New therapies for cancer

About 480,000 people get new cancer every year in Germany. Overall, four out of ten women and five out of ten men expect to get the disease during their lifetime. Nevertheless, there is good news: More and more cancer patients survive. It has just been calculated from WHO data that cancer mortality in Europe is declining. In the last five years alone, they have fallen by ten percent in men and seven percent in women.

But it still holds true: Whether patients are cured or can live well and long depends very much on the nature of their tumor. While breast cancer today is cured to 86 percent, survives, for example, in lung cancer, only one in five people affected the first five years. But recently there are hopes for a longer life, especially in the particularly dangerous types of illness. These are the most important new insights:

New therapies for cancer: The healing power of the movement has long been underestimated

Previously, cancer patients' movement was rather half-heartedly recommended and considered solely as a feel-good factor. But in recent years, several studies have shown the amazing healing power of sport. Especially with breast cancer and colon cancer can be with a light exercise program (eg walk five days a week for half an hour) reduce the risk of recurrence (recurrence) by 30 to 40 percent.

In one study, the risk of dying from breast cancer decreased in patients who were physically active after their surgery, by 45 percent compared to physically inactive women. Therefore, no cancer patient and no cancer patient should do without this therapy. Especially since the only side effects are fitness and good mood.

Breast cancer: gentler therapies

In recent years, new drugs have been developed against breast cancer and always tried new combinations. And although this results in better treatment success, many cancer experts are now beginning to hesitate. "Overtreatments", ie unnecessary therapies that only cause harmful side effects, have recently become a major topic in breast cancer. This also applies to operations.

So far was valid: If in one of the lymph nodes of the armpit (the so-called sentinel or Sentinellymphknoten) cancer cells are detected, as far as possible all lymph nodes are removed in the armpit: an incriminating operation, which can lead to lymph congestion and swell the arm. And now it is increasingly doubted whether it improves the chances of recovery at all. At the world's largest breast cancer congress in San Antonio, USA, a large study was just presented. There was no difference in whether or not the axillary lymph nodes were removed in women with breast tumors less than five centimeters in diameter and few and small lymph node metastases after five years , In both treatment groups, the tumor had not returned in 88 percent of the patients. But the women who were not operated did much better: for example, they suffered less often from edema (ie accumulation of water) in their arms.

There are situations in which patients can be spared the removal of lymph nodes from the armpit. Prerequisite: You are in a specialized breast center, where these questions are discussed with the necessary professional background and you may also be able to participate in a corresponding study. And experts are also discussing this at the moment: so-called intraoperative radiation. Immediately after the removal of the nodule, the surrounding breast tissue is irradiated once - the OP lasts about half an hour longer - and the usual "outside" radiotherapy lasting several weeks, which is necessary after breast-conserving surgery, is eliminated. The radiation during the operation not only saves the patient time, but also has medical benefits: the total radiation dose is lower, there are no skin irritations.

So far, there is no evidence that intraoperative radiation is less effective. However, it is too early to definitively judge the method. We still do not know if permanent cures are as common as with conventional radiotherapy. The procedure is offered so far only in a few clinics, usually in the context of studies.

Ovarian Cancer: New weapons against the treacherous tumors

Ovarian carcinomas are usually discovered late because they do not cause any complaints. Only 20 to 30 percent of patients with advanced tumors are cured, This cancer is one of the most vicious of all. The therapy has not changed much for fifteen years. It consists of as complete a surgical removal of the tumor as possible and subsequent chemotherapy.

But now, for the first time in a long time, a new drug has been approved for the treatment of advanced ovarian cancer, bevacizumab.This antibody inhibits a messenger that promotes tumor growth. Several clinical studies have shown that the treacherous tumors can be better controlled in combination with traditional chemo. And fortunately, especially the women who benefit the most, whose tumor could not be completely surgically eradicated, who had so far extremely bad chances: They live almost eight months longer.

Black skin cancer: Longer life with new drugs

Fortunately, melanomas are also discovered in over half of early-stage cases, thanks in part to cash-focussed early detection from the age of 35, with excellent healing prospects of over 90 percent. But once the black skin cancer has formed metastases, most patients live only a few months.

Recently there is more hope for patients in advanced stages. If your tumor has a certain genetic change - and this is true for about half of the cases - the currently approved drug vemurafenib extends life. This means that 84% of patients still live after half a year, compared with 64% for older drugs. Also new: an immunotherapy with ipilimumab. This substance activates certain immune cells and allows those affected to survive longer (in combination with standard chemotherapy).

Lung cancer: Better chances through early detection

Lung cancer is almost twice as common in women today as it was 20 years ago. Younger women are particularly affected by this increase because many have been smoking as a teenager. Rarely, lung cancer is detected in the early stages. Therefore, on average, only about 18 percent of the patients live five years after the diagnosis. That an effective early detection would be possible, but has just shown a US study. Here, more than 50,000 heavy smokers were X-rayed annually, either with a conventional scan or a CT scan (computed tomogram).

