Scientists are getting to the point when they can talk about a “cure” for breast cancer, according to a leading Irish scientist based in the US.
Within five to 10 years women with breast cancer will be dying with the disease rather than of it, thanks to groundbreaking new treatments, Prof Donald McDonnell has predicted. “We’re going to get much better at improving resilience while you have breast cancer and at treating it as a chronic disease. Incredible strides are being made at curing it,” he said.
Prof McDonnell, a specialist in molecular cancer biology at Duke University, North Carolina, told The Irish Times that having previously avoided using the word “cure” when speaking on breast cancer, he now plans to use it because so much “fantastic” progress has been made in treating the disease.
He was speaking in advance of a major cancer conference at the Royal College of Surgeons, starting on Wednesday and sponsored by Breast Cancer Ireland.
Prof McDonnell, a former winner of the Young Scientist Competition, went into breast cancer research after seeing his mother-in-law die from the disease in the early 1980s, when the clinical options were few other than chemotherapy and surgery. He says the progress made by scientists since then is “fantastic”.
“The majority of women diagnosed with early-stage breast cancer today will have their surgery and some form of therapy and never hear of it again.”
Each year about 2 per cent of women who have had breast cancer will suffer a recurrence; Prof McDonnell says he would like to see this figure go down to zero.
In a lifetime the risk of a woman who has had early-stage disease suffering recurrence now stands at 15 per cent, he says. Prevention is the major goal in tackling cancer, followed by early detection of cases.
From Limerick, Prof McDonnell was awarded Science Foundation Ireland’s St Patrick’s Day medal earlier this year in recognition of his scientific achievements. His work has led to the discovery of several drugs currently in trial, and the identification of new tumour markers to personalise and target treatment for breast and prostate cancer.
Women with a metastatic form of the disease that has spread elsewhere in the body can be “managed but not cured”, he acknowledges. “Our goal here has to be to better understand what is happening so we can stop it. We can treat women who present early so the cancer never comes back, but for late presenters the aim is to improve the chances of survival.”
Women who do develop breast cancer are benefiting from advances in surgery since the 1980s and, more dramatically, a slew of new treatments.
Asked about the high cost of new cancer treatments, Prof McDonnell says the real issue is the value they provide. Only about 4 per cent of new cancer drugs end up being approved, he says. “So someone has to be encouraged to put money into a proposition that has only a one in 24 chance of success. These drugs are too expensive, but the bottom line is that a lot of money has gone into the research behind these drugs.”