A friend of mine was recently diagnosed with a melanoma, an aggressive form of skin cancer that had spread throughout their body, including their brain.
Even a decade ago, their cancer would have been essentially incurable and rapidly fatal.
My friend’s tumours however are shrinking as their immune system attacks the cancer cells wherever they happen to be in their body.
A treatment called immunotherapy is directing their own immune system to find and attack cancer cells in all the parts of the body to which they have spread.
It’s a familiar story across multiple cancer types with new classes of treatment, often based on rapid advances in understanding of the genetics of cancer – or cancer patients themselves.
So the outgoing medical director of the NHS, Sir Stephen Powis, is not wrong: we are entering a “golden era” of cancer treatment, if we’re not living in it already.
Cancer treatment is becoming increasingly personalised to the specific mutations in the cancer itself. Oncologists know their enemy in more intimate detail than ever before.
Tools like AI can sift through that detail to identify new vulnerabilities in cancer cells and techniques like gene editing allow scientists to design previously impossible new ways of exploiting them to slow, or reverse the spread of cancers.
But we’re entering a parallel and less gilded era too.
Cancer is primarily a disease of ageing and our population is doing that rapidly.
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It is also more common in those who eat and drink too much and exercise little – which is most of us – and explains why cancer rates are now, perhaps for the first time in human history, increasing in younger people too.
As Sir Stephen points out, prevention must play an important role in reducing that increasing burden. It already has for some: smoking-related lung cancer is declining, so too is cervical cancer thanks to HPV vaccination in schools.
But the bulk of cancers linked to poor diet, poor air quality, or poverty in general are not.
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We’re also failing to make sure everybody benefits from the incredible new treatments available and those yet to come.
While people are now getting cancer diagnosed faster in the NHS, many start treatment too late. More than 30% of patients wait more than two months to see a cancer specialist following an “urgent” referral from their GP (well below the NHS target that has not been met since it was introduced in 2015).
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Cancer survival is increasing, but so too is the disparity between those benefitting from the latest treatments and those who aren’t.
Specialist treatment in some parts of the UK is far better than in others – often those in poorer places where cancer rates are higher.
And the latest, and best, cancer treatments – which are largely bespoke-tailored to the patient’s needs – are increasingly expensive.
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Affording these has always been a challenge for the NHS and will only get harder.
While the golden era unfolds, much must be done to avoid another in which cancer treatment becomes a two, or even three, tier service that offers the best only to a few.
