SP-0009: Uncomplicated cures - a paradigm shift in cancer survivorship research

Abstract

Changes in cancer incidence and mortality have been modest during the past several decades, but the number of cancer survivors has almost tripled during the same period. With the increasing cohort of cancer survivors, efforts to prevent, diagnose and manage adverse effects of cancer therapy, in general, and those of radiation therapy specifically, have intensified. Considerable progress towards reducing toxicity of radiation therapy has been achieved by the introduction of so-called dose-sculpting treatment techniques. Moreover, new insights into the underlying pathophysiology have resulted in an improved understanding of mechanisms of radiation-induced normal tissue toxicity and in development of new diagnostic strategies and management opportunities. However, the risk of normal tissue toxicity still limits the dose of cytotoxic therapy that can be given, thus limiting the curability of cancer. The steadily increasing number of cancer survivors and the demand for uncomplicated cancer cures require a paradigm shift in cancer survivorship research. Research must shift from simply describing and palliating side effects (“doing head-counts”) to adopt a more modern, goal-oriented approach. The new approach encompasses 1) epidemiological, psychosocial, and outcomes research aimed at characterizing and ameliorating the problems that afflict current cancer survivors; 2) applied clinical and preclinical research aimed at developing new treatments or response modifiers to prevent or minimize shortand longterm side effects of cancer therapy; and 3) basic research aimed at improving our understanding of the cellular and molecular mechanisms that are responsible for treatmentrelated toxicities. This three-pronged approach will ensure that progress is made toward our ultimate goal, i.e., to increase the uncomplicated cancer cure rate.