Inside the State of Cancer Today

A Cancer Care Roundtable

Nearly 2 million Americans will find out they have cancer this year — a stark reminder that the disease remains one of the nation’s most pressing health challenges. Yet cancer care today is moving at a pace few could have imagined a decade ago. From breakthroughs in immunotherapy and precision medicine to the rise of diagnoses in younger adults, the field’s only constant is change. Add in the uncertainty of future research funding, and it’s clear that physicians are facing both remarkable opportunities and significant challenges.

Decades of progress since the National Cancer Act of 1971 have transformed how physicians detect, treat, and approach cancer. Doctors have more tools at their disposal than ever before. Against this backdrop, we convened a group 

of leading cancer physicians to discuss what’s new, what concerns them, and what gives them hope for the future of cancer care.

Q: What’s new in the world of precision medicine, immunotherapy, and targeted therapy for cancer?

Natalie Reizine, MD: So much! Oncology is increasingly becoming a field where a patient’s therapy is tailored to the individual person, with the goal of minimizing side effects and maximizing efficacy. Many treatments are prolonging patients’ length and quality of life, and are no longer one-size-fits-all approaches. This also makes oncology treatment even more complicated, as we are learning that cancer is many different diseases and should not be treated the same. As our patients are living longer with cancer, it’s important to focus on their overall health.

Sara Zarnegar-Lumley, MD: For B-acute lymphoblastic leukemia (B-ALL), the most common childhood cancer, there is a paradigm-changing immunotherapy — blinatumomab — now integrated into upfront therapy for most children. This therapy harnesses the body’s own immune system to eliminate leukemia cells and has shown to improve survival outcomes for children with B-ALL.

Walter Stadler, MD: A wave of innovative cancer therapies is transforming treatment options. These include traditional small-molecule drugs, antibody-drug conjugates delivering radiation or toxins directly to tumors, bispecific antibodies that guide immune cells to target cancer, and advanced cellular therapies that re-engineer immune cells to recognize and eliminate cancerous cells.

Fatema Esmail, MD: Next-generation sequencing is transforming cancer care by identifying genetic mutations that drive each patient’s disease. This allows us to match patients with targeted therapies or clinical trials best suited to their tumor profile, advancing personalized medicine and improving outcomes while avoiding unnecessary treatments.

Q: Are there other new cancer therapies you’re excited about?

Esmail: Bispecific T-cell engagers are an exciting advance in oncology. These engineered molecules engage both the immune system and cancer cells, triggering T-cells to destroy cancer. They have shown promise in blood cancers and are being studied in solid tumors, offering hope for broader immunotherapy options ahead.

Reizine: I’m excited about many new therapies, but I will highlight the novel field of radioconjugates. These are a new modality for both treatment and diagnostic imaging. They’re administered in collaboration with nuclear medicine physicians. Radioconjugates are targeted drugs that combine a radioactive isotope with a targeting agent. These can offer more sensitive and specific imaging tests (better at diagnosing specific types of cancer), as well as offer a form of treatment with targeted radiation that is cancer specific.

Ted James, MD: Research continues to open new frontiers in cancer treatment. Two areas showing promise are antibody-drug conjugates and radiopharmaceuticals, which both use targeted delivery of therapeutic agents to attack tumors. These approaches provide more direct treatment with fewer side effects and are expanding options for patients who previously had limited choices.

Q: What do you think is causing the uptick in more cancer diagnoses among younger people?

Xuanji Wang, MD: There has been an increased incidence of young women under 40 with breast cancer. This is a difficult population because women are not recommended for screening mammograms until the age of 40 unless they are at high risk for breast cancer. The exact cause is not known because breast cancer can be caused by multiple factors, including genetics, personal exposure to estrogen, personal medical history, and even lifestyle factors. We do encourage women with palpable masses to reach out to their doctors for a diagnostic mammogram. There are continuous research projects ongoing to help answer these challenging questions.

Mauna Pandya, MD: Advances in education, healthcare access, screenings, and diagnostics enable earlier cancer detection and effective treatment in younger patients. These gains, born of rigorous research, now face political threat. Sustained progress depends on shielding science from politics and restoring public trust in medicine and the research at its foundation.

James: The rise in cancer among younger adults is a concerning trend we are working hard to understand. Possible contributors include lifestyle and metabolic health factors, environmental exposures, and genetic predisposition. This underscores the urgency for prevention strategies and early detection tailored to younger populations.

Esmail: Rising cancer rates in younger adults are likely [due to] a combination of lifestyle changes, environmental exposures, and rising obesity rates. Processed foods and increased antibiotic use alter the gut microbiome, which affects the immune system and can influence cancer development. Improved screening and awareness also contribute to earlier detection. 

Q: When President Richard Nixon declared war on cancer and established the National Cancer Act in 1971, he substantially increased government funding for cancer research in hopes of finding a cure. What were some of the best results to come out of that increased support for cancer research?

Stadler: The National Cancer Act reshaped cancer research infrastructure, laying the foundation for targeted therapies, immunotherapies, and improved survival rates. Once misunderstood and feared as contagious, cancer is now better understood. Today’s breakthroughs in biology and treatment — and the growing number of survivors reaching the five-year mark — trace back to this pivotal legislation.

