Project description
Enhanced cancer monitoring strategies could reduce surgeries and improve outcomes
Technological advances and an enhanced understanding of disease processes can expand options for less invasive and disruptive treatments. For example, not long ago, a lobotomy was a legitimate alternative treatment for severe mental illness that was resistive to other therapies. Cancer treatment is entering a new era with a growing recognition that prioritising the surgical removal of a diagnosed tumour may involve risks that outweigh the benefits. Active surveillance is now a defined treatment plan that involves closely watching a patient’s condition for signs of change without treatment. CAST plans to enhance our understanding of cancer behaviour and monitoring strategies with the ultimate goal of reducing unnecessary surgery while improving patient outcome and quality of life.
Objective
When a patient is discovered to have cancer, one of the primary goals is to have the tumour removed by surgery. Although
this provides excellent oncological control, it is associated with morbidity and functional problems in cancer survivors. Recent
studies have shown that the immediacy to perform a resection does not always lead to improved clinical outcome.
Furthermore, cancer surgery can often lead to complications where the quality of life for the patient is compromised by toxic
side effects and /or damage to nerves, organs or healthy tissues. A number of recent clinical trials in the field of cancer
surgery have advocated the concept of watch and wait, watchful waiting, active monitoring or surveillance, which are terms
used to describe a monitoring strategy for cancer. The concept may be antithetical but the functional advantage of these
alternatives is clear even though there is some concern about the risk. Though the evidence is still weak, current studies
suggest that with adequate selection and follow-up, this oncological risk is small. A major consideration for clinicians is now
to maintain quality of life for all patients. Our objective in this proposal is to implement novel approaches so that cancer
surgery can be avoided, where we aim to (a) develop new monitoring technologies from industry so that the surveillance
window can be increased to allow for better treatment options over time and to avoid surgery, (b) develop new ‘watch and
wait’ strategies in order to study the behaviour of the cancer so that any risks to the patient can be minimised leading to a
better clinical outcome and (c) train a new generation of preclinical and clinical scientists to be able to implement this new
concept as standard of care and to maximise the benefits of an active monitoring policy.
Fields of science
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Programme(s)
Coordinator
1066 CX Amsterdam
Netherlands