Cancer treatment undergoes revolution, from surgery to immunotherapy

Underdiagnosed and untreated for centuries, cancer has undergone a therapeutic revolution in recent decades. Innovations multiply, even if this does not mean replacing traditional therapies.

See below what are the treatments, old and new, available against the disease.

Surgery

Cancer has been diagnosed since ancient Egypt. Later, the Greek physician Hippocrates gave it a name: “karkinos”, which means crab in Greek. The first treatments for the disease, at the end of the 19th century, focused on surgery to remove the tumor.

Currently, these interventions continue to be “an important therapeutic weapon”, according to Professor Steven Le Gouill, an oncohematologist in charge of the outpatient clinic at the Curie Institute in Paris.

“Breast cancer, colon cancer, sarcoma… many tumors are left in the hands of surgeons”, says Le Gouill. But surgery is also “a gateway in many types of cancer, and it is thanks to it that we have access to tumor tissue that allows the diagnosis”.

Radiotherapy

Radiotherapy emerged from the advances of the German physicist Wilhelm Röntgen, who discovered X-rays in 1895. This method continues to play an important role today, as more than 70% of cancer treatments include radiotherapy sessions, which consist of sending rays (electrons, photons, protons) that destroy cancer cells.

Their disadvantage is that they damage the tissues through which they pass until they reach the tumor. Many innovations try to remedy this problem, including high-frequency radiation with stronger doses.

It’s about “being as precise as possible and sending the strongest possible dose of radiation to the tumor level, without touching healthy tissue”, explains Steven Le Gouill.

Chemotherapy

It covers cytotoxic drugs (several molecules regularly used in combination) that will also destroy cancer cells. Although often associated with its side effects, such as hair loss, this therapy continues to be effective, as in cases of acute leukemia.

Vaccines

There are vaccines to prevent cancer when it is associated with a virus: vaccines against human papilloma and hepatitis B (which can cause liver cancer).

For years, investigations have been made for “therapeutic vaccines”. In this case, it is about producing tumor antigens (through messenger RNA or the virus itself), which allow the immune system to activate and produce an appropriate response in cancer patients.

target therapy

For a few decades, targeted therapy has changed the lives of many patients. These are chemical molecules designed specifically to block or interrupt a molecular mechanism essential for the advancement, proliferation or survival of tumor cells.

Immunotherapy

It is the great revolution of recent years. It consists of strengthening the patient’s immune system to help it detect and kill cancer cells.

Immunotherapy is based on synthetic antibodies, produced in laboratories, and several modalities are possible.

These antibodies attack, for example, a protein on the surface of cancer cells. By settling on the attacked cell, the antibodies trigger an antitumor action indirectly or by stimulating the immune system.

The CAR-T cells

It is a cell therapy whose objective is to teach the immune system to recognize and attack cancer cells.

The patient’s immune system cells (often T lymphocytes) are removed, genetically modified in the laboratory, and then reinjected into the person. Your task will be to attack cancer cells.

Biotechnology companies have also bet on so-called allogeneic CAR-T cells. In this case, scientists will genetically modify cells that are not from the patient, but from a healthy carrier.

CAR-T has shown efficacy in types of blood cancer such as lymphomas, some forms of acute leukemia and multiple myeloma. However, it is still an expensive method.

“The interest is to combine all these approaches and new therapies to have a personalized plan for the patient”, observes Professor Le Gouill, who is optimistic.

“We have passed a stage in our understanding of the tumor cell. Cancer continues to be a challenge, but advances have been made exponentially”, he says.