New lifesaving advances in cancer treatment.

Although battles are lost ever day in the fight against cancer, quantum leaps are being made in treatment.

Since the early 1970s, when war was declared on cancer, the strategies used to battle the disease have continued to change and improve. This "sharpening of the weapons" is because of the ongoing extensive research, so necessary to defeat the enemy that afflicts over one million people a year. Not only has the number of casualties risen each year, but also the number of younger persons diagnosed with the disease.

"One of the changes we're seeing is that patients are younger, and that's surprising to a lot of people," says Chris Farrow, patient-care coordinator and nurse for the Ida M. and Cecil H. Green Cancer Center of the Scripps Clinic and Research Foundation. Patients travel from all over the world to the cancer treatment center located in La Jolla, California, just outside of San Diego County.

"It's a big myth that cancer is an old person's disease. Many people think of cancer patients as being in their 70s," she adds. "And although some are [that age], a lot of the braincancer patients, in particular, are very young. Other patients are in their 30s and 40s, and some of the patients that age are pregnant."

Another myth is that cancer is a single disease. Hundreds of different types of malignancies exist, each presenting a need for evaluation and treatment different from the others. For example, there are more than a dozen kinds of breast cancers - which means that some breast tumors can double in size in 30 days, while others take decades to develop. And treatment can be almost as varied as the diseases, depending on the kind of cancer, how big it is, and where and how far it has spread.

Two patients diagnosed with the same kind of cancer can receive two different types of treatment. To determine the best treatment, a patient's overall health and age must be taken into consideration, along with other factors.

Treatment breakthroughs. In 1970 the National Cancer Institute was given the primary responsibility to search and find new treatment methods. In fact, the National Cancer Act commissioned the agency to find a cure for cancer.

According to Karen Heskett, cancer information specialist at the National Cancer Institute, in Washington, D.C., "thousands of clinical trials are looking into the treatment of cancer. The trials involve different treatments all the time."

One of the biggest breakthroughs in treatment is called bone-marrow or stem-cell transplant therapy. The patient's bone marrow is extracted before high doses of chemotherapy are given. Afterward the marrow is reimplanted and stimulated by drugs to develop quickly, so that the patient can once again have a viable immune system. The process is called "rescue."

"This new treatment has proved to be very effective and is very promising," Farrow says. With the traditional standard doses of chemotherapy, the cancer usually comes back later. "Previously we couldn't kill microscopic cells (with standard doses), but now we can with the higher doses, and with rescue," Farrow says. "We're finding that the cancer cells won't come back."

"With this treatment we use a new category of drugs called colony-stimulating factor," Farrow adds. "Today, there are more drugs that are more effective in killing more cancer cells." One of the colony stimulating factor drugs is Neu Pogen, which is much used to stimulate white blood cells to come back faster after higher doses of chemotherapy. This allows the patient to have more frequent cycles of chemotherapy, and a greater chance of survival.

Improvements in chemotherapy. Another new treatment uses drugs to combat the nausea and vomiting side effects of chemotherapy. The new drugs, Zofran or Ondansetran, and Kytril, are so effective that patients are now having chemotherapy treatments on their lunch breaks.

"There's a lot of chemotherapy done on an outpatient basis," Farrow says. "Some patients come in on their lunch hour and go back to work. We can use these drugs on any patient given chemotherapy. We treat all types of cancer with them, and they work well." One drawback is that the drugs are expensive.

Targeting tumors. Still another new treatment is the use of a gamma knife for brain tumor surgery. Many tumors are inoperable and hard to treat. Even with those tumors that are operable, there's the risk that a major center of the brain, such as sight, coordination, or hearing, may be damaged or removed.

Although called the gamma knife, it's actually like a laser, able to remove a cancer through a series of treatments that apply precise, direct radiation into the cancerous area of the brain. "Before this development, there was no treatment for inoperable brain tumors," says Farrow. This lifesaving treatment available today takes only three to four hours, and the patient is released immediately after treatment. The gamma knife is also being used for treatment of Parkinson's Disease.

Not only does this advancement offer new hope and life to patients plagued with an inoperable tumor, many of whom are children, but it comes with savings in treatment costs. A typical surgery for an operable brain tumor costs between $30,000 and $90,000, and results in a long recuperation period, in addition to scarring. The gamma knife is almost a third the cost without the scarring.

This treatment is offered in only 18 facilities in the United States, one of which is the Ida M. and Cecil H. Green Cancer Research Center of the Scripps Research Center in La Jolla, where Farrow works.

The most distinct new form of treatment in recent years is proton beam radiation offered at the three-level underground proton treatment center at Loma Linda University Medical Center in California. The Proton Treatment Center is the only facility in the U.S. that's actually treating cancer patients with the proton accelerator. Massachusetts General Hospital, in conjunction with Harvard University, is experimenting with it. However, outside the U.S. nine sites are using it - three in Russia, two in Japan, and one each in Switzerland, Sweden, Canada, and South Africa.

The accelerator is designed to deliver a beam of energy sufficient to reach and destroy deep tumors in most patients. Proton treatment is particularly valuable in dealing with localized solid tumors - tumors detected prior to their spread throughout the body. This unique system allows protons to be precisely aimed at a tumor anywhere in the body.

The center specializes in the treatment of many cancers, including prostate cancer, the most common cancer among American men, and the second-most common cause of cancer death.

Proton treatment, which usually takes less than 15 minutes, introduces greater selectivity in destroying cancer cells, reduces damage to surrounding healthy tissue, and greatly reduces the side effects traditionally associated with radiation treatment.

Protons deposit virtually all their energy at the end of their desired path. Tissues in front of the targeted tumor receive a small dose, and those to the sides of and beyond the target receive virtually none.

The high precision of this system allows the oncologist to increase the dose to the tumor while reducing the dose to overlying healthy tissue.

"It's very exciting seeing all the new developments in cancer treatment," Farrow says. "We expect that in 10 years some cancers won't even exist."

Although battles are being lost everyday in the fight against cancer, the number of quantum leaps being made in clinical trials and treatments is increasing. With that being so, there is hope of victory.