Since the dawn of time, people have battled a common foe: cancer. Some of the earliest references to the disease date to 3000 BC. Much later, Greek physician Hippocrates, considered the “Father of Medicine,” used the words carcinos and carsinoma, which refer to crab in Latin, to describe certain types of tumors. Obviously, today’s patients are in a much better place than those of Hippocrates’ day. Technology has helped propel research, treatment, care and prevention of cancer to new levels. Will cancer ever be eliminated? We can hope, but in the meantime, researchers continue to use basic science and cutting-edge research to increase their arsenal of weapons to battle the disease. Here are a few of the latest developments: Neutron Capture Therapy.

Researchers at Loma Linda University Health (LLUH) are studying a way to target isolated cancer cells that have spread to nearby tissues. Neutron capture therapy, while still under development, has shown the potential to precisely target and eliminate cancer cells that have infiltrated healthy tissues, according to LLUH. In neutron capture therapy, the patient is first injected with a drug designed to molecularly target specific cancer cells. This drug delivers, for example, harmless, non-radioactive boron-10 atoms to these cancer cells but not to normal cells. Next, the patient is exposed to an intense field of low-energy (slow) neutrons (known as epithermal neutrons).

The neutrons set off a nuclear reaction in the boron atoms, emitting helium and lithium ions of a very limited range (less than a cell diameter). The ions kill cancer cells without damaging nearby normal cells. Immunotherapy. Scientists have spent decades analyzing cancer cells: what they are, what they’re made of, how they change and move, and what makes them grow in the first place. For several years, immunotherapy—using the body’s own immune system to beat back cancer cells—has been at the forefront of the fight against cancer. Researchers continue to be excited about this form of treatment. “Cancer immunotherapy has revolutionized the treatment of several cancers, such as melanoma, in the past decade, but some cancers do not respond to these new therapies,” says Fiona Pixley, associate professor and head of Pharmacology and Toxicology at the University of Western Australia. Some cancer cells are resistant to immunotherapy.

Pixley and her research team discovered that isolating a particular molecule found in certain immune cells that hadn’t traditionally responded well to immunotherapy could make resistant cancer cells vulnerable to attack. Studies are ongoing. Breast Cancer Bombs. Two “smart bomb” drugs are offering new hope to women with aggressive breast cancers, a pair of clinical trials show. Both medications are antibody-drug conjugates, consisting of a chemotherapy drug that’s been joined to an antibody that delivers the chemotherapy directly to cancer cells. “That’s a way to take the chemo right to the cancer cells and spare the rest of the body a lot of toxicity,” says Shanu Modi, M.D., a medical oncologist at Memorial Sloan Kettering Cancer Center in New York City. “When the antibody finds its target, the whole complex gets internalized into the cell, and then the chemo gets released inside the cancer cell.” Both antibody-drug conjugates are already U.S. Food and Drug Administration-approved for use in treating certain types of breast cancer.

The new clinical trials show they could be useful for even more patients. New Imaging Technology for Prostate Cancer. Early diagnosis and treatment of prostate cancer, the third leading cause of cancer deaths in the United States, is key to surviving it. According to researchers, early detection and proper imaging of the disease is vital in determining the specific location and stage of the cancer. Imaging methods, such as computed tomography (CT), magnetic resonance imaging (MRI) scans and bones scans, are often used. But a promising new imaging technology is emerging called prostate-specific membrane antigen positon emission tomography (PSMA PET). Researchers says PSMA is an antigen found in high levels on the surface of prostate cancer cells and is a potential biomarker for the disease. PSMA PET uses a radioactive tracer to locate and attach to PSMA proteins, which are then visible by PET.

This method can be used in conjunction with CT or MRI scans to pinpoint the location of cancer cells. According to researchers at the Cleveland Clinic, experts anticipate the PET-tracer procedure will soon become the new standard of care for detecting prostate cancer metastasis. The technology received FDA approval in 2020. Engineered T Cells. A team led by UCLA’s Anusha Kalbasi, M.D., has found that giving T cells an engineered boost helps them fight cancer without chemotherapy or radiation. T cells engineered with the synthetic IL-9 receptor, designed in the laboratory of Christopher Garcia, Ph.D., at Stanford University, were potent against tumors in mice. In addition to eliminating the need for chemotherapy and/or radiation, researchers are hopeful that T cells could eventually be administered much like a blood transfusion. Attacking Cancer Cells’ Immunity. To fend off tumor-killing immune cells, cancer cells load up their surfaces with a protein called PD-L1. But a team of UCLA Jonsson Comprehensive Cancer Center researchers led by Roger S. Lo, M.D., Ph.D, has identified a method to degrade tumor cell-surface PD-L1, making tumors susceptible to immune attack. This approach, in combination with existing therapies, could improve treatment responses of metastatic melanoma and other cancers by suppressing resistance to current therapies.

