they have symptoms, generally have a better chance of successful treatment. Surgery, radiotherapy and anti-cancer drugs ( chemotherapy ) are now better focused to treat with minimum damage to normal tissues.


There are ~200 different main cancer types , and many more subtypes. Every patient has a cancer with a unique genetic profile, which changes with time. It’s therefore highly unlikely that ONE cure could be found regardless of cancer type, or stage ( how far advanced it is ).


We now realise that the molecular features of a cancer, such as its genetic traits, are more important than where it started growing ( such as lung, breast or bowel ).



This is the era of " precision medicine " whereby molecular testing of a cancer biopsy ( sample ) may find mutations which could be matched with drugs designed to tackle that type of cancer. If the cancer has spread, further biopsies could be impractical, but it IS possible to find cancer DNA in blood samples. A stage further is " personalised medicine ", whereby a patient’s own cells are " re-engineered " to attack their cancer.


Cancers MAY also have mutations which are common to those starting in different sites of the body. There are already drugs which target ALL cancers having a particular mutation, and/or stimulate the patient's immune system.


The bad news is that such newer forms of treatment are very expensive, and cancer cells constantly mutate to develop drug resistance ( just like bacteria and antibiotics ).


Not all cancers can be prevented, although lifestyle changes could reduce their numbers. Ideally any treatment should be proven to work with good evidence, and affordable - whether paid for directly, through insurance / taxation, or donation / charity.


We DO have better hope than ever before that cancers will become either curable - or at least chronic, allowing many years of survival .