When the cancer will cease to be a sentence: answers of the Ministry of health and scientists give hope

In 2018, physicians in the Russian Federation has established on average for 47 000 new cancer cases every month — according to data of the Ministry of health, from January to August discovered 379 351 new cases of malignant tumors.

In recent years this figure grew steadily: if in 2012 in Russia was recorded about 526 thousand cases of cancer, by the end of 2017, this figure amounted to more than 617 thousand people.

According to oncologists, one in five patients diagnosed with cancer die within the first year after diagnosis. While the world health organization predicts that the level of cancer rates in the world will continue to grow.

Federal news Agency appealed to the Ministry of health and leading specialized research center, SMRC radiology, with a question: when cancer in Russia will cease to be an invincible disease? In response, the Ministry of health and scientists told about the advanced technologies of cancer treatment in our country, but the exact date the experts are not named.

The fact that medicine recently studied tens of thousands of varieties of malignant tumors. Each has its own localization, scripts, treatments and predictions of survival and find a recipe or invent a vaccine for everything is impossible. But the answers are still encouraging. Some of the cancer types the proportion of past successful treatment and returning to normal life patients now is 99.6%.

“To answer for “refusal” cases”

A couple of decades ago in the treatment of cancer was relatively uncomplicated. Doctors distinguish types of cancer only in organs in which it was formed, — for example, treating cancer of the pancreas, without going into details, what kind of cell mutation in which part of the body caused cancer. A full range of therapies is most often boiled down to two main: chemotherapy and surgery to remove the organ or its part.

Today it is much easier to get lost: thousands of types of cancer, dozens of methods of influence on the wrong cells, until the editing of the genetic code, plus an even greater number of combinations of different technologies that are personalized for each individual case.

SMRC in radiology found that over the last 10 years the rate of so-called “one-year lethality” (when the patient dies within the first year after diagnosis) decreased by 30% although patients in this period has increased by 20.6 per cent.

However, the figure for the total number of cancer deaths, meanwhile, it has not appreciably changed. If in 2012 per 100 thousand of the population of Russia had 201 cases of death from cancer, last year he averaged 197,7 deaths for the same number of Russians. It turns out that doctors are increasingly able to prolong the life of patients for several years, but the proportion of fully recovered patients, while not significantly increased.

“How can we formulate our goal in these conditions? On the one hand is to make coverage cases, as large as possible and to find solutions to change the situation in General. On the other hand to provide answers on the most complex, including the single, “abandoned” cases,” — said in an interview with the FAN, the General Director of “national medical research center of radiology”, chief freelance oncologist of MoH of Russian Federation, Professor Andrey Kaprin.

Proton accelerator, gamma knife and light treatment

Experts do not exclude that in the near future will be able to change survival rates and mortality for cancer. Given the modern pace of technology development, the Russian medical sample January 2018 already very different even from the current situation.

The most important event of this year, the Ministry of health of the Russian Federation said the opening of the Obninsk Center of high-precision Gamma radiology Clinic.

“The center is the gamma knife, which is considered the “gold standard” of radiosurgery. In the centre is the treatment of both benign and malignant tumors and functional and vascular brain diseases”, — said the FAN in the office.

Besides, Andrey Kaprin said another achievement of the experts on the basis of the Medical radiological center. A. F. Tsyb in Obninsk: they began to use the proton accelerator to impact on cancer cells.

“The use of protons is a major breakthrough in Oncology. Proton center in Obninsk with the most compact and successful, in my opinion, accelerator “Prometheus” created by our colleagues from the Physico-technical scientific centre FIAN Lebedev in Moscow under the leadership of corresponding member of RAS Vladimir Balakina”, — said Andrey Kaprin.

The invention Balakina greatly exceed the characteristics of known foreign analogues and will find wide application in domestic medicine, expressed the hope that the interlocutor of the FAN. According to him, “Prometheus” has won a number of foreign tenders for the supply of boosters in the US, Israel and China, winning the world leaders in this field.

Another significant event Professor calls the beginning of domestic production of radioisotopes on the basis of a form of iodine. For this work a team of scientists from SMRC radiology and physics and energy Institute. Laparoscope was awarded the RF government prize in science and technology.

Today, the method of brachytherapy which uses radioactive pharmaceuticals that are used in a number of malignant tumors: prostate, uterus, breast, liver. For the first time in Russia it started to be used in pancreatic cancer.

“Become a standard surgery on the liver (which until recently had the worst predictions on survival) to remove not only large solitary metastases, but thermoablative multiple foci. Began routine operations on the brain, recovery bone pelvic ring,” — said the chief oncologist of Ministry of health.

In addition, according to the physician, using the proton accelerator in Russia increasingly treat tumors of the brain, lungs and mammary glands. Actively develops combined and complex methods of treatment using techniques of nuclear medicine: it is a hadron, the proton, neutron, radionuclide therapy.

According to the Ministry of health, SMRC radiology jointly with the Fund “SKOLKOVO” implementing projects for the development of photodynamic therapy — when the body entered the light-sensitive substance, and after the cancerous areas of the body directed light beam.

“Several institutions are working in the field of so-called liquid biopsy. This technology allows using specific markers to identify the presence of tumors (in the cells or their DNA) in biological fluids. For the analysis of ample saliva or blood sample. The method has high sensitivity, enables to constantly monitor the situation and to identify the recurrence for 3-6 months prior to clinical symptoms”, — says Andrey Kaprin.