Reducing the accumulation of PD-L1 allows tumor-killing T-cells to do their work. Closing the Disparity Gap. Cancer affects all population groups in the United States, but because of social, environmental and economic disadvantages, certain groups bear a disproportionate burden of cancer compared with other groups, according to the National Cancer Institute (NCI) at the National Institutes of Health. Statistics from NCI’s Surveillance, Epidemiology and End Results Program include information specific to racial and ethnic populations as well as populations defined by age, gender and geography.

Some key cancer incidence and mortality disparities in the United States include:

• Blacks/African Americans have higher death rates than all other racial/ethnic groups for many, although not all, cancer types.

• Despite having similar rates of breast cancer, Black/African- American women are more likely than White women to die of the disease.

• American Indians/Alaska Natives have the highest rates of liver and intrahepatic bile duct cancer, followed by Hispanics/ Latinos and Asians/Pacific Islanders.

NCI-funded researchers are working to identify ways to improve outcomes for groups disproportionately affected by cancer. Their research efforts range in scope from designing and implementing culturally appropriate health interventions, to improving access to care and clinical trials, to examining genetic factors that may explain differences in rates of aggressive cancers. Having a greater diversity of people taking part in clinical trials is crucial, researchers say. The effectiveness of a treatment is often related to genetic factors, yet the patients enrolled in most clinical trials are primarily white, according to the City of Hope. Researchers there, and at other institutions, hope to change that in order to help the greatest number of people possible.

CANCER CARE IN THE INLAND EMPIRE … ARROWHEAD REGIONAL MEDICAL CENTER (ARMC) revealed its new state-of-the-art Oncology/Infusion Therapy Clinic on June 7, 2021. The clinic, which is equipped with two waiting areas, four patient restrooms, 11 private exam rooms, and 17 spacious and semi-private infusion bays, is headed by renowned physicians specializing in Medical and Surgical Oncology. The clinic is designed for enhanced workflow and patient access with Patient Navigators and Social Workers embedded in the clinic. Patients receive screenings and follow-up from a Social Worker including referrals to additional services and/or community resources. Patient Navigators help guide patients through and around barriers in the complex cancer care system to help ensure timely diagnosis, treatment and support. The clinic also features a welcoming and warm consultation room for patients and families to meet with allied health professionals to further discuss cancer treatment options and plans of care. For more information about Arrowhead Regional Medical Center visit www.arrowheadregional.org.

RIVERSIDE UNIVERSITY HEALTH SYSTEM (RUHS) provides patients with a variety of cancer treatments, from screenings, to chemotherapy and radiation. “I think one of our strengths is the lengths that our team will go to in order to help people get funding for treatment. We do not turn away outpatients who cannot pay,” said Monika-Kief Garcia, MD, FACR, Chair Radiology. The radiology team at RUHS Medical Center is also offering screenings using a state-of-the-art Molecular breast imaging (MBI) camera, which offers new ways to “look” at the breast in high risk patients, especially those with dense breast tissue. When a breast is dense, a cancer sometimes can be hidden by the surrounding normal breast tissue. This lowers the sensitivity of the mammogram as a test for breast cancer detection. However, MBI is not affected by dense breast tissue and can reveal breast cancers in women with dense breast tissue that mammography cannot. In addition to providing a more detailed image, “the compression is light, so the test should not be painful or uncomfortable, and the patient is seated comfortably during the exam,” said Radiologist Dr. Lisa Mahoney. “These supplemental exams are beneficial for improved detection and assist us in finding breast cancer as early as possible.” At

REDLANDS COMMUNITY HOSPITAL’s new Center for Cancer Care, our focus is on compassionate cancer care. Our oncology team is committed to providing personalized care tailored to each patient’s needs, offering the latest in evidence-based therapies and technologies. From screening and diagnosis to treatment and recovery, we’ve got you covered. Our cancer treatment center includes chemotherapy, targeted immunotherapy and adjacent radiation therapy. Additionally, patients have access to national clinical trials supported by the pharmaceutical industry, major university centers and community-based physician practices. Participation in clinical trials can provide innovative treatments and advanced approaches to care. Want to know if you are on the right treatment path? Request an appointment for a second opinion—call 909.793.4336. Redlands Community Hospital is an independent, not-for-profit, stand-alone community hospital. redlandshospital.org

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