Good news about cancer

Prof. dr. Dr Hans Gelderblom is professor of internal medicine – in particular Experimental Oncological Pharmacotherapy – at the Leiden University Medical Center (LUMC). He is also chairman of the Dutch Association for Medical Oncology.

Immunotherapy

Hans Gelderblom: “With immunotherapy, we strengthen the patient’s own defense against the tumor. The drug ipilimumab has been on the market for two years against melanoma, an aggressive form of skin cancer. Previously, metastatic melanoma was fatal. With ipilimumab, one in five patients was suddenly cured. A second drug will be released in 2015: nivolumab. A combination of these drugs provides a cure for half of the melanoma patients. That is really a breakthrough. They are very expensive drugs. That is a thorn in our side, but we want to use them.

Immunotherapy will soon be applied to other types of cancer, such as lung and bladder cancer. There are more new drugs with fewer side effects. We will also use them in high-risk patients, immediately after surgery, to reduce the chance of metastases or increase the chance of a cure. We are also developing combination treatments with targeted therapy and radiation.”

Patient benefit: “It’s a new type of treatment with great success in cancers that were previously untreatable.”

‘Targeted therapy’ gaining momentum

Hans Gelderblom: “So-called ‘targeted therapy’ uses the unique properties of a tumor that determine why that particular tumor grows – they all do that slightly differently. We take a biopsy of the tumor, watch how it grows and then block the path to growth , for a number of months to years.We now know the unique growth characteristics of more than half of the tumors.

For example, in melanoma there is a certain mutation (‘BRAF’); targeted therapy can prolong life in this group of patients by up to eight months. Targeted therapy is also available for prostate, colon, breast and lung cancer. We also know better and better for which patients the therapy is useful or not.”

Benefit for the patient: “Some of the patients live longer thanks to these new treatments. We also know better for whom it works and who does not. As a result, fewer patients are burdened with a treatment that is meaningless to them.”

Better cancer care

Hans Gelderblom: “Cancer care is becoming more and more specialized. But how can you, as a patient, be sure that you will end up with a doctor who has sufficient experience with your type of cancer? Agreements have now been made about this. The quality of doctors has recently been registered by the Dutch Institute of Clinical Auditing. Hospitals have also made mutual agreements about quality criteria they must meet in order to be allowed to offer a certain treatment, so that ‘rare’ care will no longer take place in small hospitals.” Patient benefit: “You can rest assured that the hospital to which you are referred has sufficient knowledge and experience.”

Treat colorectal cancer faster thanks to screening

Hans Gelderblom: “The population screening for colorectal cancer started in January 2014. As a result, a lot of intestinal tumors are now found. The screening ensures that many tumors are detected at an earlier stage; they are often still small and there are fewer metastases. treatments are more curative.” Benefit for the patient: “In the long run, fewer people will die from colon cancer.”

Faster certainty in ’emergency clinic’

Hans Gelderblom: “More and more hospitals have a special rapid diagnosis outpatient clinic for cancer. Patients there receive all the necessary examinations in quick succession, often within one day. This already happened in many places for breast cancer. But now people can also do this quickly for many other types of cancer. get a biopsy and the diagnosis For bone tumours, this takes a little longer.

The project started in four hospitals: Antoni van Leeuwenhoek, LUMC, Radboud UMC and UMC Utrecht. The website www.sneldiagnose.nu offers an overview of the hospitals with such an outpatient clinic.” Advantage for the patient: “You are as short as possible in uncertainty about the diagnosis.”