Authored by Allan Bowditch, Engage Estero’s Chief Communications Officer.

Introduction

Engage Estero continuously assesses topics that we believe are important and beneficial to improve the quality of life in greater Estero. This is one such topic.

A cancer diagnosis often brings a range of intense emotions and concerns, both immediate and long-term. Understandably, many people worry about the prognosis, the progression of the disease, and its impact on their lifespan.

Cancer treatments, such as chemotherapy, radiation, and surgery, frequently come with side effects like fatigue, nausea, hair loss, pain, or long-term complications. The fear of these side effects can be overwhelming. Many families do not have full-coverage health insurance and are thus concerned about medical bills, lost income, and long-term financial instability.

Such a diagnosis has a much broader effect on the individual, their family, and their friends. This can frequently result in emotional stress or changing family dynamics. The psychological burden can be heavy. The unpredictability of the disease can cause anxiety about what comes next. People often struggle with depression, anxiety, or feelings of hopelessness after receiving a cancer diagnosis.

Each person reacts differently to a cancer diagnosis, and these concerns can vary depending on the type of cancer, stage, age, and personal circumstances. Support from family, friends, healthcare professionals, and counselors can play a significant role in addressing these worries.

While these concerns are undeniable, the advances made in the recent past should bring hope and reassurance that much can now be done to overcome the fear and negativity that such a diagnosis can cause.

Part1

Improved Treatments

Several significant advances in cancer treatments have improved patient outcomes and offered new disease management possibilities in recent years. Some of the most notable advances include:

1. Immunotherapy

Immunotherapy has been one of the most groundbreaking treatments in cancer care. It involves harnessing the body’s immune system to fight cancer. Notable advancements include:

• Checkpoint Inhibitors (e.g., pembrolizumab, nivolumab): These drugs block the proteins that prevent immune cells from attacking cancer cells, allowing for a stronger immune response.
• CAR-T Cell Therapy: Chimeric Antigen Receptor T-cell (CAR-T) therapy involves modifying a patient’s T cells to recognize better and attack cancer cells. This has shown promise in blood cancers like leukemia and lymphoma.
• Cancer Vaccines (e.g., therapeutic vaccines): Vaccines designed to stimulate the immune system to target specific cancer antigens.

2. Targeted Therapy

Targeted therapies focus on specific molecules or pathways that drive cancer growth, offering more precise and often less toxic treatments than traditional chemotherapy. Some advancements include:

• PARP Inhibitors (e.g., olaparib): These drugs target cancer cells with specific genetic mutations (like BRCA mutations), preventing them from repairing DNA damage.
• Kinase Inhibitors: These drugs block the activity of abnormal proteins that drive cancer growth, such as in cases of chronic myelogenous leukemia (CML) or non-small cell lung cancer (NSCLC).

3. Personalized Medicine

Advancements in genetic testing and biomarker identification have paved the way for precision medicine, where treatments are tailored to an individual’s genetic makeup and a tumor’s genetic profile. This allows for more effective treatments and avoids unnecessary side effects.

4. Liquid Biopsy

A liquid biopsy is a non-invasive method that uses blood samples to detect genetic mutations or cancer-related DNA. It offers the potential for early cancer detection, monitoring treatment response, and detecting recurrence, often before traditional imaging methods.

5. Advancements in Radiation Therapy

Radiation therapy has become more precise and effective through technologies such as:

• Proton Therapy: This radiation therapy uses protons instead of X-rays. It allows for more targeted treatment, which can spare healthy tissues.
• Stereotactic Body Radiation Therapy (SBRT): This allows high doses of radiation to small, well-defined tumors with high precision.

As many residents in greater Estero will be aware, Estero now has one of only 42 Proton Therapy Centers in the United States. This is located on the northwest corner of Three Oaks Parkway and Estero Parkway. It is the first on Florida’s West Coast to offer proton therapy, an advanced radiation therapy.

The $80 million project, a joint venture between Advocate Radiation Oncology and Lee Healthcare Holdings (a subsidiary of Lee Health), is expected to be a game-changer for cancer care in the region. Once the complex medical equipment, including the particle accelerator, is installed by the end of 2024, calibrating the machines will take approximately 4-6 months before the first patients can be treated in mid-2025.

