Last year, MD Anderson President John Mendelsohn, M.D., proposed 10 steps that can be taken to ensure cancer deaths decrease more rapidly, the ranks of survivors swell, and an even greater number of cancers are prevented in the first place.
2. Develop better tests to predict cancer risk and enable earlier detection of cancer.
New technologies similar to those that enable identification of abnormal genes and gene products in cells in a patient's cancer can be used for early detection of cancer (or pre-cancer) in cells or molecules that are shed into the blood or other body fluids.
Changes in the levels of prostate-specific antigen (PSA) in the blood signify the possible presence of prostate cancer. Most recently, changes in the blood levels of CA-125 have been reported as successful for detecting the presence of ovarian cancer. The new technologies also can be used to predict increased risks of cancer. Variations in the DNA sequences of "normal" genes are being discovered, and some of these predict a somewhat greater risk of developing certain types of cancer during a patient's lifetime.
Abnormalities in the BRCA 1 and 2 genes predict a particularly high risk for breast cancer, which can guide the decisions of physicians and patients on preventive measures.
Many more gene- and gene-product-based predictors are needed, and will be forthcoming. They will include laboratory tests, and eventually imaging tests, to further our progress in early detection and risk assessment.