This atlas illustrates the latest available data on the cancer epidemic, showing causes, stages of development, and prevalence rates of different types of cancers by gender, income group, and region. It also examines the cost of the disease, both in terms of health care and commercial interests, and the steps being taken to curb the epidemic, from research and screening to cancer management programs and health education.
The National Cancer Institute's (NCI) Clinical Trials Cooperative Group Program has played a key role in developing new and improved cancer therapies. However, the program is falling short of its potential, and the IOM recommends changes that aim to transform the Cooperative Group Program into a dynamic system that efficiently responds to emerging scientific knowledge; involves broad cooperation of stakeholders; and leverages evolving technologies to provide high-quality, practice-changing research.
Tumor progression is driven by mutations that confer growth advantages to different subpopulations of cancer cells. As a tumor grows, these subpopulations expand, accumulate new mutations, and are subjected to selective pressures from the environment, including anticancer interventions. This process, termed clonal evolution, can lead to the emergence of therapy-resistant tumors and poses a major challenge for cancer eradication efforts. Written and edited by experts in the field, this collection from Cold Spring Harbor Perspectives in Medicine examines cancer progression as an evolutionary process and explores how this way of looking at cancer may lead to more effective strategies for managing and treating it. The contributors review efforts to characterize the subclonal architecture and dynamics of tumors, understand the roles of chromosomal instability, driver mutations, and mutation order, and determine how cancer cells respond to selective pressures imposed by anticancer agents, immune cells, and other components of the tumor microenvironment. They compare cancer evolution to organismal evolution and describe how ecological theories and mathematical models are being used to understand the complex dynamics between a tumor and its microenvironment during cancer progression. The authors also discuss improved methods to monitor tumor evolution (e.g., liquid biopsies) and the development of more effective strategies for managing and treating cancers (e.g., immunotherapies). This volume will therefore serve as a vital reference for all cancer biologists as well as anyone seeking to improve clinical outcomes for patients with cancer.
Advances in cancer research have led to an improved understanding of the molecular mechanisms underpinning the development of cancer and how the immune system responds to cancer. This influx of research has led to an increasing number and variety of therapies in the drug development pipeline, including targeted therapies and associated biomarker tests that can select which patients are most likely to respond, and immunotherapies that harness the body's immune system to destroy cancer cells. Compared with standard chemotherapies, these new cancer therapies may demonstrate evidence of benefit and clearer distinctions between efficacy and toxicity at an earlier stage of development. However, there is a concern that the traditional processes for cancer drug development, evaluation, and regulatory approval could impede or delay the use of these promising cancer treatments in clinical practice. This has led to a number of effortsâ€"by patient advocates, the pharmaceutical industry, and the Food and Drug Administration (FDA)â€"to accelerate the review of promising new cancer therapies, especially for cancers that currently lack effective treatments. However, generating the necessary data to confirm safety and efficacy during expedited drug development programs can present a unique set of challenges and opportunities. To explore this new landscape in cancer drug development, the National Academies of Sciences, Engineering, and Medicine developed a workshop held in December 2016. This workshop convened cancer researchers, patient advocates, and representatives from industry, academia, and government to discuss challenges with traditional approaches to drug development, opportunities to improve the efficiency of drug development, and strategies to enhance the information available about a cancer therapy throughout its life cycle in order to improve its use in clinical practice. This publication summarizes the presentations and discussions from the workshop.
Pharmaceutical companies, academic researchers, and government agencies such as the Food and Drug Administration and the National Institutes of Health all possess large quantities of clinical research data. If these data were shared more widely within and across sectors, the resulting research advances derived from data pooling and analysis could improve public health, enhance patient safety, and spur drug development. Data sharing can also increase public trust in clinical trials and conclusions derived from them by lending transparency to the clinical research process. Much of this information, however, is never shared. Retention of clinical research data by investigators and within organizations may represent lost opportunities in biomedical research. Despite the potential benefits that could be accrued from pooling and analysis of shared data, barriers to data sharing faced by researchers in industry include concerns about data mining, erroneous secondary analyses of data, and unwarranted litigation, as well as a desire to protect confidential commercial information. Academic partners face significant cultural barriers to sharing data and participating in longer term collaborative efforts that stem from a desire to protect intellectual autonomy and a career advancement system built on priority of publication and citation requirements. Some barriers, like the need to protect patient privacy, pre- sent challenges for both sectors. Looking ahead, there are also a number of technical challenges to be faced in analyzing potentially large and heterogeneous datasets. This public workshop focused on strategies to facilitate sharing of clinical research data in order to advance scientific knowledge and public health. While the workshop focused on sharing of data from preplanned interventional studies of human subjects, models and projects involving sharing of other clinical data types were considered to the extent that they provided lessons learned and best practices. The workshop objectives were to examine the benefits of sharing of clinical research data from all sectors and among these sectors, including, for example: benefits to the research and development enterprise and benefits to the analysis of safety and efficacy. Sharing Clinical Research Data: Workshop Summary identifies barriers and challenges to sharing clinical research data, explores strategies to address these barriers and challenges, including identifying priority actions and "low-hanging fruit" opportunities, and discusses strategies for using these potentially large datasets to facilitate scientific and public health advances.