With the help of CT, lung cancer was discovered more frequently - and more importantly, several tumors were found so early that eight years later 20 percent fewer study participants had died than in the X-ray group. Normal X-ray is therefore not suitable as an early detection method This has just been confirmed by another major study by the University of Minnesota. CT examinations of the lungs, however, do not belong to the early detection program - just like normal X-rays.

Anyone who has smoked long and hard and is therefore worried should get individual advice from the doctor. Overall, the chances of a cure for lung cancer are still poor. But at least when the cancer cells have certain genetic changes, some new remedies work. For example, erlotinib and gefitinib are even better in women than in men. In a Japanese study, women with advanced lung cancer, who did not have other therapies, lived on an average of 22 months after gefitinib treatment, men only 12 months. And in the US, crizotinib has just been approved for the treatment of lung cancer with very specific genetic alterations - about one in twenty have these so-called ALK-positive tumors. This means that two thirds of the patients still live two years after the therapy, without the new substance only one third.

The approval of the new active substance in Europe is imminent. The problem here: Not only against lung cancer are always new drugs on the market, which only act on certain genetic changes. But the tests that detect these changes before therapy can often only be done in a few specialized laboratories and are extremely expensive. Therefore, it is now thought about such new drugs only to be allowed if the manufacturer delivers a test suitable for everyday use right away.

Cervical cancer: gentle surgical method

Cancer of the cervix (cervical carcinoma) has been treated radically so far. The uterus, a part of the vagina, the lymph nodes and a lot of tissue in the pelvis have been removed - and, unfortunately, nerves have also been severed. The burdening consequences: About half of the patients have problems urinating or defecatingEvery third person loses her sexual sensibility.

Much gentler, however, is a new surgical method called compartment resection or TMMR. The revolutionary thing about it is that it only removes tissue that functionally belongs together because of organ development during the embryonic period - because it is only within these units that the cancer spreads preferentially. Heavy side effects are reduced by one-third, with no less thorough tumor removal. In several clinics, the procedure is already offered.

How do you find good specialists against cancer?

At www.onkozert.de you will find the addresses of all certified cancer centers, broken down by types of cancer (such as breast cancer, gynecological tumors, lung cancer).

The Cancer Information Service of the German Cancer Research Center in Heidelberg also helps with the freephone number 0800/420 30 40 or www.krebsinformation.de.

Anyone interested in participating in a scientific study will find an overview of studies planned and ongoing in Germany at the German Cancer Society at www.studien.de/uebersicht.php and especially for breast cancer at www.brustkrebs-studien.de.

Bestsellers, films, TV series: Cancer is a big topic in culture right now

WATCH TV: The big C, "The Big C," is the title of an award-winning US series starring superstar Laura Linney, who will be broadcasting the third season this year in America. C like cancer, cancer. The big C determines the existence of Cathy, a teacher and mother, who after the diagnosis takes her life into her own hands and keeps her illness secret. Tip: The second season is currently running in Germany on the pay station Fox, the first season's in German on DVD.

MOVIE THEATER: Alone in the second half of last year, four films ran on dying. Best known: "Stop on the open track" by director Andreas Dresen, in which he relentlessly shows the dying of a father in the middle of life.

"Dad, can I have your iPhone when you're dead?", The little son asks his dying father - and that brings this honest and very loving film exactly to the point.

Others deliberately approach the difficult topic with ease, such as the pop, lush festival success "Life is ours" from France. For years, a young couple is battling with their little son against his brain tumor - but do not stop going to parties or sledging, even in front of the hospital. The director Valérie Donzelli and her ex-partner Jérémie Elkaïm play the lead roles and thus process their own story: Their common son Gabriel has defeated the cancer in real life after years. Tip: from 26th April in our cinemas.

Also very interesting: "50/50", a smart, emphatically unsentimental US independent comedy about a young man with cancer and his best friend who wants to help him and has no idea how. Tip: The movie starts on May 3rd.

BOOKS: The autobiography "Today I'm blond" (9 Euro, Knaur paperback) is being filmed. In it, the Dutch Sophie van der Stap reported frankly, touching and humorous about her cancer - at the time of diagnosis, she was only 21 years old. The film by Marc Rothemund is expected to be released in the cinema by the end of the year.

A detailed scientific biography on 670 pages is Siddharta Mukherjee's "The King of All Diseases: Cancer" (26 euros, Dumont). A "grandiose cultural history of cancer" called the "mirror" the book. Cancer researcher Mukherjee was awarded the Pulitzer Prize for this.

New Options for Lung Cancer Therapies (May 2024).