Evolution of targeted cancer therapies: a radiation oncologist’s perspective

On July 1, 1987, I started treating cancer patients as a full-time radiation oncologist – a cancer specialist who uses radiation therapy to help cancer patients beat their disease. Now, nearly 37 years later, I have the privilege of caring for cancer patients at a cancer center. Nearly every type of cancer is treated differently; for example, breast cancer is treated differently than colon cancer, which is treated differently than lung cancer, and so on. In other words, the ultimate cure for cancer will occur in a series of advancements related to each individual type of cancer. That said, the Zig Ziglar quote above captures a common thread in the noble quest to conquer cancer – that thread is called targeting.

During my 35 years in practicing cancer medicine, I have personally witnessed the evolution of new targeted cancer therapies that have remarkably improved the cure rates and/or the survival experience for cancer patients. The goal of cancer care in 2023 and beyond is not only to cure the patient but to do so without causing undue complications. That goal is accomplished by creating new drug therapies that specifically target and kill the abnormal cancer cells while leaving the body’s normal cells unharmed to continue their daily duties and functions. In my field of radiation oncology, that goal is achieved by targeting a tumor or cancer in the body with radiation treatment while leaving the good normal tissues around it intact and not damaged.

During the COVID-19 pandemic, significant investments were made to upgrade and install advanced targeting radiation equipment. A radiation linear accelerator, for instance, combines the ability to “see the tumor/target” with real-time, three-dimensional imaging and sophisticated motion management and then delivers sterilizing (tumor-killing) doses of radiation accurately and precisely to that tumor/target with speed. The machine rotates around the patient to deliver a prescribed radiation dose from nearly any angle. It has computer-controlled “leaves” or “fingers” that create apertures of different shapes and sizes that sculpt the radiation beam to precisely match the three-dimensional shape of the tumor. This technology minimizes dose to the surrounding healthy tissue while treating tumors with accuracy measured in submillimeters. It allows for advanced treatment techniques, including intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), stereotactic body radiotherapy (SBRT), and stereotactic radiosurgery (SRS).

This advanced technology gives us the ability to precisely tailor cancer treatments that are the very best for each individual patient’s condition. It provides breakthrough tools that allow us to treat challenging cancers such as lung, liver, breast, prostate, head and neck, gastrointestinal, kidney, pancreas, and brain/spine tumors. Treatments that previously took 10 to 30 minutes to deliver can now be completed in less than two to five minutes, allowing for a more comfortable experience for the patient with less time on the treatment machine. And best of all, this amazing treatment that previously required long-distance travel is now available close to home.

Kevin L. Schewe is a radiation oncologist.


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