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Personalized Cancer Care

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Fifty years ago, cancer was much simpler to understand. It was seen as one disease and diagnosed anatomically. Available treatments were indiscriminate; lung cancers received treatment X, breast cancers treatment Y, and so on.

Our understanding has grown to acknowledge that lung cancer and breast cancer are not simply two types of cancer, but two individual diseases. The mapping of the human genome helped this process along considerably. Doctors and researchers now look past the anatomical level of a cancer, and go to the cellular or molecular level to find the things that make that particular cancer the way that it is. This is important because one of the cornerstones of the new understanding of cancer is that every single cancer is different from every single other cancer.

Because of these differences, patients will respond to treatments differently. It is no longer reasonable to assume that one treatment will fit all, or even many. The answers lie in the changes that the cell has undergone to become a cancerous cell, and the finding responses to those changes is at the heart of personalized cancer care.

The National Cancer Institute

The National Cancer Institute (NCI) has actually made personalized cancer care a major priority, or Signature Initiative, in the form of the Personalized Cancer Care/Drug Development Platform, believing that it holds enormous promise for the future of cancer care:

Preventing, detecting, and treating cancer will become even more precise as we identify genetic alterations through accumulated knowledge and increasingly sophisticated technologies.

The Personalized Cancer Care/Drug Development Platform is composed of four programs:

  • The Cancer Genome Atlas (TCGA). This database is an ever-growing, comprehensive catalogue of the genomic changes being discovered in adult cancers
  • Therapeutically Applicable Research to Generate Effective Treatments (TARGET). This is similar to the TCGA except it maps genomic changes in childhood cancers;
  • The Cancer Human Biobank (caHUB). This is a repository of "quality biospecimens" for research;
  • The NCI Community Cancer Centers Program (NCCCP). This program involves data from patients and volunteers for cancer clinical trials

Whereas many years ago, the treatment target was the tumor but the entire body absorbed the blow, today the treatment target is becoming a targeted treatment aimed ever more directly so that only the tumor absorbs the blow.

 

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