6. Oncolytic Virus Therapy

This is an emerging area where genetically modified viruses are used to infect and kill cancer cells while stimulating an immune response. Clinical trials are showing promise, particularly for melanoma and glioblastoma.

7. Artificial Intelligence (AI) and Machine Learning

AI is growing in improving cancer diagnostics, predicting treatment responses, and identifying new drug targets. It can analyze vast amounts of medical data to uncover patterns that may be missed by human doctors, thus improving accuracy in early detection and personalized treatment planning.

8. Combination Therapies

Combining different types of treatments, such as immunotherapy with targeted therapy or chemotherapy, has become a key strategy to enhance effectiveness and overcome resistance in cancers like melanoma, lung cancer, and breast cancer.

These advancements transform cancer care by offering more effective, less toxic, and highly personalized treatment options. Research is ongoing, promising even more significant breakthroughs in the coming years.

Part 2

Significant Advances for Particular Cancer Types

Recent advancements in cancer treatments have significantly impacted several types of cancers. These breakthroughs transform how some cancers are diagnosed, treated, and managed. Below are some of the cancers where these advances have made the most substantial difference:

1. Melanoma

• Immunotherapy: Checkpoint inhibitors like nivolumab (Opdivo) and pembrolizumab (Keytruda) have revolutionized the treatment of melanoma. These therapies have dramatically improved survival rates, even in advanced stages.
• Targeted Therapy: For melanoma with specific mutations (e.g., BRAF mutations), targeted therapies like vemurafenib and dabrafenib have shown significant efficacy. These therapies provide durable responses when combined with MEK inhibitors (e.g., trametinib).
• Adjuvant Treatment: New immunotherapies and targeted therapies are now being used earlier to prevent recurrence, significantly improving long-term survival.

2. Lung Cancer (Non-Small Cell Lung Cancer – NSCLC)

• Targeted Therapy: Advances in EGFR inhibitors (e.g., osimertinib) and ALK inhibitors (e.g., crizotinib) have transformed the treatment of NSCLC, especially for patients with these genetic mutations. These therapies are often more effective and cause fewer side effects than traditional chemotherapy.
• Immunotherapy: Drugs like pembrolizumab (Keytruda) and nivolumab (Opdivo) have made immunotherapy a mainstay in treating advanced NSCLC, particularly in patients with high levels of PD-L1 expression. Immunotherapy has been integrated into both first-line and later-stage treatment regimens.
• Liquid Biopsy: Non-invasive testing for mutations using blood samples has enabled earlier detection and monitoring of treatment responses, allowing for more personalized and timely interventions.

3. Breast Cancer

• HER2-Positive Breast Cancer: Drugs like trastuzumab (Herceptin) and newer agents such as neratinib and fam-trastuzumab deruxtecan have significantly improved survival rates for patients with HER2-positive breast cancer.
• PARP Inhibitors: For BRCA-mutated breast cancers, particularly triple-negative breast cancer (TNBC), PARP inhibitors like olaparib have become an important treatment option, especially in the metastatic setting.
• Immunotherapy: The use of atezolizumab (Tecentriq) and pembrolizumab (Keytruda) in combination with chemotherapy has improved outcomes for patients with triple-negative breast cancer, a particularly aggressive form.          Bronson Healthcare

4. Blood Cancers (Leukemia, Lymphoma, and Myeloma)

• CAR-T Cell Therapy: Chimeric Antigen Receptor T-cell (CAR-T) therapy has transformed the treatment of blood cancers like acute lymphoblastic leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL). These treatments involve modifying a patient’s T cells to attack cancer cells and have shown high efficacy, even in cases where other treatments have failed.
• Immunotherapy and Targeted Therapy: In cancers like chronic myelogenous leukemia (CML), tyrosine kinase inhibitors (TKIs) like imatinib have greatly improved survival, turning CML into a manageable disease. Similarly, checkpoint inhibitors are promising in non-Hodgkin lymphoma and other blood cancers.
• Multiple Myeloma: Advancements in immunomodulatory drugs (e.g., lenalidomide) and proteasome inhibitors (e.g., bortezomib) have dramatically improved outcomes for patients with multiple myeloma. Additionally, newer therapies like bispecific antibodies (e.g., teclistamab) are showing promising results.

