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Using The Power Of The Immune System

With the dawn of immunotherapies, it is now possible to harness your own immune system to fight against cancer tumours.

fightSingapore’s cancer statistics make for grim reading. Each day, 36 people are told that they have cancer. According to the National Registry of Diseases Office, cancer is the top cause of death here, with one in three dying of it. Cancer cases have increased by 17% since 2010, marking a worrying trend.

However, what is reassuring is that technological advancements are progressing more rapidly than ever before. It is estimated that around four in 10 cases may be prevented and that early detection of the disease leads to a better chance of recovery and even complete recovery.

A new class of drug – immunotherapies – designed to encourage our body’s immune system to attack malignant cells could be the answer to addressing cancers that affect a large number of our population, such as lung cancer.

Using our immune system
Our immune system contains three key lymphocytes (the main type of cell found in lymph): T-cells, B-cells and natural killer (NK) cells.

T-cells, which are primed to identify and destroy infections and abnormalities, have a built-in brake to stop them from attacking healthy tissues. Cancer cells activate the brake, effectively hiding themselves from our T-cells and staving off an attack.

Recent successes involve developing an antibody to inhibit the braking mechanism. Freed from their brakes, our T-cells are able to attack cancer cells, especially cells that are more mutated as they look more different from normal cells. This treatment is able to shrink or even eliminate tumours in some patients with terrible prognoses, such as those with advanced metastatic cancer.

This finding is extremely encouraging because patients with advanced cancers tend to be physically weaker, hence harder to treat with conventional options such as cytotoxic drugs, radiation and surgery.

In the long-term, it is likely that such immunotherapies could be supported by more personalised selection methods, like specialised markers or genomic tests to determine the customised approach for each patient. In the long run, oncologists may work out the best approach for each patient by reading the DNA of their cancer cells, a procedure that is becoming more affordable as genomic technology advances.

It is increasingly possible that we will be able to wipe out tumours permanently for some patients, while others may live with cancer for a longer period of time.

Treatment limitations
At present, there are usable immune-oncological therapies for some cancer patients. Although the current response rate is encouraging, the risk of this treatment is an immune system with too many brakes removed, leading to autoimmune disease.

Some tumours, such as those in the brain, sit in a protected environment and are more difficult to treat and the utility of immunotherapies needs to be further tested.

Tackling cancer
Recent advancements in cancer treatment help us move away from the old ‘cancer equals death’ viewpoint.

As we understand cancer better and target tumours with a combination of modern treatment methods, survival rates will rise. But it is imperative that people are conscious about their health and schedule regular screenings.

As with any disease, cancer evolves over time. The best evaluation done early will allow you to carefully consider all treatment methods and achieve the best results. In many instances, this could mean long term cure.

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Mount Elizabeth Novena Hospital

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