A growing number of Americans are living with cancer for years and even decades, thanks to a new generation of targeted drugs that attack tumors based on their unique genetic fingerprints. Two women, Cathy Smithwick and Michelle Vacca, have survived breast, ovarian and lung cancers for more than a decade each while remaining active and traveling the world. Their stories reflect a broader shift in oncology: the American Cancer Society now estimates that 18 million Americans who have ever had cancer are alive today.
A record 7 out of 10 cancer patients now survive for at least five years, up from less than half in the 1970s and 63% in the mid-1990s. The improvement comes as scientists have moved beyond traditional chemotherapy, which kills all fast growing cells, toward drugs that target specific genetic mutations driving tumor growth. A study presented at the recent American Society of Clinical Oncology meeting showed that cancer deaths in people ages 15 to 49 have dropped 25% since 1990. Newer treatments like Revolution Medicines’ daraxonrasib, which targets a variant of the RAS gene, can help patients overcome resistance to standard therapies. Dr. Vincent Chung, a pancreas cancer specialist at City of Hope, explained that patients on targeted therapy often become sensitive again to older chemotherapy drugs.
Smithwick, now 67, was diagnosed with breast cancer in 2005 and later with ovarian cancer. Her tumor tested positive for the HER2 protein, found in about 25% of breast cancers, and she received Roche’s Herceptin, one of the first antibody drugs designed to block a cancer causing protein. She now takes an estrogen targeting pill, and if her tumor grows, doctors will biopsy it to test for additional genetic markers. “Meanwhile I am living my life,” she said, noting she recently climbed in the Himalayas and plans a fourth trip to Kenya. Vacca, 59, who never smoked, was diagnosed with lung cancer after an unrelated chest x-ray. A biopsy revealed an EGFR mutation, and she was treated with AstraZeneca’s Tagrisso. When the cancer returned, City of Hope identified a rare EGFR 20 insertion mutation, seen in only about 2% of lung cancers. She enrolled in a trial of CLN-081 three years ago. “It’s still working for me,” Vacca said. “It hasn’t stopped me from traveling to K-pop concerts.”
Looking Ahead: Genomic Profiling and Survivorship Research
Success rates for clinical trials have nearly doubled when researchers select patients based on specific genetic markers rather than treating all comers. Dr. Julie Gralow, ASCO’s chief medical officer, said the field is moving toward full genomic profiling for every cancer. Dr. Saro Armenian, director of City of Hope’s survivorship program, noted the center is “doubling down on research to understand the journey of cancer survivors,” even as some patients still face dire prognoses.
Rebecca Siegel of the American Cancer Society expects survival rates to continue rising, though cancer will likely remain the second leading cause of death after heart disease. For patients like Smithwick and Vacca, the era of targeted drugs means more time to travel, attend concerts and climb mountains. As Smithwick put it, “I am living my life.”