The professor warned that more people will die quickly from these diseases than from cardiovascular diseases

While experts’ predictions suggest that the situation could get worse in the next twenty years, scientific progress offers hope. Cancer that metastasized a few decades ago could mean only one thing: rapid death, but today medicine allows not only to prevent it, but also to find ways to control it.

According to data on causes of death, oncological diseases are the second most common cause after cardiovascular diseases, but scientists predict that in the near future the situation may change and malignant tumors will become the most common cause of death not just in Lithuania but all over the world, the outlet reported.

In 2018, 3.9 million people in Europe contracted cancer and 1.9 million died of cancer. population. Worldwide, 18.1 million were registered in the same year. new cases of cancer and up to 9.6 million people died from the disease. world population.

“Scientists predict that the number of new cancers in the world will increase by more than 63.4 percent in the next twenty years, by 2040. and their number will reach 29.56 million annually. It is also estimated that up to 71 , 5 percent. It will also increase the number of deaths from oncological diseases. Looking at the growing trends, experts assume that cardiovascular diseases will leave a place in the mortality structure of cancer “, says Prof. Elona Juozaitytė.

According to the professor, in Lithuania similar trends are observed in the incidence of oncological diseases, but the mortality rate here remains stable or even has a tendency to decrease.

“It is very difficult to control morbidity, because here we are faced with many lifestyle characteristics – obesity, harmful habits, low physical activity – that affect morbidity and are very difficult to control. And mortality can be influenced, managed or stabilized, since it depends on early diagnosis, new medical technologies and modern treatment options ”, says the professor.

According to the doctor, the modern revolution in biotechnology, nanomedicine, genomics and information creates new opportunities to fight cancer diseases and poses new challenges for the development of oncology.

Cancer does not happen overnight

The entire onset, progression and metastasis of a cancerous tumor is determined by genetic and epigenetic changes in cells – mutations. Some mutations are inherited, others occur in the course of life in a single cell of the body, which then becomes the originator of cancer.

“A normal cell turns into cancer when a mutation occurs that gives the tumor cell primer an advantage over healthy cells. And then things change. The new properties of tumor cells determine the success of carcinogenesis, that is, the development of the tumor, because healthy cells act in the same way and the altered cell proliferates aggressively, grows and divides ”, says the professor.

Prof. According to E. Juozaitytė, the onset of cancer is usually a long-term, multi-stage process that does not occur overnight or for several days. Sometimes decades can pass from the onset of a mutation to the onset of the disease.

“At a certain age, a mutation can occur, tumor proliferation can begin and then another change can occur. Then the tumor begins to grow, it becomes invasive and this can last for decades. For example, the colon carcinogenesis model: Initial changes can occur from the age of 30 and a person can become ill only at the age of 60. It is a multi-stage process of tumor formation, ”says Prof. E. Juozaitytė.

Chance to look deeper

According to the professor, previously important clinical features were known only in oncology. For example, if a woman has breast cancer, the patient’s choice of treatment and prognosis depended on the size of the tumor, lymph node damage, the presence of distant metastases, the patient’s age, and other factors.

“It is still important today, but now it is possible to analyze what changes have occurred more deeply, in the tumor itself. It is possible to study genes that become targets and develop drugs that can block those targets and control the disease. development of research and the emergence of new treatment options, there is a growing awareness that treatment must be individualized, taking into account the genetic changes that have occurred in the tumor ”, says Prof. E. Juozaitytė.

It is the progress of biological science – molecular, genetic methods, generation of sequences of new generations that allows to find a pathological link in the pathogenesis of a specific patient’s tumor and at the same time predict and select the most effective antitumor treatment.

After investigating the cancer genome and analyzing what treatment would be appropriate for the tumor, it sometimes happens that it has never been used to treat such a cancer, but genetic changes show that such a treatment would be effective for him.

According to the professor, in clinical practice we had to deal with sufficiently successful treatment results, which are not typical in routine practice, but are suitable for that particular patient.

“We used to think that treatment in humans depends on the location of the tumor: that lung cancer is treated in one way, breast cancer in another and kidney cancer in another. However, it turns out that the same mutations may have occurred in both cancers. It may be that some type of mutation occurred in the lung cancer, but the exact same thing was observed in the analysis of, say, breast cancer. In this way, we discover more possibilities to treat one person, to block the path that leads to the progression of the disease and to stop its metastasis according to these mutations ”, assures the professor.

Metastasis is no longer a verdict

In clinical practice, a situation is often encountered where the oncological disease initially responds to prescribed treatment and then resistant cells develop that do not respond to treatment and metastasize. Metastases can consist of certain heterogeneous clones and some of them are overtaken by drugs, while others continue to spread and progress.

“The heterogeneity and resistance of the tumor, which occurs during long-term treatment, becomes a problem, so we ask ourselves: where can we move forward? Then, we look for new technologies, such as the ability to carry out a genome study and extract tumor DNA from tumor material or a liquid biopsy, identify genetic changes and see what we can offer the patient ”, says prof. E. Juozaitytė.

According to the professor, to diagnose an oncological disease, a morphological examination of the tumor is necessary, so the “gold standard” remains the morphological material of the tumor for all subsequent examinations. Liquid biopsy is especially important to monitor the course of the disease, to assess whether the molecular profile of the tumor has not changed if the prescribed treatment is no longer effective.

“In such cases, it is possible to repeat the test that, for example, the tumor has changed and needs to be treated differently. It is also possible to identify new mutations or determinants of resistance, choose another course of treatment, discover new possibilities”, he says The teacher.

Cancer genome testing is available at all stages of the disease and is especially necessary if the disease is progressing and metastasizing. Comprehensive examination of the cancer genome is essential to refine the diagnosis of a rare atypical tumor and to select treatment when the tumor is on an aggressive course and all conventional treatment options have been exhausted.