Cancer represents one of the most complex challenges in medicine. Within the umbrella of cancer are manifold diseases of abnormal growth, each with different causes, molecular mechanisms, and treatment approaches. Given the inherent complexity of addressing these many types of cancer, where does cancer detection, prevention, and treatment go from here?

To discuss the promising technologies and emerging therapies currently being developed, the Hopkins Business of Health Initiative convened a panel of experts to share their perspectives. The panelists included Paul Billings, CEO and Director of Biological Dynamics; Jordan J. Green, Director of the Biomaterials and Drug Delivery Laboratory and Professor of Biomedical Engineering at Johns Hopkins University; Lilja Solnes, Associate Professor and Director of Nuclear Medicine and Molecular Imaging at Johns Hopkins University; and John Steuart, Managing Director of Steuart Ventures.

"Over the past decades, we have made truly remarkable progress in detecting cancer earlier and more accurately, and these advances have saved many lives and improved outcomes for many patients," said Mario Macis, professor at Johns Hopkins University's Carey Business School and the panel's co-moderator with fellow Carey Business School professor Emilia Simeonova. "However, the science and technology and also the policy questions around early detection are increasingly complex, so we hope this discussion can advance the knowledge needed for making informed decisions."

Here are eight takeaways from our experts on the future of cancer detection and treatment:

1. Theranostics is the emerging breakthrough to watch.

Theranostics combines therapy and diagnosis so that doctors can not just see but also treat cancer at the same time. "We take very specific targets that recognize tumor cells, add radioactive material, and using this, we can detect the cancer, and we can then change the isotope and treat cancer," said Solnes. "The continued development of these targets, which recognize tumor cells and avoid healthy tissue as it goes to the tumor cells, will revolutionize the way we approach cancer."

2. Developments in nanotechnology will amplify progress.

"Emerging technologies, including those coming out of biomedical engineering and other fields related to nanoparticles, are creating potential for multifunctional particles that could deliver different kinds of imaging modalities and therapeutic modalities in the same agent," said Green. "These are really tremendous breakthroughs that have happened recently and as they continue to advance, I think we'll get better and better patient care."

3. Cancer can now be detected dramatically sooner.

"We have begun to move from a system where symptoms are the driving force for diagnosis to the ability with liquid biopsy and other imaging modalities to detect cancer much earlier," said Billings. "We're still missing lots of people and the technology has a long way to go, but we also need to educate the public about the value of detecting cancer before it's symptomatic, in its earliest stages."

4. Infrastructure and information dissemination are lagging.

"We need to do better to make sure that everyone knows what treatments are available, and we need the infrastructure to deliver these new discoveries to all parts of the country," said Solnes. "With radioactive material, you can't always get it to the middle of the country, and there is equipment that you need in certain areas to actually perform the diagnostic studies." Despite these challenges, she remains optimistic: "We have a long way to go, but I, as a clinician, I'm pretty excited about where we are and where we are going."

5. Current health care spending on cancer isn't aligned with the greatest impact.

"In terms of the cost and value, diagnostics are incredibly valuable and ever more valuable, yet they're relatively less valued in terms of pricing as compared with therapeutics," said Billings. "How we pay for things, what we pay for and insisting that the payment system recognize the value of diagnostics has to be something that we work on in the near term."

6. Genetic risk stratification will transform cancer prevention.

Universal genetic testing at birth will fundamentally change how we approach cancer prevention. "We are moving to a world where everyone at birth will have their genomes done and so their germline predispositions to cancer will be largely identified at birth," said Billings. "We can then immediately risk stratify the newborn population and the people who are at high risk for cancer." However, this advancement brings new challenges in how to effectively survey high-risk individuals and communicate genetic predisposition information sensitively.

7. Immunotherapy represents a paradigm shift in cancer treatment.

The human immune system naturally surveys for abnormal cells and destroys cancer cells at a microscopic level, but cancer can sometimes evade this surveillance. "Our bodies actually nip cancer in the bud all the time," explained Green. "If there are diagnostic tests that are early but we don't know exactly where the cancer is for surgery, it could be that we have certain immunotherapy compounds that then let the immune system do its job even better, to find those rare cancer cells while they're still rare."

8. Access and equity remain fundamental barriers to progress.

Despite technological advances, systemic issues continue to limit cancer care access. "Cancer is racist. African Americans die at substantially higher rates than Caucasian Americans," said Steuart. "It's elitist, it's classist. Poor people die of cancer at much higher rates than middle class and rich people do. And yet, it's completely fixable if we either adopted Medicare for all or universal health care." The panel emphasized that addressing these disparities is essential for realizing the full potential of emerging cancer technologies.

“Conversations on the Business of Health” is a series of one-hour webinars hosted by HBHI that engages leaders from business and academia on the cutting edge of improving American healthcare.

Moderated by faculty members and jointly hosted by the Bloomberg School of Public Health, the Carey Business School, the School of Nursing, and the School of Medicine, the series is open to all. Learn more here.