These days, cancer treatment has come into focus in ways unknown just a few decades ago. The treatment is smarter and more effective than just having the old scorch-earth policy with chemo ripping through one’s body and the indiscriminate destruction of all cells – good and bad. The new treatment is under the umbrella of targeted therapy and it was the subject of a Lifetime TV program which aired on Sunday May 28, 2006.

The program is part of a series called “Health Corner,” and it is on each Sunday morning with various topics. The program on May 28th focused on the new treatments being used to target cancer cells, and specifically, multiple myeloma. The program featured Ken Anderson, from Dana Farber. Dr. Anderson has been at the forefront of developing these new drugs. As a patient, I have been lining up for these treatments through medical trials ever since I was diagnosed with this disease in 1996. I am a strong advocate for these new approaches. They offer the greatest hope for managing the disease while providing a good quality of life. Someday, these targeted therapies could even lead to a cure.

Targeted therapies work directly in the environment of the cancer cells. In the case of myeloma, chemicals are released on a molecular scale which allows a variety of unwanted processes to take place. The cancer cells grow in the marrow, they attach themselves to the marrow walls, and in the process grow unchecked because of the absence of normal moderators, and then, unwanted proteins are released into the bloodstream to do damage collecting in other parts of the body. Of course, too, as these cancer cells make their home in the marrow, they inhibit the normal bone process, and osteoclasts go at it by breaking down the bones. The entire marrow neighborhood is unstable. Targeted therapies stabilize the environment by regulating some of the complex chemicals which cause the cancer cells to thrive.

Thalidomide and Revlimid are just two of the most common targeted therapies now being used by myeloma patients. These shut off the growth enzymes, shake the myeloma cells from the marrow wall, and even can lead to cell death, itself. In combination with other drugs, such as Decadron, the weakened cells are clobbered even more, and the myeloma cells shrink – they don’t go away completely, but they back off, and let us live our lives.

Velcade is another drug which targets the proteasomes that help flush and clean out cells. Evidently, cancer cells are more sensitive to the cleaning process than normal ones, and if that is inhibited, than the myeloma cells will diminish – that has happened for a high percentage of patients who have been treated with Velcade. In every type of cancer, targeted therapies are finding applications – Gleevec has done well with chronic myeloid leukemia and has been used to treat a form of gastrointestinal tumors. Genasense has been used to treat leukemia, non-Hodgkins lymphoma and solid tumors. Monoclonal antibodies, cancer vaccines and gene therapy are considered to be part of the targeted arsenal because they interfere specially with the growth of cancer cells.

Dozens of these smart, targeted treatments are being tested – not all as effective as others. But they are out there, and certainly in combination with other therapies such as standard cancer drugs, they have the potential to work wonders, and that it why we have lots of hope.