Cancer is not just about tumours—it’s about the people who develop cancer. In my career, I have seen a lot of improvements in the treatments for cancer, which include better survival rates and less toxic treatments. I have also seen an increased appreciation for cancer prevention and for survivorship—the two ends of the spectrum.
I have been involved in a number of prevention activities, including a large trial with the National Cancer Institute of Canada–Clinical Trials Group (NCIC-CTG) that just reported a beneficial effect for the drug exemestane in preventing breast cancer. I am also involved in a new study looking at shift work and breast cancer. We are looking at biological samples of women with cancer and their breast density to try to better understand how breast cancer develops.
In terms of survivorship, I have been involved with some very exciting studies that look at the role of exercise. We have done two large studies looking at exercise during chemotherapy to determine the effect exercise has on tolerating chemotherapy and outcomes, as well as to assess what kind of exercise a woman can do during chemotherapy. We have built a small gym that is really a research lab. The women—100 in the most recent study—who participated have been very excited by both the exercise and the camaraderie experienced; and it appears to have improved their recovery after chemotherapy.
The future of cancer care is exciting. Each person has not only a unique tumour, but a unique reaction to the disease and how they are treated. This will shape our entry into personalized medicine. There is also a better understanding of the continuum of cancer care, from diagnosis to follow up and onwards. And I think there will be more success in prevention strategies for people at a higher risk of developing cancer.
We may not be able to prevent all cancers or cure all cancers, but if we can decrease the numbers of cancers that develop and improve the treatments for those that do occur—including higher cure rates— then we will have made incredible strides. In my career at the BC Cancer Agency, I have already seen major improvements in this direction. By continuing to link science and care, we can do much more.