Seren Award

Why have we still not

managed to cure cancer?
Angela Andrianopoulou
Cancer Institute, Division of Medicine, UCL
 Session 2
Cells out of control – what do we do?
Learning objectives

• Discuss the significance of screening

• Differentiate between screening and diagnosis
• Explore characteristics of cancer cells vs normal cells
• Link tumour development mechanisms to treatment
options
What do you think makes curing cancer
difficult?
• Any barriers to diagnosis and treatment you can think of?

• What mechanisms do you think cancer cells might employ

to make it easier for them to survive?

Think of what we talked about on Monday and also what

cells might need to survive…

Go to www.menti.com and use the code 5972 3067

Screening
• Screening means testing people for early stages of a disease.
• Before any symptoms
• For screening to be useful the tests:
o need to be reliable at picking up cancers
o overall must do more good than harm to people taking part
o must be something that people are willing to do
• Not perfect and have some risks
• Should be good value for money for the NHS
• There must be an effective treatment for the disease when
detected at an early stage
What problems might be associated with screening?
Diagnosis vs screening

Screening tests Diagnostic tests

Screening tests
Purpose To detect potential disease indicators To establish presence/absence
of disease
Target population Large numbers of asymptomatic, but Symptomatic individuals, or
potentially at risk individuals asymptomatic individuals with a
positive screening test
Test method Simple, acceptable to patients and staff May be invasive, but justifiable as
necessary
Positive result Indicates suspicion of disease that Result provides a definite
warrants confirmation diagnosis

Cost Cheap, benefits should justify the costs Higher

TRUE or FALSE? Go to www.menti.com and use the code 5972 3067

Survival statistics

• Almost half (45.5%) of all cancer cases were diagnosed at

stage 3 & 4 in England in 2018
• Breast:
o Stage 1: Most women (around 98%) will survive for 5 years or more
o Stage 4: Around 25 out of 100 women (around 25%) will survive for 5
years or more
• Lung:
o Stage 1: Almost 6 in 10 (57%) people will survive for five years or more
o Stage 4: Almost 5 in 100 (3%) people will survive for five years or more
What makes cancer cells special? –
Hallmarks of Cancer
Treatment options

Surgery Chemotherapy Radiotherapy

• Targeted treatments
• Immunotherapy
• Combinations
Resistance

• Cancers that have initially been responding to a

therapy suddenly begin to grow
• Adaptations
• Heterogeneity:
o Differences between tumours of the same type in
different patients
o Differences between cancer cells within a single tumour
o Difference between a primary (original) tumour and a
secondary tumour.
Questions?