People of all ages get cancer, but nearly all types are more common in the middle-aged and elderly. George Weiner, MD, director of the Holden Comprehensive Cancer Center at The University of Iowa, talks about cancer and cancer risks:
Who is most likely to develop cancer?
Cancer is more common in people as they get older, so age is actually a pretty important risk factor with respect to developing cancer. There are other factors that can impact the risk for developing cancer. One of them is life style. We all know that tobacco exposure is far and away the most common cause of environmental cancer. Physical fitness is also important. People who are not obese, people who stay physically fit have a decreased risk of developing many types of cancer. Finally, inherited genes can play a role in whether someone is likely to develop certain cancers.
Does genetics play a role in the development of certain cancers?
In fact, there are genes that can be inherited that can impact on the risk of getting certain types of cancers; with the most common and most extensively studied being the risk for breast cancer.
There are certain genes that will significantly increase the risk of a woman developing breast cancer sometime in her life. These are not absolutes, so if someone inherits one of these genes, their chance of getting breast cancer may be higher, but it doesn't mean they absolutely will develop breast cancer. On the other hand, breast cancer can occur in anybody, even people who do not inherit these genes.
Are some types of cancer preventable?
Prevention is a very strong word. What we do say is that there are types of cancer where we can dramatically reduce the risk of developing the cancer. Obviously lung cancer is the most extensively studied. We know that approximately 90 percent of lung cancers are caused by tobacco smoke and we can prevent 90 percent of lung cancers therefore, by decreasing exposure to tobacco. However, occasionally a cancer will develop even in someone who doesn't smoke--a lung cancer will develop--so it's preventable in many people, but it doesn't mean the risk of developing a cancer is zero.
How is the treatment of cancer changing?
We're moving into an era of individualized therapy, of personalized medicine. We've learned that cancers are not all the same, even if they develop in the same part of the body--a breast cancer or lung cancer or lymphoma--can be very different in what causes them and the types of treatments that are effective for them. We're learning to dissect out, based on the patient's makeup of their immune system and the makeup of the cancer, which treatments are likely to be most effective and have the fewest side effects. We still have a very long way to go in research in this area, but we're starting to make good progress in individualizing therapy for patients.
The Holden Comprehensive Cancer Center is a National Cancer Institute (NCI) designated center. What does that designation mean for Iowans with cancer?
Our designation as a comprehensive cancer center by the National Cancer Institute is based on:
Excellence in research
- Excellence in cancer prevention
- Early detection
- Broad cancer therapies
- The ability to take those advances and bring them out to the community
Having such a center in Iowa--and there are only 41 such centers across the U.S.--means that the newest discoveries get to the people faster, obviously that's the main goal of doing the research.
Do you hope to see the day when all cancer can be treated and cured? How far away do you think that day is?
What we're learning is that cancer is not just one or even 20 different diseases, but in fact, it's hundreds. They have different causes, they have different treatments that are effective, so trying to identify a date when all cancer can be cured is something that's very far in the future.
However, we are making great progress with certain cancers, and one of the things were learning is that we're actually able, for many cancers, not to cure them but to get them under control so that they don't cause problems.
We get them to behave like a manageable disease; so if someone can develop a cancer at age 50 and live to be 90 years old on treatment that doesn't have side effects--well that's almost as good as a cure. So we're working on treatments that can result in cure, but also treatments that can make cancer a treatable disease. I do think that as we continue to invest in cancer research, we're going to see--in the next five to 10 years--a dramatic decrease in the burden of cancer.
The day when we can cure all cancers is, I'm afraid, rather far away. |
