Open Access Highly Accessed Debate

Imagine a world without cancer

Björn LDM Brücher1234567*, Gary Lyman8, Richard van Hillegersberg9, Raphael E Pollock10, Florian Lordick11, Han-Kwang Yang12, Toshikazu Ushijima13, Khay-Guan Yeoh14, Tomas Skricka15, Wojciech Polkowski16, Grzegorz Wallner16, Vic Verwaal17, Alfredo Garofalo18, Domenico D’Ugo19, Franco Roviello20, Hans-Ulrich Steinau21, Timothy J Wallace7, Martin Daumer12223456, Nitah Maihle23, Thomas J Reid24, Michel Ducreux25, Yuko Kitagawa26, Alexander Knuth27, Bruno Zilberstein28, Scott R Steele29 and Ijaz S Jamall12330456

Author Affiliations

1 Theodor-Billroth-Academy®, Munich, Germany

2 Theodor-Billroth-Academy®, Sacramento, CA, USA

3 Theodor-Billroth-Academy®, Richmond, VA, USA

4 INCORE, International Consortium of Research Excellence of the Theodor- Billroth-Academy®, Munich, Germany

5 INCORE, International Consortium of Research Excellence of the Theodor- Billroth-Academy®, Sacramento, CA, USA

6 INCORE, International Consortium of Research Excellence of the Theodor- Billroth-Academy®, Richmond, VA, USA

7 Bon Secours Cancer Institute, Richmond, VA, USA

8 Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA

9 Department of Surgery, University Medical Center, Utrecht, The Netherlands

10 Surgical Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH, USA

11 Medical Oncology, University of Leipzig, Leipzig, Germany

12 Department of Surgery, Seoul National University Hospital, Seoul, Korea

13 Division of Epigenomics, National Cancer Center Research Institute, Tokyo, Japan

14 Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

15 Department of Surgery, Masaryk University, Brno, Czech Republic

16 Surgery, Medical University of Lublin, Lublin, Poland

17 The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

18 Institutio Nazionale Tumori Regina Elena, Roma, Italy

19 Department of Surgery, Catholic University Rome A, Rome, Italy

20 Surgical Oncology, University of Siena, Siena, Italy

21 University of Essen, Essen, Germany

22 Sylvia Lawry Center for MS Research, Munich, Germany

23 Biochemistry and Molecular Biology, Georgia Regents University, Augusta, GA, USA

24 Regional Cancer Center Memorial Hospital of South Bend, South Bend, IN, USA

25 Departement of Medicine, Institut Gustave Roussy, Villejuif, Universite Paris-Sud, Le Kremlin, Bicetre, France

26 Department of Surgery, Keio University, Tokyo, Japan

27 National Center for Cancer Care and Research, Doha, Qatar

28 Digestive Surgery Division, Sao Paulo University, San Paulo, Brazil

29 Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA

30 Risk-based Decisions Inc, Sacramento, CA, USA

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BMC Cancer 2014, 14:186  doi:10.1186/1471-2407-14-186

Published: 14 March 2014

Abstract

Background

Since the “War on Cancer” was declared in 1971, the United States alone has expended some $300 billion on research, with a heavy focus on the role of genomics in anticancer therapy. Voluminous data have been collected and analyzed. However, in hindsight, any achievements made have not been realized in clinical practice in terms of overall survival or quality of life extended. This might be justified because cancer is not one disease but a conglomeration of multiple diseases, with widespread heterogeneity even within a single tumor type.

Discussion

Only a few types of cancer have been described that are associated with one major signaling pathway. This enabled the initial successful deployment of targeted therapy for such cancers. However, soon after this targeted approach was initiated, it was subverted as cancer cells learned and reacted to the initial treatments, oftentimes rendering the treatment less effective or even completely ineffective. During the past 30 plus years, the cancer classification used had, as its primary aim, the facilitation of communication and the exchange of information amongst those caring for cancer patients with the end goal of establishing a standardized approach for the diagnosis and treatment of cancers. This approach should be modified based on the recent research to affect a change from a service-based to an outcome-based approach. The vision of achieving long-term control and/or eradicating or curing cancer is far from being realized, but not impossible. In order to meet the challenges in getting there, any newly proposed anticancer strategy must integrate a personalized treatment outcome approach. This concept is predicated on tumor- and patient-associated variables, combined with an individualized response assessment strategy for therapy modification as suggested by the patient’s own results. As combined strategies may be outcome-orientated and integrate tumor-, patient- as well as cancer-preventive variables, this approach is likely to result in an optimized anticancer strategy.

Summary

Herein, we introduce such an anticancer strategy for all cancer patients, experts, and organizations: Imagine a World without Cancer.

Keywords:
Cancer; Carcinogenesis; Multimodal therapy; Cancer classification; Personalized anticancer therapy; Individualized anticancer therapy