Living Beyond Cancer

This year’s Combating Cancer report highlighted that the cancer survival rate in the UK has more than doubled since the 1970s. Here, our Head of Research, Dr Naomi Elster, looks at why more people are living beyond cancer.


Survival rates are important, but not to individuals

We use cancer survival rates to compare how many people with cancer survive for a particular length of time, compared with people who don’t have cancer. To calculate it, we work out the percentage of cancer patients who are still alive five years after being diagnosed, and divide that by the percentage of people in the general population, of the same age and sex, who are still alive at the end of the same period. 

These numbers are extremely useful to those of us who work in cancer research, because we can zoom out and take a look at the broader picture. They tell us, for example, if things are improving overall, or if there’s a particular stage of the disease where we need to concentrate our efforts

But as an individual patient, it’s important not to dwell on these rates too much. Survival rates are based on averages from a very large number of people, whereas factors affecting your personal health will be quite unique to you. 50% of all cancer patients in England and Wales survive for a decade or more after diagnosis. This does not mean that you, as an individual, have a 1 in 2 chance, and it is impossible to predict from these numbers what your figures are. 

It’s also important to remember that many people diagnosed with cancer today are in a better situation than survival figures show. These figures are always based on people who were diagnosed and treated several years ago, and treatments are improving all the time. 

Combating Cancer 2021

What’s behind the survival increase?

Cancer is a notoriously complicated disease and every single step taken to understand it better accumulates into a bigger picture. If our knowledge of the disease and how to treat it is a jigsaw, the puzzle has millions of invaluable pieces, so it’s not quite right to talk about single events which changed the course of this disease. For example, in 2001, clinical trial results showed that a drug called imatinib transforms a usually fatal leukemia into a manageable condition. It works in people who have a protein called the Philadelphia chromosome, which was discovered decades earlier, in 1960. 

Treatments such as surgery, chemotherapy, and radiotherapy were discovered a long time ago, but they are still being improved. Surgeries have become less invasive. One of our projects focuses on a type of radiotherapy which can even hunt down cancer cells that have broken away from the prostate and spread around the body, with potential for less side effects than current radiotherapy. We also have two projects aiming to improve hormone therapy, by keeping it working for longer in more men.  

One of the most fundamental shifts in cancer is that we’ve moved towards a much greater understanding of the very detailed biology that drives it. A huge international research programme over 12 years called The Cancer Genome Atlas kicked off in 2006 and has transformed our understanding of cancer – and the mountains of data generated from over 20,000 tumours spanning 33 cancer types are available for free, for any cancer researcher in the world to use to drive research even further. We now know that ‘cancer’ is a group of diseases, not a single disease, but we are able to draw comparisons based on biological details such as the signals cells send to the cells around them, the intrinsic, tiny changes which drive tumours, and this allows us to learn from different cancer types.  



Tamoxifen is a tablet which was originally intended as a contraceptive, but its effects on estrogen activity led to it being approved for breast cancer in the late 1970s, making it one of the first therapies to be targeted to cancer cells. It can sometimes be used to treat breast swelling and pain in men who are on hormone therapy for breast cancer. 

Finally, it would be wrong to talk about the improved outcomes for cancer without mentioning some of the non-cancer inventions which have also changed the state of play. Antibiotics and anesthesia have made surgeries safer. Improvements in medical imaging have been transformative, allowing us to see tumours more clearly and diagnose and treat them more accurately. Steroids are sometimes used to treat cancer itself, depending on the type, and are often used to reduce symptoms and side effects such as pain, fatigue, and as anti-sickness drugs. 

The Future

We haven’t finished our cancer research journey. There’s more work to be done in the later stages of the disease. In prostate, survival drops from close to 100% to 30% when cancer spreads around the body, which is why our organisation puts more focus on this stage. More work needs to be done to understand which treatments are best for which individual, to reduce side effects, and to understand who has cancer which can safely be left untreated. All of those are reasons why we are still here. But the incredible progress made to date means that the present is better than the past, and the future will be better still.  

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