The future of cancer treatment is rapidly evolving, with advancements in sequencing laboratories, algorithms, and hospital pharmacies' price lists. According to US-based oncologist and biologist Siddhartha Mukherjee, cancer is not a single disease, but hundreds of diseases that require personalized treatment. Mukherjee, who runs a laboratory at Columbia University, has written a Pulitzer Prize-winning book, The Emperor of All Maladies: A Biography of Cancer, which demystifies the disease for lay and specialist readers.
Mukherjee emphasizes that every individual cancer specimen is "its own disease" genetically speaking, making it unlikely that there will be a single "cure" for cancer. Instead, there will be many "cures" for different types of cancer. He cites immunotherapy, which turns the body's immune system against tumors, as a successful approach in treating advanced-stage lung cancer. Immunotherapy has led oncologists to ask not only where but what a tumor is, with the answer lying in its genetic fingerprint and unique vulnerabilities.
The use of genetic information has led to the development of targeted treatments, such as Chimeric antigen receptor (CAR) T-cell therapy, which "re-engineers" patients' immune cells to hunt down cancer. This approach has shown significant promise in treating children with relapsed or treatment-resistant leukemia, with cure rates of around 50-60% and five-year survival rates. Additionally, a new drug that blocks RAS, a gene family that drives many cancers, has extended survival in a pancreatic cancer trial from six to 13 months.
Advanced antibody-drug conjugates (ADCs) combine the precision of immunology with the potency of chemotherapy, functioning like "guided missiles" to direct payloads to cancer cells. Globally, 23 ADCs are approved, with 16 in the US, and hundreds more are in development. These treatments are turning once-untreatable breast, lung, and bladder cancers into manageable chronic diseases. The American Association for Cancer Research (AACR) 2026 Progress Report counts 11 new anticancer agents approved over the past year.
Artificial intelligence (AI) is accelerating change in cancer treatment, with Mukherjee seeing AI as a companion, not replacement, for doctors. UK researchers have developed AI technology using 3D imaging and geometric deep learning to analyze cancer cells' exposure to new drugs, predicting cell responses with 99.3% accuracy and slashing years off drug discovery. However, Mukherjee warns against overtesting, false positives, and a screening industry that manufactures anxiety without benefit.
Prevention remains a blind spot in cancer treatment, with Mukherjee calling it "probably the most difficult science". He notes that scientists have found no preventable chemical carcinogen big enough to dent cancer deaths since the 1960s. However, he suggests that a pill to prevent cancer may be possible, with doctors "closer … maybe closer than many think". One preventive pill, Tamoxifen, already works by blocking oestrogen and cutting the risk of oestrogen receptor-positive (ER-positive) breast cancer in high-risk women.
Mukherjee also dispatches common cancer myths, such as the link between mobile phone use and brain cancer, and the effectiveness of cutting sugar to "starve" tumors. He emphasizes that good news accompanies myth busting, such as the potential for human papillomavirus (HPV) vaccination to push cervical cancer risk close to zero. Overall, the future of cancer treatment is promising, with many new treatments and approaches in development.
Key points
- There will be many "cures" for different types of cancer, rather than a single "cure".
- AI is being used to accelerate change in cancer treatment, including predicting cell responses to new drugs.
- Prevention remains a blind spot in cancer treatment, but a pill to prevent cancer may be possible.
