“The future belongs to prevention and individualised diagnosis and therapy!”

(Vienna, 30 August 2010) There are 230 different types of cancer, with tens of thousands of doctors and scientists battling to deal with them. Cancer is a business worth billions. And according to the information of the American Cancer Society (ACS) – if nothing happens, cancer will kill more than 200 million people, a quarter of all Europeans and Americans alive today. But: fewer and fewer people are dying from cancer – even though more and more people are falling ill with the disease.

We spoke with cancer specialist Prof. Michael Micksche on developments in cancer research, the focal points of research at the Cancer Research Institute and about his hopes for the Cancer Research Run on 9 October.

For the first time in more than seventy years death from cancer is clearly in retreat. Is this the start of a lasting descent?
There are types of cancer where we can clearly talk of a positive trend, in particular breast, stomach and intestinal cancer. With breast cancer there has been a trend reversal thanks to the prevention campaigns of the Cancer Society. Tumours today are discovered and operated on at an early stage. This means the chances of being cured are better and the radical step of breast removal is often no longer necessary. Preventive medical checkups and improved forms of treatment have led to these cancer patients surviving well beyond the five-year limit.

Death from cancer cannot be defeated with the classic means of tumour medicine alone. In the future we will have to check what is practical for cancer treatment, as demanded, for example, by the President of the German Cancer Society. A large part of the resources should be used for prevention and screening.
This is the most cost-saving method. If cancer is detected early, an operation can be performed early and less treatment is necessary. Advanced stages of cancer need a lot of treatment though. With new forms of therapy there have also been great successes when treating colorectal and lung cancer, including in these late stages.

Is cancer a disease which is easier to prevent than treat?
No, that is too complex. At the moment there is only one single disease, colorectal carcinoma, where it is at all possible to prevent the cancer occurring. In the case of cervical carcinoma, prevention is by vaccination and medical checkups. Of course keeping away from smoke, a healthy diet and exercise are important forms of prevention too. Access to preventive measures also depends on factors such as education and social status, however. And: are people ready to heed this information and change their lifestyles?

What is the situation like with the currently available resources for prevention and screening?
Bad; unfortunately no-one wants to pay the costs of prevention campaigns at the moment. Prevention means, for example, the responsibility of the citizens and also providing the financial means which would be urgently necessary for the likes of organised mammography screening.

With early detection a curse and blessing are close to each other. In which area does early detection currently provide earlier diagnosis AND reduce the mortality rate?
With breast and cervical cancer and also colorectal cancer there is scientifically proven evidence that organised screening is worthwhile with these tumours. It is different with prostate cancer: here studies show that early diagnosis – as part of organised screening – of prostate cancer still does not extend life. In individual cases it is different.
 
Often, and for an unknown reason, a tumour which has already been treated returns after 10, 15 or more years. Metastases have then often developed and the disease can no longer be cured.
Sleeping cancer cells which are lurking somewhere. These cells are kept in check by the immune system but then, because of a still unclear event, these cells are activated. The objective is therefore an operation where all tumour cells are removed and then subsequent chemotherapy.

The Cancer Research Initiative demands that top-level research is maintained under new general conditions. What are these exactly?
A new research building, our building is ready to be demolished. Our staff have the potential to carry out top-level research which compares with any country internationally. What we are lacking are the financial means. We urgently need well-funded research and the financial means to acquire new equipment. In the future the initiative therefore also wants to campaign for this as well as funding for research projects. Our mailing campaign, for example, is very successful here.

What do you want from the Cancer Research Run on 9 October?
With the help of the kilometres covered by the runners, in 2009 we were able to intensify examinations for lung cancer to show which medication can be used with which patient.
In 2010 we want to intensify biomarker research with the help of the donated money. By studying biomarkers we want to prevent our patients having to take medication with high side effects but without any benefit. We are on the right track here!

Where do you see the main challenges for cancer research?
Our goal is to provide all cancer patients with individualised diagnosis and therapy by, for example, developing biomarkers so we can say where a certain form of therapy is worthwhile or not. Chemotherapies and new drug therapies do not work with every patient.

We also have to make our research results available to the general public for therapy and prevention and reach more people than we have so far.
We have to make sure our daily work is in an understandable language and announce one main message: cancer research helps! Unlike in the USA, we are lagging behind when it comes to specialisation. Operations should be performed only where there is expertise. This means that not every state hospital can and should do everything. What we are lacking is a national cancer strategy, a political unit to deal with the issue of cancer and therefore the coordination of all research projects – without patronising researchers. A national cancer research centre would be a good idea.

Many thanks for the interview!

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