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Will there ever be a cure for cancer?
So many people have asked this question – those who are living with cancer, those whose families have been touched by the disease and those who fear that cancer might be in their future.
The good news is that research has increased our understanding of the many diseases called cancer, leading to better treatments and improved prevention and risk reduction strategies. Today, about 60% of Canadians diagnosed with cancer will survive at least 5 years after their diagnosis. In the 1940s, survival was about 25%.
Some experts doubt that we’ll ever find a single, universal cure for cancer, which isn’t really a single disease but actually more than 100 different diseases. Yet researchers have uncovered a staggering amount of information about cancer over the past 2 decades and will continue to do so in the coming years.
This revolution in our understanding of cancer has set the stage for a new era in cancer therapy and prevention, due in part to the many studies and clinical trials funded by the Canadian Cancer Society.
Our history of research
On January 27, 1947, a group of leading Canadian scientists and health authorities met with 1 goal in mind – to create a national organization that could support and stimulate important cancer research. On that historic day in Ottawa, the National Cancer Institute of Canada (NCIC) was officially founded as a joint initiative of the Department of National Health and Welfare and the Canadian Cancer Society.
From these modest beginnings, the NCIC became Canada’s premier cancer research organization. During its 62-year history as the Society’s research partner, NCIC contributed more than $1 billion in funding to thousands of outstanding researchers nationwide and helped build and nurture a vibrant community of cancer researchers. More importantly, the NCIC supported cancer research that has made a difference in lives of people with cancer and all those touched by cancer – in Canada and around the world.
In February 2009, the NCIC integrated with the Society, building on more than 6 decades of stimulating and supporting excellent cancer research. Together we will achieve our vision of creating a world where no one fears cancer.
Milestones from the 1950s
Cobalt therapy first used to treat tumours
In 1951, Dr Harold Johns developed the Cobalt-60 Unit or Cobalt Bomb in Saskatoon. At the time, it was the newest and most effective kind of radiation therapy used to treat tumours. Dr Johns and his colleagues also led the way in devising techniques to measure how much radiation cancer patients received during treatment. These 2 discoveries improved the outcome for millions of cancer patients around the world. Cobalt treatment is still widely used as a cancer treatment.
New life-saving drug for Hodgkin lymphoma
In 1958, Drs Robert Noble and Charles Beer in London, Ontario, discovered vinblastine, a substance isolated from the periwinkle plant. The drug was first used to treat patients with Hodgkin lymphoma. Children who died within weeks now live for many years with this treatment. Today vinblastine is also used to treat certain lymphomas, testicular cancers and Kaposi’s sarcoma, a type of cancer common in people with AIDS.
Recognizing the dangers of hypercalcemia
Dr Harold Warwick, a Toronto physician, recognized that hypercalcemia – too much calcium in the blood – led to major complications such as pain, fatigue, collapse and even death in some cancer patients. Dr Warwick was also involved in early clinical trials of the anti-cancer drug vinblastine.
New approaches to radiation and breast cancer surgery
Dr Vera Peters in Toronto pioneered the use of radiation to treat Hodgkin lymphoma. She found that patients with this type of cancer lived longer after treatment and were often cured by radiation. Dr Peters also observed that lumpectomy with radiation was just as effective in treating women with early stage breast cancer as mastectomy.
A model for cervical cancer screening
In 1955, Drs David Boyes and H.K. Fidler in Vancouver developed a large-scale provincial screening program to detect very early cancers of the cervix, leading to a dramatic decline in deaths and illness due to cervical cancer. The BC Division of the Society supported the program, which became a model for the entire country.
Milestones from the 1960s
Advances in bone marrow transplantation
Drs Jim Till and Ernest McCulloch in Toronto discovered that all blood cells come from blood-forming stem cells in the bone marrow. This finding led directly to the development of bone marrow transplantation in the treatment of many cancers. When they began their work more than 25 years ago, survival rates for childhood leukemia were 50%. Today, survival rates are more than 80%.
Improving chemotherapy and radiation treatments
Dr Robert Bruce in Toronto discovered how various drugs work to kill cancer cells. The design of current chemotherapy treatment for cancer is based on this knowledge.
Dr Jack Cunningham, also in Toronto, created the first computer program to accurately determine the dosage of radiation aimed at a tumour. Before this research was carried out, radiation oncologists had to rely on intuition and crude calculations to determine how much radiation cancer patients were given. Dr Cunningham’s methods set the standard for computer-based radiation treatment planning that exists today.
