Cancer diagnosis is not a death sentence anymore

A cancer diagnosis was a death sentence until a few years ago, but the field of medicine is developing and for many types of cancer there are already effective treatments and even tools that help prevent the disease.

On the occasion of World Cancer Day, which is celebrated on February 4, we invited the director of the oncology department at the Ichilov Hospital, Prof. Ido Wolf, to the "Expert Clinic" studio to ask what we must know about cancer today - and what the future holds for us.

"Oncology is considered a very tough field, many are not even able to say the words oncology or cancer, the newspapers always say 'severe diseases' or 'complex conditions'," said Prof. Wolf. "But in the end, cancer is just another disease, in my opinion not even the most difficult, there are more difficult things. I'm not sure that terrible dementia is easier than cancer."

Good news

According to him, the most important thing to know about cancer is that "in recent years there has been a big change in the field of cancer treatment. If once it used to be a death sentence, looking at Israel's statistics, the chance of getting cancer is always decreasing  while the chance of recovery is increasing. So the news is good."

It is important to know that the population is ageing and this also affects the incidence of cancer. "Cancer is a disease of old age, and as the population gets older we see more cancer cases around us ... It is precisely because of the extension of life expectancy that we see more cancer cases," explained Dr. Wolf, but emphasized that despite this, the statistics in Israel are "great."

Much of this improvement in cancer incidence is thanks to preventive medicine. Many Israelis are more aware and regularly perform tests to detect cancer such as mammography or colonoscopy, thus "cancer is detected earlier and treated better".

Worth the pain

Prof. Wolf also had an encouraging answer to the question about the price that cancer patients pay during complex treatments such as chemotherapy.

"First of all, if we detect it early, we will need less treatments," he explained, "and if we do need treatments - even here there are already big changes compared to what used to be. True, there is still chemotherapy, especially with breast cancer, where it causes hair loss and more side effects, but in other cancers we have been able to give much less harsh combinations and in some cases we are switching from chemotherapy treatments to all kinds of biological and immune treatments that are much easier for the patients, so we absolutely have successes".

Even in the more difficult cases, Prof. Wolf emphasizes, it is usually a very tough war lasting a few months "but we are doing this war in order to reach a long life later. The advantage of today's treatments is that the vast majority of patients can be cured and living a long life afterward is a realistic forecast, to reach recovery from cancer."

"So it's true, there will be some difficult, even very difficult months along the way, but the optimistic side is that if I have a 35 or 40-year-old patient with breast cancer, who in the past I would have known she would die of this cancer, today I know that after a few difficult months she will be able to live and be with family and the children, and even the grandchildren," he said.

A simple blood test

One of the problems with cancer, especially the metastatic and simple one, is that it can sometimes be difficult to find or locate it, but even in this field there has been significant progress in recent years.

"Today there are already blood tests that are developing in this direction, which can detect really tiny elements of the tumor in the blood, super super sensitive tests, which can detect even if there is a minimal disease", Prof. Wolf said. 

"It is currently in research and I can assure you that in 3-5 years we will use these tests routinely and we will be able to know who has or does not have these small things and adapt treatment better. And more than that, I assume that in 3-5 years we will test healthy people, and already with a blood test we will be able to detect the cancer."

Today we aren't there yet, there are only regular screening tests that can be done to detect early cancer, "but in a few years, which is not a long time, each of us will go to the doctor and have a blood test done and look for the cancer at an early stage," clarified Prof. Wolf.

He added that in England they have just started a study on exactly this test and plan to test several hundreds of thousands of people, "so a study that is actually being carried out today will produce results in two, three, four years, and it is likely that not many years from now each of us will go to the doctor once every few years saying "Give me a blood test and tell me if I have cancer."

He added that "the test already exists, it is at hand, I think that in 10 years our conversation will be completely different."

No clear cause

When there is cancer, most people look for a cause, but it is not always possible to find it. "When someone has cancer, they try to find the cause, which is natural and many times the cause of cancer is attributed to all kinds of events that happened to us, of all kinds and species."

However, according to Prof. Wolf, about 5 percent of cancer cases are the result of genetics and heredity, 30-35 percent are mutations caused by the environment, such as smoking and sun exposure, and about 60 percent are other factors that have no clear cause.

"When something happens randomly, it's called bad luck, but in fact we see a large group of people who say, 'But I behaved well, why did this happen?'. The real answer is that many of the processes are biological processes that behave according to a mathematical model, and they don't really care what we did or didn't do," Prof. Wolf clarified, "that is important to understand."

This understanding, of course, should not harm optimism, because as Prof. Wolf made clear, the chance of getting cancer decreases and the chance of recovery is increasing - but it is important to be able to deal with this diagnosis, which, despite the optimism, is still scary.