We have been conditioned, over years, to expect that chemotherapy is part and parcel of cancer treatment. I expect that if you had any mental images from reading that last sentence, it was of someone having lost their hair. And, if you yourself have been through chemotherapy, there’s a lot you’d rather not remember, I’m sure. That is less and less the future for cancer treatment, though. As with much in medicine, that paradigm is shifting– genetic testing is changing the landscape of chemotherapy.

Cancer treatment is becoming increasingly a combination of different therapies targeted to navigate the genetic quirks of peoples’ individualized disease. For decades the standard has been to treat the cancer – nearly any cancer – with chemotherapy, sometimes different rounds with different kinds of chemotherapy, and hope one works.

Now, patients commonly undergo genetic testing with the aim of identifying, first, if chemo would provide significant benefit. And, based on the results of this testing, many oncologists are opting for other therapies that more proving to be successful. Some specialized cancer drugs, for example, are designed to destroy cancer cells by destroying the proteins on their surface. Immunotherapy helps boost the patient’s own immune system response to attack the cancer cells; hormonal therapy for breast cancer deprives certain types of breast cancer the estrogen they need to survive. For breast cancer alone there are now fourteen drugs, with dozens more in clinical trials, available to oncologists.

This is all because, broadly speaking, patients are seeing better outcomes from these targeted therapies. Five year survival rates are improving, and patients are providing anecdotal evidence of improved quality of life under these therapeutic regimens. Even patients with late stage cancers are seeing improved outcomes.

The continued goal, of course, is to design robust therapies for each patient, on the results of that patient’s genetic tests. For now, this remains leading edge of cancer treatment.