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One of the most exciting developments in oncology in recent years has been the advent of targeted therapies, which have paved the way for personalized medicine. These therapies have been developed specifically to take advantage of a mutation or deficiency in a tumor or a surface characteristic that make it susceptible to the targeted therapy. This is even more exciting given that for the past 50 years, we have been delivering therapies that affect all of the cells in the body (often with substantial toxic effect) in the hopes that we will hurt the cancer cells the most and perhaps even kill them off. This, of course, is chemotherapy, and while it will not be going away any time soon, the prospect of personalized and targeted cancer therapy promises better outcomes with fewer toxicities since the cancer cells are the sole focus of the treatment.

As exciting as these new therapies might seem, we must be mindful that our ultimate goal should be to prevent cancer through early detection. Mammograms, pap smears, and colonoscopies are all proven strategies for detecting cancers and precancers at an earlier stage when they can be more easily cured, and the positive effects and outcomes of these prevention efforts have been well documented.

Early detection vs cost-effectiveness in screening for lung cancer
On page 441 of this issue of Community Oncology, we highlight another early detection screening strategy—for lung cancer—that is bound to change practice. In a study of more than 50,000 persons aged 55 years and older and at high risk for lung cancer (a history of smoking of 30 pack-years), participants were randomized to receive low-dose CT screening or chest radiography annually for 3 years. The investigators found that lung cancer was detected at an earlier stage in the CT-scan group for a 20% reduction in mortality compared with the radiography group. ...

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