“The picture changes considerably”

The Russian health system has adopted all the latest achievements of world science. One of the real breakthroughs in this area is targeted therapy, including the use of immune drugs.

“For 2018, the FDA is the primary regulator of pharmaceuticals in the West — has registered more than 30 new drugs aimed at the correction of immune failure in patients with aggressive cancers that do not respond to standard therapy due to rare mutations in the genome. Most patients with lymphoma, unresectable and metastatic melanoma, lung cancer, squamous cell carcinoma of skin, recurrent adenocarcinoma of the stomach and esophagus, liver cancer 5-10 years ago had virtually no chance of survival. Today, the picture changes significantly,” — said the chief oncologist.

October 1, 2018 in Stockholm announced the winners of the Nobel prize in 2018 in the field of physiology and medicine. Scientists James Allison of the US and Tasuku Honjo of Japan made a “discovery in the field of inhibition of the immune system to more effectively attack cancer cells”. Working in this direction and aspiring entrepreneurs in the science city of “SKOLKOVO”: the laboratory staff “Ecounit” seek new approaches to gene editing and immunologii — when the drug affects specific cancer causing a failure in the human body.

The neighbors “Ecounit” science city learn other ways of dealing with the disease: they investigate anti-cancer properties discovered in one of the ponds the algae Mallomonas, analyze the tumor causing mutations and predict how the body will react to specific type of treatment, type of biological tissue to test drugs. Any of these developments could theoretically go on a continuous cooperation with medical institutions of Russia and to enter into the medical insurance system.

“The Ministry of healthcare is constantly monitoring the emergence of a new perspective for health sector development, working, including, and with the SKOLKOVO Foundation, state Corporation “Rosatom” for competence in the development of technologies of nuclear medicine and radiotherapy”, is confirmed in the Ministry of health.

“The construction of the canyon under the nuclear accelerator”

According to Andrew Kaprina, the problems of cancer need to be solved by combining the efforts of several divers specialists and agencies.

Managed by Andrei Dmitrievich SMRC radiology cooperates with several research centers of Rosatom, Russian Academy of Sciences, Moscow state University, foreign colleagues. Today, on the basis of one of the branches SMRC radiology — Medical radiological research center. A. Tsyb built canyon under the most perfect accelerator with a capacity of 6 MeV. It will be a launching pad to re-equip the entire Oncology service with modern domestic accelerators.

“In cooperation with the laboratory of academician Manevitskogo we have created a sample microbioreactor, could materially change the scheme of selection of drugs for chemotherapy, and in the future — and radionuclide therapy. This device simulates a live environment for cancer cell specific patient, which in the conditions of the device are exploring the efficacy of a drug for a particular tumor. That is, we can talk about the long term transition to a completely different, individualized approach to cancer treatment”, — said Andrey Kaprin.

Together with scientists IMET RAS and Moscow state University in SMRC radiology learn to restore carved with a tumor parts of organs and tissues, re-imprinting on a 3D printer three-dimensional implants of the desired parameters of the biomaterials and saturating them with the necessary drugs for treatment and restore lost functions.

“The main trend of modern Oncology is a personalized approach and to reduce the effects of surgical intervention. That is, the task is not only increase in terms of survival but also preservation of quality of life, prevention of disability,” explained Kaprin.

“Increasing life expectancy to 80 years”

To the question about when will be found the ultimate weapon for victory over cancer, all the experts unanimously answer: it’s impossible.

“Tumor cells are characterized by high variability, quickly accumulating mutations and acquiring new properties. Therefore, expectations of creating a universal cure for cancer is not very justified,” — said the FAN in the Ministry of health.

However, according to representatives of departments and physicians, the lack of a universal weapon does not mean that the enemy is invincible.

“Our goal is to detect and radically disarm. Therefore, all these goals of availability, efficiency and timeliness of oncotomy walked by today the National program for the fight against cancer, which is personally headed by the Minister of health of Russia Veronika Skvortsova”, — says Andrey Kaprin.

The word referred to a physician program involves the upgrading of about one hundred regional agencies in Russia to help people with cancer, building a network of proton centers for nuclear medicine development, of clusters for the training of radio chemists, medical physicists, radiophysicists, outpatient cancer services on interregional and intermunicipal levels.

“It is clear that without a broad education, including the promotion of a healthy lifestyle, without careless of primary care physicians and specialists, without the availability of methods for early diagnosis and all treatments we are not able to reverse the situation”, — says Andrey Kaprin.

The most promising strategy, according to experts of the Ministry of health, will be a combination of various approaches to treatment: targeted therapy to radiolocator influence and also personalization of treatment is identification of the most effective methods of treatment for each individual patient.

If a motion vector and even the first success in this way in General already clear, the answer to the question, when the cancer no longer a death sentence, is more complicated. However, here is a guidance that the Ministry of health have outlined in your response FAN.

“One of the goals and strategic objectives development of the Russian Federation until 2024, defined by the presidential decree No. 204, of may 7, 2018, is to increase life expectancy to 78 years (by 2030, up to 80 years),” — said a FAN in the Ministry of health.

There is a chance that the statistics of the next five years will be markedly different from the present in a better way. From the point of view of the development of modern technology, 2019 may be observed in transition towards a new era of medical care for cancer patients: each month, practitioners, scientists, pharmacists, innovative entrepreneurs around the world make a minor step forward to a common goal — the victory of humanity over cancer.