Middle East doctors hail tailored treatments as breast cancer death rates decline

Immunotherapies and increased awareness are helping to increase survival rates, UK study shows

Death rates from breast cancer have fallen by two thirds in 20 years, thanks to better understanding of tumours and personalised treatment, research shows. EPA

Doctors in the Middle East say tailored treatments, medical advancements and raised awareness are helping to drive down cancer death rates, even as prevalence of the disease is on the rise across the globe.

A UK study published this week showed deaths from breast cancer have fallen by two thirds since the 1990s, highlighting successful efforts by the health sector to improve patient outcomes.

The University of Oxford report gathered data from the National Cancer Registration and Analysis Service on 512,447 women in England diagnosed with early breast cancer between 1993 and 2015, with women tracked until December 2020.

It provided a detailed picture of breast cancer mortality in a population of women with early signs of the disease.

Immunotherapy is taking over chemotherapy in some instances, and improving the overall survival rates of patients

Dr Yasser Abdel Kader,
Professor of Oncology, Egypt

For women diagnosed with early invasive breast cancer during the 1990s, the risk of death within five years of diagnosis was 14 per cent on average, but just 5 per cent for women diagnosed from 2010-2015.

Meanwhile, the risk of death within five years fell to less than 3 per cent, the study found.

Chemotherapy no longer 'only option'

The encouraging UK findings were backed up by a doctor in the UAE, who said better understanding of tumours was increasing survival rates for all cancers, while chemotherapy was likely to be gradually phased out due to improving access to alternatives such as immunotherapy.

“We know for each type of breast cancer, the route for therapy will be very different,” said Dr Shaheenah Dawood, consultant medical oncologist and Adjunct Clinical Professor at Mohammed Bin Rashid University of Medicine and Health Sciences.

“By individualising therapy, we can improve the prognosis of patients.

“Chemotherapy was once the only option for patients with triple negative breast cancer, now we know that we can give immunotherapy to those in the early stages.

“This has improved patent outcomes.”

Breast cancer screening – in pictures

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  Doctors have urged women over the age of 40 to have a mammogram every year. PA

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  The simple screening consists of an X-ray of the breasts that doctors use to look for early signs of cancer. Photo: Cleveland Clinic Abu Dhabi

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  The study showed that despite awareness campaigns, 50 per cent of the women surveyed were reluctant about having a mammogram. Mona Al-Marzooqi / The National

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  Among the main reasons for the hesitancy was a lack of symptoms (31 per cent), worried about the results (26 per cent), no family history of breast cancer (25 per cent), and that it felt uncomfortable. EPA

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  Dr Holland Ravelle said it's importan for women over the age of 40 who live a healthy lifestyle to undergo regular screenings. SSMC

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  Sharjah’s breast cancer awareness campaign - known as the Pink Caravan - offers free consultations, mammograms and ultrasound screenings across the UAE. Friends of Cancer Patients in Sharjah.

Endocrine therapy that blocks the hormone pathway is now the mainstay of therapy in some patients.

Hormone therapy has become a proven weapon in cancer treatment, by slowing the growth of cancer that uses hormones to grow, or stopping it altogether.

“We have learnt to de-escalate the need for chemotherapy in some patients by looking at the genomic make-up of the patient’s tumour to tell us if they need chemotherapy, or not,” said Dr Dawood.

“Personalising therapy is also making a difference in those with stage four cancer.

“In 2023 it is no longer acceptable for a patient diagnosed with breast cancer to walk into the clinic and be treated the same.

“Each person needs to have individualised therapeutic management based on the biology of their disease.

“That is how you improve outcomes.”

The lead author of the UK study said its findings should buoy women diagnosed with the disease.

“Our study is good news for the overwhelming majority of women diagnosed with early breast cancer today because their prognosis has improved so much,” said Carolyn Taylor, Professor of Oncology at Oxford Population Health.

“Their risk of dying from their breast cancer in the first five years after diagnosis is now 5 per cent on average.”

Boost for UAE patients

Breast cancer accounts for a third of all female cancers in the UAE and is the number one cause of cancer mortalities.

In January, the National reported on how a large-scale review of breast cancer in the UAE showed better screening was reducing the number of advanced cases of the disease, with improved survival rates comparable with those of leading western nations.

Forty-six doctors compiled anecdotal evidence and research outcomes from 2001 to 2021 to develop a real-time picture of breast cancer in the UAE.

In 2018, an evaluation of 988 UAE patients at Tawam Hospital in Al Ain found 97 per cent had survived for two years, while 89 per cent had survived five years post-diagnosis – a similar figure to the US, Australia and Canada.

Although the most recent statistical data from the National Cancer Registry was collected from 2017, medics used personal experience from daily clinics to present an overall disease assessment.

While mortality rates have steadily dropped across the globe, there were more than 19 million new cases of cancer detected in 2022, as the global death toll from all types of cancer reached approximately 10 million.

Lung cancer recorded the highest fatality rate, accounting for 1.8 million deaths, followed by colorectal cancer with 900,000.

A report published last year found cancer is increasing in younger age groups, largely because of poor lifestyle choices, diet and obesity, a global oncology review concluded.

But researchers also say the greater incidence could be the result of better screening programmes.

The rapidly growing global population and extended lifespans are also key factors in rising cancer rates.

The report, published in Nature Reviews Clinical Oncology, a monthly peer-reviewed academic journal, showed a significant increase in many types of cancer in those aged 50 or younger, including cancer of the breast, colon, oesophagus, kidney, liver and pancreas.

Anti-smoking campaigns

Long-term projections indicate a 1.8 fold increase in cancer incidence by 2030 in the Arab world, according to medical publication, Cancer in the Arab World.

Dr Yasser Abdel Kader, Professor of Oncology and Director of the Oncology Department Research Unit, Cairo University, Egypt, said precision medicine for patients was having a significant impact on outcomes.

“The picture of lung cancer has definitely changed over the years, with new treatments and better survival rates,” he said.

“This is down to two facts; anti-smoking campaigns and the discovery of new targeted treatments.

“Thanks to a broader molecular profiling of our patients, we can achieve even more success.

“We now know that patient A is different to patient B, even though they are carrying the same clinical diagnosis.

“Immunotherapy is taking over chemotherapy in some instances, and improving the overall survival rates of patients.”