Blood tests for colorectal cancer
Drs Phil Gold and Sam Freedman in Montreal discovered a substance called CEA or carcinoembryonic antigen. CEA is a tumour marker found in the blood of many people with colorectal cancer, and it can be used to indicate the presence, spread or recurrence of cancer. This early work led to a whole new field of cancer research around the world – blood testing to detect cancers and also to monitor patients’ progress during treatment.
Milestones from the 1970s
Pap testing and cervical cancer
Dr Anthony Miller in Toronto evaluated the effectiveness of Pap smear screening as a way to reduce the numbers of Canadian women who were dying from cervical cancer. He showed that for women aged 30 to 64 years, regular screening was linked to a significant decline in deaths from cervical cancer.
Why cancer cells become resistant
Dr Victor Ling in Toronto discovered that a certain protein – P-glycoprotein – sits on the surface of cancer cells and flushes out the anti-cancer drug before it has a chance to work, making cancer cells resistant to chemotherapy. Dr Ling observed that tumour cells had the ability of exploit this protein, which normally protects cells from toxic substances in the environment. Later research found that P-glycoprotein’s effects could be avoided in certain patients by giving them the drug cyclosporin.
Developing a super-microscope
Dr Peter Ottensmeyer in Toronto became one of the first scientists anywhere to see individual atoms. His work led to the development of a new electron microscope which gave scientists much clearer, sharper, 3-dimensional images of protein molecules and tissue sections. The new microscope finally allowed cancer researchers to view the DNA genome within each chromosome. Dr Ottenmeyer’s microscope design is now being used around the world to study cells and other structures.
Milestones in the 1980s
Clinical Trials Group established
The importance of carefully evaluating cancer therapies through strict scientific studies was recognized when the NCIC Clinical Trials Group was established in Kingston, Ontario. The Clinical Trials Group has grown to become an internationally recognized clinical research organization.
Bone marrow transplantation
Drs Connie Eaves, Allen Eaves and colleagues in Vancouver showed in 1982 that stem cells – which give birth to all blood cells – could be kept alive and even coaxed to grow in a test tube while, at the same time, nearby leukemic cells were killed. This finding had important implications for leukemia patients and may one day help people with other cancers. Instead of waiting for a compatible bone marrow donor, they might be able to undergo transplantation using their own bone marrow which has been purged of leukemic cells.
Developing digital mammography
Drs Martin Yaffe and Donald Plewes in Toronto made important advances in the area of digital mammography. This technique creates enhanced computerized images of breast tissue, allowing doctors to detect small tumours with significantly reduced exposure to radiation versus conventional (film) imaging. Images obtained using digital mammography can be transmitted electronically, making high quality mammography available in remote areas.
The role of cell signals in cancer
Dr Anthony Pawson in Toronto discovered that a specific protein molecule plays an important role in transmitting cancer-inducing signals inside malignant cells. This led to a new understanding about the role of communication signals between cells in the development of cancer.
Dr Tak Mak in Toronto was the first scientist to clone a T-cell receptor gene, opening a new chapter in the understanding of how the immune system works to recognize and fight cancer. Dr Mak’s discovery is regarded as the Holy Grail of immunology because knowledge of T-cell receptor gene function is a key to understanding the immune system.
Early detection of breast cancer
Drs Anthony Miller and Cornelia Baines in Toronto launched the National Breast Screening Study, designed to evaluate the benefits of screening mammography and breast examination in the early detection of breast cancer. The study, which followed nearly 90,000 Canadian women, influenced public policy around breast cancer screening in Canada and other countries.
Milestones in the 1990s
Breast density, diet and cancer
Dr Norman Boyd in Toronto was among the first to demonstrate that breast density is an important risk factor for breast cancer. He continues to study whether a low-fat diet can reduce breast density and also decrease women’s risk for breast cancer.
Causing tumour cells to commit suicide
Dr Arnold Greenberg in Winnipeg purified and identified a protein – called protease granzyme B – that led to a greater understanding of how the body stimulates tumour cells to commit suicide. Dr Greenberg went on to study how researchers might harness this power and develop new treatments for cancer.
Breast cancer gene
An international team of researchers, including Dr Steven Narod in Toronto, discovered and isolated the BRCA1 gene – suspected of causing between 2% and 4% of all breast cancers and between 5% and 10% of all ovarian cancers. Understanding the function of the BRCA1 gene may help researchers identify the causes of breast cancer and could lead to better prevention and treatment strategies.
Yeast and cell growth
Drs Gerry Johnston and Richard Singer in Halifax and Dr Brenda Andrews in Toronto each pioneered the use of yeast cells in cancer research. By closely studying how the simple yeast cell multiplies, they began to understand more about human cancers – especially why normal healthy cells suddenly begin to multiply out of control. This knowledge is helping researchers develop more precise treatment strategies to target cancer cells much more directly.
