More and more real cases tell us that the current clinical use of surgery, chemotherapy and radiotherapy cannot achieve the goal to have a cancer-free state. It is very difficult for the realization of cancer-free survival. Professor Sun Yan, a famous oncologist, said, “Previously we focused on radical treatment of cancer. It now appears that this is a wrong approach. In fact, cancer is a chronic disease. We can take a two-prone approach of disease prevention (defence) and treatment (reform). Long-term survival with cancer is feasible.”
The National Cancer Institute of USA has used the improvement in patient’s quality of life and the extension of survival time as important indicators on the evaluation on the efficacy of cancer treatment. The current understanding of cancer treatment has led to the change from total elimination of cancer cells to the process of effective disease control or basic control of disease development; from total “confrontation till the end” to “peaceful coexistence” with cancer.
The development of cancer treatment can be divided into four phases which are: exploration, cytotoxic therapy, molecular targeted therapy and individualized treatment. Individualized treatment firstly requires individualized diagnosis, determination of patient’s genes and their expression. Different diseases require different therapies. Based on the molecular level, the most suited therapy is determined; a treatment plan which is people-centred and tailored-made is worked out. This requires close coordination and interactive conversion of basic and clinical research. This is what is called “from bench to bedside” or the reverse. The most successful example is the use of EHFR-TKI for the treatment of advanced non-small cell lung cancer on oriental patients. This drug is much less effective for Westerners but it is more effective among oriental people. Many patients survive 3 – 4 years after treatment and this is the difference expressed by EHFR-TKI between Westerners and Oriental people. Currently, research on this area is still at its early stage.
As clinicians, we cannot wait until there is a breakthrough in cancer treatment before we treat patients. Patients with advanced cancer normally either cannot tolerate conventional treatment or conventional treatment has failed to work in them. We must not place our hope on one particular treatment method neither we can apply all available treatment methods. On 14th April 2010, a seminar on minimally invasive cancer treatment was held in Shenzhen. Professor Wu Peihong, the chairman of the minimal invasive treatment committee of the Anti-Cancer Association of China proposed that for treatment of advanced, medium and late stage cancer patients, we must be humane, rational, and apply individualized minimal invasive therapy. This was well summarised and I appreciate Professor Wu for his wisdom very much.