radiolabeled glucose tracer, called 18fluorodeoxyglucose
(FDG), to identify micrometastases that were previously
undetectable by standard imaging techniques, which informs
subsequent treatment options (see Figure 10, p. 44).
In addition, it is now possible to combine advanced imaging
technologies, such as FDG-PET, with CT, or double contrast
magnetic resonance imaging (DC-MRI). These combination
scans are now being used to simultaneously obtain detailed
information about the extent of a patient’s cancer and the
precise location of metastases, enabling better surgical
removal and/or directed radiation of the tumor.
Advances in Supportive Care
A number of palliative or supportive care approaches and
technologies have been developed that make the
administration of chemotherapy safer and more tolerable.
Anti-emetics have improved the ability of patients to tolerate
chemotherapy by reducing nausea and vomiting. The
hematopoietic growth factors, which stimulate the
production of red and white blood cells in the bone marrow
that have been depleted by chemotherapy, have helped
prevent severe infections that were common during cancer
treatment, allowing for treatment without interruption.
Additionally, the class of drugs, known as bisphosphonates,
and a new therapeutic antibody, called denosumab (Xgeva;
see Table 3, p. 42), are now used to reduce bone fractures
“Treatments that offer what is seemingly only
incremental survival might actually be the ticket
to longer-term success, because they may get
you to the treatment that ultimately works.”
from metastases of certain cancers to the bone, as well as
the metastases themselves.
Finally, our increased understanding of pain management
has led to the wider use of analgesics. These drugs have
greatly improved the quality of life for patients during and
after treatment. This is especially important today as the
new therapies and improved management of metastatic
disease continue to increase the number of years that
patients can survive after initial treatment, thus changing an
increasing number of cancers into chronic, manageable
conditions rather than a death sentence.
All of these advances have made a real difference in the
lives of cancer patients and their families. Because of
the molecular revolution, we are now in an era of great
promise in our ability to reduce the number of deaths due
to cancer and to reduce the suffering caused by this
most feared disease.
“This Nation’s investment in basic cancer research has led us to an
unprecedented understanding of the cancer cell. With this new knowledge, we are
undertaking major efforts to prevent cancer; to reverse the process once it starts;
to find ways to activate the body’s own immune system; and to treat the disease
and its symptoms more effectively.”
President Ronald W. Reagan
Cancer Control Month Proclamation, April 7, 1986