How has cancer treatment changed in the past 70 years? In the last of our July blogs commemorating 70 years of the NHS, we’re reflecting on the breakthroughs and changes that have advanced the way we diagnose, monitor and treat cancer.
The past 70 years has seen many advancements in a variety of cancer treatments. In fact, it was around the time that the NHS was established when the first cancer drugs were discovered. In the World War II era, scientists discovered that derivatives of mustard gas were effective at treating a certain type of lymphoma, and so the age of cancer drugs began. Of course, many new and effective compounds have since been produced and chemotherapy has gone on to become a key line of defence in the treatment of cancer.
Similarly, advances in radiation physics and computer science mean that radiotherapy has also seen a number of advances in the lifetime of the NHS. Being able to better detect the border of a tumour or using a sequence that can more precisely deliver maximal dose to the tumour mass means that tumours can be treated more effectively than ever before while, crucially, damage to surrounding healthy tissue is minimised. These advances continue, with the creation and opening of the first centres proton therapy centres in the UK, in the very year the NHS celebrates its 70th birthday.
One of the most promising areas of cancer treatment in the past 7 decades has been in biological therapies, including immunotherapy. As scientists advance our understanding of the biological basis of cancer, it opens up new avenues for developing better treatments. For example, we know that cancer tumours possess specific proteins, called antigens. One of the most profound applications in this area has been the development of technology that enables the mass production of antibodies, which can be specifically targeted to destroy tumour cells via their antigens. The first therapeutic monoclonal antibodies were introduced in the late 1990s, including Herceptin, which has revolutionised how advanced breast cancers are treated today.
Though patients in Wales have benefitted from these new and varied treatments, it is important to acknowledge that the UK still lags behind other countries in terms of cancer outcomes. However, steady improvements have been made in recent history. It is perhaps hard to remember a time when a diagnosis for cancer did not involve a scan of some description, but many medical imaging methods were actually only introduced in the past 40 years. The invention of these techniques, such as CT and MRI, have significantly improved our ability to conclusively diagnose cancer at an earlier stage.
Similarly, the introduction of national screening programmes for breast cancer (1989), cervical cancer (1999) and bowel cancer (2008) have had a positive effect on the number of people being diagnosed earlier, when prognosis is better. However, there is no room for complacency, as at the last count, screening uptake rates remain below target for bowel cancer and the rate for cervical screening has dropped.
Given that the rates of cancer are predicted to rise steadily in Wales over the next 20 years, it is envisaged that the greatest gains will be made through prevention. An estimated 38% of cancer cases in Wales are considered preventable, therefore, it is not surprising we increasingly hear the idiom that ‘prevention is the cure!’ The majority of these preventable cancers result from poor lifestyle choices and equate with deprivation status, with the most deprived regions carrying the greatest burden. In future, social care that is carefully aligned with cancer prevention and treatment, will be just as important when it comes to tackling the unique challenges to health in Wales.
So, it seems apt to round off this blog series with a quote from the architect of social care and the NHS, Aneurin Bevan:
“Yet the victories won by preventive medicine are much the most important for mankind. This is so not only because it is obviously preferable to prevent suffering than to alleviate it. Preventive medicine, which is merely another way of saying health by collective action, builds up a system of social habits that constitute an indispensable part of what we mean by civilization.”
We hope that the next 70 years holds just as many breakthroughs as recent history, and that by continuing to fund world-leading research into the early diagnosis, prevention and treatment we can play our part in moving ever closer to a Wales without cancer.