Global Health Asia-Pacific March 2020 | Page 35

Online tool allows cancer patients to know their odds of dying Website draws from official data to show survival rates A Global study unravels cancer genomes Thousands of scientists publish 23 papers to trace comprehensive genetic map A n international team of researchers has completed the most comprehensive study of whole cancer genomes to date, significantly improving our fundamental understanding of cancer and suggesting new directions for its diagnosis and treatment. Involving more than 1,300 scientists and clinicians from 37 countries, the project analysed more than 2,600 genomes of 38 different tumour types, creating a huge database of primary cancer genomes. While previous studies only focused on the one percent of the genome that codes for proteins, the new study explored in considerably greater detail the remaining 99 percent of the genome, including regions that control switching genes on and off. In 23 papers published in the journal Nature, the researchers reported that scientists can now characterise every genetic change found in a cancer, all the processes that have generated those mutations, and even the order of key events during a cancer’s life history. They’re also closer to cataloguing all of the biological pathways involved in cancer and having a fuller picture of their actions in the genome. At least one causal mutation was found in virtually all of the cancers analysed, and the processes that generate mutations were found to be hugely diverse, from changes in single DNA letters to the reorganisation of whole chromosomes. More than a dozen regions of the genome controlling how genes switch on and off were identified as targets of cancer-causing mutations. The researchers have also put forward a new method that can identify mutations which occurred years, sometimes even decades, before the tumor appeared. This opens, in theory, a window of opportunity for early cancer detection, they explained. GlobalHealthAndTravel.com new website enables cancer patients to view survival rates for their diagnosis based on a few simple data points. While some doctors are skeptical about patients turning to the internet for answers, providers behind the tool say it could help patients have more impactful discussions with their doctors. Stephen Buck, co-founder of the drug-pricing information site GoodRx, is behind the new website, CancerSurvivalRates.com. The site has a tool that prompts users to enter information about their age and gender, as well as details about their cancer diagnosis, including things like the stage of their cancer, its grade, how much time has passed since their diagnosis, and their histology. The tool then draws on data from the National Cancer Institute in the United States to calculate how many people have survived that type of cancer for up to five years. “We designed this site to be extremely simple for people to understand. People aren’t versed in odds and survival rates,” Buck told the media. “We wanted to say out of 10 people, how many are alive after one, two or five years.” He said the information the tool offers should be used to foster discussion between patients and providers about their future. “We want this to be a conversation starter, for someone to take this information and ask their physician, what do you think about my prognosis?” Buck added. The site has received some criticism from oncologists who say survival chances are best discussed in a doctor’s office, where support is available for the patient. MARCH 2020 33