Dr Helen Chan and her colleagues in Toronto greatly improved the outlook for some children with retinoblastoma – a serious form of childhood eye cancer. Building on earlier discoveries by Dr Victor Ling about how cancer cells are able to resist chemotherapy, they developed a new approach to treatment that means a large proportion of children with retinoblastoma can now be cured without harmful radiation.
Increasing the cure rate for lung cancer
The NCIC Clinical Trials Group found that small cell lung cancer can sometimes be cured with drugs and radiation. The clinical trial demonstrated that if treatment with a combination of chemotherapy and radiation was started early enough, 1 in every 5 patients was cured (compared to 1 in every 10 patients who received the then-standard approach.) This treatment for small cell carcinoma of the lung changed practice throughout North America.
Milestones in the 2000s
Reducing risk of breast cancer recurrence
In 2003, a clinical trial led by the NCIC Clinical Trials Group found that post-menopausal survivors of early stage breast cancer who took the drug letrozole after completing an initial 5 years of tamoxifen therapy had a 43% reduced risk of cancer recurrence compared to women taking a placebo. The research is significant because more than half of women who develop recurrent breast cancer do so more than 5 years after their original diagnosis. Prior to this research, there was no treatment to reduce the risk of recurrence after 5 years of tamoxifen. Just over half of women with breast cancer are potentially eligible for this new treatment.
A few puffs enough to addict teens to smoking
Dr Jennifer O’Loughlin in Montreal found that smoking just 1 or 2 cigarettes may be all it takes for some teens to become addicted to nicotine. The findings challenged the idea that it takes adolescents 2 to 3 years of daily smoking to develop nicotine dependence and demonstrates why the stop-smoking message doesn’t always get through to teens. Her work opened the door to further research into effective smoking cessation aids for teens.
A good virus?
In 2001, a cancer biologist Dr Patrick Lee in Calgary discovered that a common and relatively harmless virus called a reovirus could kill a certain kind of cancer cell. Dr Patrick Lee and co-researcher Dr Peter Forsyth found that the virus caused glioma (brain) tumours to completely regress or shrink significantly. Clinical trials in humans are now underway to see if reovirus could be an effective new treatment.
Impact factor highest for Canadian clinical cancer research
A study ranking the impact of clinical, or patient-oriented, cancer research around the globe concluded that Canadian clinical cancer research is the best in the world. The Italian study, published in the January 2003 issue of the European Journal of Cancer, rated the so-called impact factor – how often clinical cancer research articles published between 1995 and 1999 were cited over the next 2 years in major scientific journals.
Canadian researchers international leaders in stem cell research
Dr John Dick in Toronto found that colon cancer originates from a rare type of colon cancer stem cell, laying the groundwork for the development of treatments that target and kill these cancer-causing cells. Dr Dick also discovered that isolated human leukemia stem cells cause the development of leukemia. This could lead to improved knowledge about how to prevent the disease.
Dr Mick Bhatia and his research team in Hamilton were the first in the world to discover the key differences between normal human embryonic stem cells and abnormal cancer stem cells. This could lead to treatments that target cancer cells and leave the healthy cells alone.
Dr Bhatia also discovered that some stem cells build a protective niche, which nurtures the cells with special growth proteins. The proteins also determine whether the stem cells copy themselves or develop into new kinds of cells, including cancer. The researchers hope to be able to target the protective niche to cut off the nutrient supply to tumours and prevent growth.
Milestones in the 2010s
Landmark trial finds exemestane significantly reduces risk of breast cancer
A large international clinical trial investigating a new way to prevent breast cancer in women at increased risk of developing the disease found that the drug exemestane reduces this risk by 65 per cent compared with placebo. The trial was led by the NCIC Clinical Trials Group, funded by the Canadian Cancer Society. This discovery was recognized by the American Society of Clinical Oncology as one of the world’s most important cancer treatment breakthroughs in 2011.
New surveillance protocol improves survival for individuals at high risk for cancer
A Toronto research team led by Dr David Malkin found that a new cancer surveillance protocol dramatically improves survival for adults and children with Li-Fraumeni syndrome, a hereditary disease that significantly increases a person’s susceptibility to cancer. The study found that those under surveillance had a 100% survival rate after cancer was detected. For those not under surveillance, the survival rate was 21%.
Drug holiday will change standard of care for men with recurring prostate cancer
A trial led by the NCIC Clinical Trials Group, funded by the Canadian Cancer Society, found that men with prostate cancer who are treated with intermittent courses of androgen-suppressing (hormone) therapy live as long as those receiving continuous therapy. The results are expected to change current treatment protocols and reduce some of the side effects of hormone therapy, including impotence.
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Printed: August 5, 2020
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