James: The National Cancer Act marked a turning point in the fight against cancer and fueled decades of discovery in tumor biology, leading to improved survival across many tumor types, including breast, colorectal, and childhood malignancies. The investment also advanced targeted treatments and immunotherapies, and built the foundation for today’s clinical trial system and cancer centers of excellence.

Q: How do you think about cancer differently today compared to when you started your career?

Stadler: The share of cancer patients with a realistic chance of cure has grown, though it remains a minority. Decades ago, treatment options for prostate cancer were limited; today, far more exist. Many advanced cancers are now managed like chronic conditions — similar to heart disease, diabetes, or chronic lung disease — offering patients longer, better lives.

Zarnegar-Lumley: Emerging cancer therapies minimize the toxicity of conventional chemotherapies. As we integrate these immunotherapies and targeted inhibitors into treatment regimens, we must participate in shared decision-making with adolescent and young adult patients and their caregivers. I have learned the importance of empowering patients to participate in their cancer treatment.

James: We once saw cancer as a single disease. Today, it’s understood as several distinct conditions requiring tailored approaches. Treatment is no longer one-size-fits-all but guided by molecular, genetic, and individual patient factors.

Reizine: Over the years, I’ve learned that taking care of cancer patients is so much more than just giving anti-cancer medications. It’s about helping patients to live longer, fuller lives with a good quality of life. Patients are so much more than their cancer diagnosis, and it’s important to take many other factors into account, like their lifestyle, overall health, nutrition, and other [considerations], when coming up with a treatment plan. Taking care of cancer patients is also better in a team. I think it’s essential to work closely with my patients’ navigators, dietitians, social workers, pharmacists, physical therapists, and many other team members. 

Q: Are you watching or participating in any exciting cancer clinical trials?

Wang: We offer many clinical trials at Rush MD Anderson Cancer Center. We are part of multiple national clinical trials through our partnership with MD Anderson Cancer Center. Patients can always come see us [to find out] which clinical trials they qualify for.

Reizine: Absolutely. There are many exciting clinical trials evaluating new medications, therapies, tests, and interventions, with the goal of continuing to improve the existing standard of care. Ongoing clinical trials at UI Health can be found at uihealth.uic.edu/research-clinical-trials, and you can search for clinical trials available throughout the country at clinicaltrials.gov, where all are registered.

James: Yes, clinical trials are essential to how we are advancing cancer care. We’re excited to offer a growing portfolio of studies in precision oncology, immunotherapy, and early detection. These trials give patients direct access to innovations shaping the future of care and allow them to receive tomorrow’s therapies close to home.

Q: How are clinical trials helping to inform future treatment options, and potentially lead to earlier and more accurate diagnoses?

Zarnegar-Lumley: All childhood cancers are rare diseases, and clinical trials are the only way to answer important questions among enough patients. In cancers with excellent survival outcomes, trials have allowed for therapy de-escalation and toxicity reduction while preserving outcomes. Other trials are identifying patients who may benefit from treatment intensification. 

James: We see clinical trials as central to shaping tomorrow’s standards of care. These studies allow us to provide novel therapies that may change how cancer is managed. For example, we are conducting clinical trials in multi-cancer early detection that focus on biomarkers to detect cancers earlier and match therapies more accurately to patients.

Reizine: There are many types of clinical trials that may focus on improving treatment, diagnosis, prevention, screening, and quality of life of cancer patients. Clinical trials focusing on improving screening tests may help identify cancer diagnoses earlier. Clinical trials are developed and reviewed with guidance from safety monitoring boards and require that patients participating undergo informed consent, a process of education and mutual decision-making. Participants in clinical trials help advance the state of science and cancer care for all. 

Stadler: Lifesaving treatments begin with research. Clinical trials reveal whether lab discoveries truly help patients, advancing care and outcomes. At City of Hope, our research now pushes cellular therapies, like [chimeric antigen receptor T-cell], beyond blood cancers to broader applications.

Q: What do you wish more people understood about cancer?

Wang: Breast cancer comes in different types and forms. Treatment for breast cancer has really evolved to tailoring treatment based on the cancer biology and patient factors. We tell patients that no two cancer treatments are exactly alike. Having a thorough discussion with the cancer treatment team is important to formulating a curated plan.

Reizine: Receiving a cancer diagnosis is life-altering for not only the patient themselves, but also for their caregivers, family, friends, and community. Advocating for yourself in your appointments and allowing others you care about into your cancer journey can be beneficial not only to yourself but to your entire care team. 

James: Caring for patients with cancer is not just about treating the disease; it involves addressing the whole person. Navigation, survivorship programs, and attention to financial and social needs are just as critical as the therapies themselves.

Stadler: Cancer care is complex, requiring multiple treatment options and a multidisciplinary team to address physical, emotional, and social needs. Seeking a second opinion is encouraged. Early, individualized screening — especially for prostate cancer — can detect disease sooner, empowering men to seek care, make informed decisions, and improve outcomes.