Cancer diagnosis and treatment doesn't have to be a passive experience, and it shouldn't be. Dr. Kathryn Schmitz's Moving Through Cancer introduces a 21-day program of strength training and exercise for cancer prevention and recovery. Go from diagnosis to thriving with this empowering guide to using strength training and exercise to improve your mental and physical health before, during, and after cancer diagnosis and treatment. This groundbreaking program will show you how to use exercise and movement to: • Recover more quickly from surgery • Withstand chemotherapy (or other drug treatments) or radiation with fewer side effects • Bounce back to daily life following cancer treatments • Prevent loss of function or fitness due to treatment • Return to work more quickly or stay at work throughout treatment • Protect against late side effects of treatment that come years after diagnosis Leading exercise oncology researcher Dr. Kathryn Schmitz shows you how to prepare for cancer treatment and begin regularly exercising in just 21 days using five key steps: Move, Lift, Eat, Sleep, and Log. Both informative and practical, Moving Through Cancer explains the science of healing and prevention and delivers a paradigm-shifting message for patients, doctors, and caregivers about using exercise to live with and beyond cancer. FOR READERS OF: Anticancer Living and The Cancer-Fighting Kitchen. A PRACTITIONER AND CAREGIVER: Dr. Kathryn Schmitz is a pracademic (practitioner + academic) and a caregiver: In 2010, the publication of one of her trials in The New England Journal of Medicine and the Journal of the American Medical Association overturned years of entrenched dogma and conventional wisdom that told breast cancer survivors to avoid upper body exercise. In 2016, Dr. Schmitz's wife, Sara, was diagnosed with stage 3 squamous cell carcinoma—she is currently NED (no evidence of disease) and cancer free. Moving Through Cancer is inspired by Dr. Schmitz's professional and personal experience with cancer. HELPS PATIENTS AND CAREGIVERS TO COMBAT THE POWERLESSNESS OF THE CANCER JOURNEY: Dr. Schmitz's empowering message will not only resonate with anyone who has been diagnosed with cancer but with their family and loved ones as well. Dr. Schmitz is able to give life back to readers by providing results that include better sleep, better sex, less chemo brain, reduced nausea, and improved recovery. PARADIGM-SHIFTING PROTOCOL: Moving Through Cancer is the center of Dr. Schmitz's campaign to have doctors prescribing exercise to cancer patients as common practice by 2029. THE FIRST MAINSTREAM EXERCISE-FOR-CANCER BOOK: Until now, exercise-for-cancer books have been limited to academic approaches or one-cancer-specific (breast) or one-exercise specific (yoga, pilates) books. Moving Through Cancer is for all cancer patients and survivors and their caregivers. GREAT FOR THE CLASSROOM: Students and teachers will want to use these techniques in their classrooms to provide a better understanding of how to treat cancer patients. Perfect for: 18+, Health enthusiasts, rehab, exercise, academia, medical professionals
An unprecedented constellation of experts—leading cancer doctors, policymakers, cutting-edge researchers, national advocates, and more—explore the legacy and the shortcomings from the fifty-year war on cancer and look ahead to the future. The longest war in the modern era, longer than the Cold War, has been the war on cancer. Cancer is a complex, evasive enemy, and there was no quick victory in the fight against it. But the battle has been a monumental test of medical and scientific research and fundraising acumen, as well as a moral and ethical challenge to the entire system of medicine. In A New Deal for Cancer, some of today’s leading thinkers, activists, and medical visionaries describe the many successes in the long war and the ways in which our deeper failings as a society have held us back from a more complete success. Together they present an unrivaled and nearly complete map of the battlefield across dimensions of science, government, equity, business, the patient provider experience, and more, documenting our emerging understanding of cancer’s many unique dimensions and offering bold new plans to enable the American health care system to deliver progress and hope to all patients.
