Drug development efforts begun during 70’s are now coming into existence, which results in the availability of several new anticancer drugs with impressive activity against additional types of cancer. These drugs improve several times and quality of life for patients with advanced diseases, and they hold promise as part of multimodality therapies during earlier stages of many common cancers in adults.

Cancer prevention efforts, including cancer screening, vaccination, tobacco control, healthy eating, and physical activity, remain key to reducing the effect of cancer and improving outcomes across communities worldwide. In fact, researchers estimate that 50% of cancer cases and deaths in the United States could be prevented if people adopted simple healthy lifestyle choices that include avoiding smoking and alcohol, maintaining a healthy weight, and exercising regularly [1] Lung cancer is among the most common types of cancer and the leading cause of cancer death in men and women worldwide. Radiation therapy for lung cancer increases the risk for heart problems. High dose radiation has been the backbone for treatment of different stage of cancer and it is believed that few live long experience heart complications. Studies published in 2017challenge this notion by showing that heart problems are relatively common in this patient population.

In an analysis of patients who were treated in six clinical trials from 1996 to 2009, 21% of those who received a high dose of radiation developed symptomatic heart problems within 2 year[2]. Heart problems were independently linked to high doses of radiation and underlying risk (eg, smoking and cardiovascular disease). A second analysis of patients who were treated in four clinical trials from 2004 to 2013 demonstrated similar results; 11% developed severe heart problems within 2 years [3]. As in the other study, patients who received a higher radiation dose and/or had pre-existing heart disease were more likely to develop heart problems. Furthermore, both cancer worsening and heart problems were linked. Research presented in 2017 demonstrated that a single radiation treatment may be sufficient for cancer patients with a shorter life expectancy [4]

Scientists are only beginning to understand how the complex interplay of all these factors raises or lowers the chance of developing cancer in an individual with an inherited cancer gene mutation. It is also not clear why changes in genes with broad functions, such as the DNA repair and MMR genes, predispose people for certain, but not all cancers. Large-scale genomics studies are providing insights by which to fine-tune cancer risk assessment for each person. Genomic information, along with reproductive and family history, lifestyle, and other factors, may help patients decide whether and when to have preventive surgery. Scientists are also exploring the possibility of using immune based approaches, such as vaccines for cancer prevention in healthy people with cancer predisposition syndromes [5]. With the new national investment in cancer prevention through the Cancer Moon shot initiative and cutting-edge technologies, such as sequencing the genomes of individual cells, the opportunity to advance this field is closer than ever. Socioeconomic disparities have also reversed over time. In 1950, people in the most-deprived socioeconomic group had a 27% lower cancer mortality rate than those in the most affluent group, but by 2010 to 2014, the most deprived group had a 22% higher cancer mortality than their most affluent counterparts [6]. Another analysis demonstrated that among people with no health insurance, black patients had rates of cancer mortality that were similar to those of white patients, but had higher mortality rates among either Medicaid or private insurance groups [7]. Taken together, this body of research suggests that addressing cancer disparities and achieving equity calls for multifaceted approaches that are focused on efforts to improve prevention, screening and access to high- quality cancer care.

Early detection of disease is known to lead to a higher probability of survival in many cancer types [8, 9]. As life expectancy after a cancer diagnosis continues to improve, there is growing recognition of the need to address patients’ emotional and psychosocial needs from the time of diagnosis through treatment and survivorship. Clinical Cancer Advances 2018 highlights efforts to preserve patient quality of life by avoiding unnecessary treatment or by lowering therapy dose or duration. Furthermore, new tools that engage patients in their own care, for symptom monitoring, psychological support, and end-of-life planning, are showing benefits for both patients and health care systems. Finally, we are entering a new era in care in which biomedical research is no longer solely driven by researchers and physicians, but also by patients who are more and more directly engaged in driving progress forward. By donating tissue samples and clinical information, or by helping to design research studies and formulate practice guidelines, patients are providing valuable perspectives and contributing to better care. Progress against rare cancers is often slow because of a combination of scarce funding and a limited availability of patients and tumor samples for research. An attractive solution to this problem is crowd sourcing. More and more people with rare and common cancers today have the opportunity to rapidly and directly affect research by sharing their tumor tissue samples and medical and/or genetic information to help others with the same or similar diseases. In return, researchers share what they learn with participants. Cancer survivors are prone to persistent psychological distress which can have wide reaching and persistent effects on family, friends, and care givers[10, 11].