Pandya: There is no single cure for cancer because cancer has no single cause. The most effective approach is individualized treatment matched to each person’s cancer. This isn’t the exception; it’s modern medicine’s standard, and it’s how I treat each of my patients.

Q: What are the most important factors in seeking cancer care, and how do people best access it?

Zarnegar-Lumley: For children and young adults with cancer, it is important to seek cancer care at a center with access to pediatric oncologists with expertise in clinical trial implementation and the support of a multidisciplinary care team. Lurie Children’s Hospital offers access to the most clinical trials in the region.

Stadler: You need a cancer care team that involves you in decisions, considers your goals, and applies expert, up-to-date knowledge. Collaborating through tumor boards, they ensure the right treatment at the right time, acting with urgency to provide effective care and peace of mind throughout your journey.

Esmail: Access to experienced specialists, timely initiation of treatment, patient navigation and supportive care services, clinical trials, and personalized treatment options. Many centers have an experienced multidisciplinary team that reviews cases and provides treatment recommendations. Your primary care provider can give you a referral to see a trusted oncologist.

Reizine: Seeking care from a primary care physician is so important to make sure that you are maintaining your health overall. Primary care providers can make sure that you are up to date on your age-appropriate cancer screening tests and that you are evaluated for other chronic medical conditions that can affect your overall health. Even after a cancer diagnosis, patients must take care of their overall health, and this is best done with a multidisciplinary team of providers who all communicate together.

Q: Besides face-to-face conversations with cancer providers, where can people find reliable resources to learn about cancer?

Esmail: Many reputable organizations and medical institutions, including cancer.gov, cancer.net, and nccn.org, offer reliable, accurate, and up-to-date information on screening, prevention, and treatment, as well as information regarding coping and supportive care for a number of different cancers.

Stadler: Effective communication with your healthcare team is essential. Additional trusted information is available from the American Cancer Society, National Cancer Institute, and professional organizations like the American Society of Clinical Oncology, the American College of Surgeons, and the American Society for Radiation Oncology. Discuss these resources with your doctor to ensure you are fully informed and empowered in your care decisions.

Wang: There are many resources available about breast cancer. Breastcancer.org is a reliable source with patient-centric information. Susan G. Komen (komen.org) also provides educational guides on breast health and breast cancer-related topics. 

Q: What can providers do to ensure the best outcomes for patients with cancer? What does that success look like?

Zarnegar-Lumley: We can achieve the best outcomes by establishing a partnership with our patients and caregivers to allow for shared decision-making when possible. We can also ensure a provision of services that allow patients to remain healthy during cancer treatment, including nutrition, physical therapy, psychosocial support, palliative care, peer support, and school services for children.

Wang: Transparency about the process is important for the best outcomes. Breast cancer treatment can be a long journey for the patient and her family. We try to provide a roadmap for which treatments to expect and how the process will be. Success comes in many forms, and patients should celebrate each accomplishment and milestone throughout the treatment.

Q: What are the biggest challenges in cancer today?

Stadler: Far too many patients still lack effective therapies or access to modern standard care. City of Hope supported the Illinois Cancer Patients Bill of Rights to help ensure proven treatments are available. Expanding new options remains a critical priority to improve outcomes for all people living with cancer.

Zarnegar-Lumley: When we cannot attain remission (refractory) or cancer comes back (relapse) for certain pediatric cancers, including acute myeloid leukemia or osteosarcoma, it is difficult with current therapies to achieve a cure. It is essential to advance biomedical bench research to better understand the biology of these diseases and translate findings into therapeutic clinical trials.

Q: Illinois is projected to lose 6,700 jobs and $1.6 billion in fiscal year 2026 due to the National Institutes of Health funding cuts. Will funding cuts affect you, and if so, how?

Pandya: Cuts to research funding slow medical progress for everyone. Some consequences are immediate; others take years to surface. Without sustained support, the U.S. risks falling behind in innovation, and future generations may not have the breakthrough treatments we take for granted today.

Zarnegar-Lumley: Only 4% of government-allocated funding supports pediatric cancer research. Funding cuts will jeopardize drug development and clinical trials for children with cancer. Many NCI-funded trials focus on patient populations often ignored by pharmaceutical studies, including children. Now, more than ever, children with cancer require advocacy from healthcare providers.

Q: How can individuals contribute to cancer research?

Wang: We always encourage patients to participate in clinical trials. Research is the most important thing to continue moving forward early breast cancer detection and personalized treatments. There are many trials available at the different institutions across Chicago, and we always try to connect patients to these trials.

Zarnegar-Lumley: Individuals can contribute to cancer research through philanthropy and advocacy. This year, the Cal’s All-Star Angel Foundation provided transformative support to Lurie Children’s Hospital to develop the Advanced Leukemia Clinical and Research Program, which will expand access to cutting-edge treatments and resources for pediatric patients with high-risk leukemia.

Esmail: Individuals can contribute by enrolling in clinical trials, donating tissue or blood samples for research, volunteering their time, and supporting cancer foundations either through donations or advocacy. Raising awareness and participating in community events also helps to support cancer research.

Originally published in the Fall 2025/Winter 2026 print issue.