5. Prostate Cancer

• Targeted Therapy and Hormone Therapy: PARP inhibitors and newer hormone therapies like apalutamide and enzalutamide have shown significant effectiveness in treating metastatic castration-resistant prostate cancer (mCRPC). These therapies provide new options for patients previously running out of treatment choices.
• Immunotherapy: Though still under investigation, the use of immunotherapies like sipuleucel-T (Provenge) has become an option for advanced prostate cancer, providing a therapeutic approach based on immune system activation.
• Proton Therapy: This newer form of more targeted and less aggressive radiation treatment has also become an option. The success of this treatment is still under review. Standard radiation therapy is still considered appropriate in certain circumstances.

6. Pancreatic Cancer

• Immunotherapy: While pancreatic cancer remains challenging to treat, using checkpoint inhibitors and combination therapies is showing early promise in clinical trials, especially in patients with specific genetic mutations (e.g., BRCA mutations).
• Chemotherapy Regimens: New chemotherapy combinations, like FOLFIRINOX (a combination of fluorouracil, leucovorin, irinotecan, and oxaliplatin), have improved survival rates for patients with pancreatic cancer, particularly in the earlier stages.

7. Colorectal Cancer

• Targeted Therapy: Drugs targeting EGFR (e.g., cetuximab) and VEGF (e.g., bevacizumab) are improving outcomes for patients with metastatic colorectal cancer, especially when combined with chemotherapy.
• Immunotherapy: Pembrolizumab and nivolumab are approved for treating microsatellite instability-high (MSI-H) colorectal cancers, a subset that is exceptionally responsive to immunotherapy.
• Liquid Biopsy: Advances in liquid biopsy are enabling earlier detection and better monitoring of colorectal cancer progression, which could improve treatment strategies.

8. Ovarian Cancer

• PARP Inhibitors: Olaparib and rucaparib are changing the landscape of treatment for BRCA-mutated ovarian cancer, particularly in patients with advanced disease or those who have relapsed.
• Immunotherapy: While still being studied, immunotherapies like nivolumab and pembrolizumab are promising in clinical ovarian cancer trials, especially when combined with other therapies.

9. Glioblastoma

• Immunotherapy: Advances in immunotherapy, particularly the use of checkpoint inhibitors and oncolytic virus therapies, are offering hope for glioblastoma, which remains one of the most aggressive and difficult-to-treat cancers.
• Targeted Therapy: Drugs like temozolomide (for first-line treatment) and emerging targeted agents are improving the treatment landscape, though glioblastoma remains challenging.

10. Esophageal and Gastric Cancer

• Immunotherapy: The approval of nivolumab and pembrolizumab for certain types of esophageal and gastric cancer has significantly impacted treatment options, particularly in advanced stages.
• Targeted Therapy: Targeted therapies for specific mutations in esophageal and gastric cancers, like HER2-targeted treatments, improve outcomes for some patients.

 

These advancements reflect a shift toward more personalized, less toxic, and more targeted treatments, improving survival rates and quality of life for patients across many different types of cancer. Continued research and clinical trials are expected to lead to even more breakthroughs in the coming years.

While no one wants to hear about a big “C” diagnosis, hopefully, hearing about these important new treatment approaches and the developments that continue to take place will be somewhat reassuring.

Cancer is not the most frequent cause of death in the United States; heart disease holds that position. According to the Centers for Disease Control and Prevention (CDC), in recent years, heart disease has consistently been the leading cause of death, followed closely by cancer. The death rate associated with cancer has declined over the past three decades, although the incidence of certain cancers is rising among specific populations, including women and younger adults.

While there is no surefire way to prevent cancer entirely, many lifestyle changes and habits can help lower the likelihood of developing certain types. Here are some strategies to minimize cancer risks:

• Avoid Smoking and Tobacco Use
• Maintain a Healthy Diet
• Stay Physically Active
• Limit Alcohol Consumption
• Protect Your Skin from UV Exposure
• Get Regular Screenings and Checkups
• Avoid Environmental Toxins
• Maintain a Healthy Weight
• Manage Stress
• Know Your Family History

Engage Estero wishes everyone a healthy, happy, and enjoyable future in our corner of paradise.