Vision of a golden age: cancer charity looks to the future

BMJ 1995; 311 doi: (Published 07 October 1995) Cite this as: BMJ 1995;311:897
  1. BMJ

    A new golden age of drug discovery, which could see a reduction of 75000 in the annual death rate from cancer by 2020, is predicted in a new report from the Imperial Cancer Research Fund. The fund paints a picture of myriad improvements in treatment for cancer, care, and survival rates over the next 25 years—but says that this can happen only if patients with cancer receive better support.

    The report, which has been submitted to the Department of Health, was compiled by a group of more than 30 leading scientists and doctors led by the fund's deputy director of clinical research, Professor Karol Sikora. It is intended to help the government's expert advisory group on cancer to plan for the future.

    On the basis of current rates, the report says that deaths from cancer will soar to 220000 in 2020, given an aging population and if there are no improvements in prevention and cure. But it estimates that as many as a third of these lives could be saved.

    Dr Gerard Evan, a laboratory scientist with the fund, said that a collective will was vital for the future: “Strong, creative partnerships between research organisations, pharmaceutical and biotechnology companies and the department of health will be essential if we are to reap the huge reward of turning this vision into reality.”

    The report profiles prevention, diagnosis, and treatment measures for cancer for three different periods—1995-2002, 2002-20, and 2020 onwards. For this last period it predicts that prevention will be improved by measures such as the identification and treatment of precursor lesions, by individualised assessments of the risk of cancer,and by vaccines against changes unique to tumour cells and against bacteria that cause cancer.

    With regard to surgeons in 2020, the report says that they will be “highly skilled technicians, expert in robotics and computer-driven image reconstruction systems. Like radiologists, surgeons may work from locations remote from the patient, carrying out highly specific tasks by remote control.”

    But Professor Sikora paints a bleak picture of the future in terms of society, predicting the breakdown of religion, cohesive families, and social services. He says: “In the shorter term, more patients will neither die from their cancer nor be cured, but must learn to live with it, often being given complex therapies to control it for many years.

    “Longer term, they will face increasingly high tech treatments. They have to deal with all this in the face of the gradual decline of organised religion and family structures and inadequate social services. It will be up to those providing treatment to ensure that proper support is in place.”

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