Two women are defying cancer odds thanks to breakthrough treatments that specifically target their tumors’ genetic makeup, representing a growing trend of Americans living longer with the disease.
Cathy Smithwick, age 67, has battled breast cancer followed by ovarian cancer for over two decades using a combination of targeted therapies, immune system treatments, chemotherapy and hormone medications.
Michelle Vacca, recently 59, has managed lung cancer for almost a decade and continues thriving on an investigational treatment that addresses a uncommon tumor genetic change.
These cases reflect a broader shift as researchers decode cancer’s biological foundations and create medications tailored to each tumor’s genetic blueprint.
According to the American Cancer Society, approximately 18 million Americans with cancer histories remain alive currently.
An unprecedented seven in ten cancer patients now live at least five years beyond diagnosis, compared to fewer than half in the 1970s and 63% during the mid-1990s when targeted cellular treatments first appeared, the cancer organization reports.
Traditional chemotherapy that destroys all rapidly dividing cells — which remains central to cancer care — was previously the sole treatment avenue for most malignancies.
“It’s taken decades for us to really understand the biology of cancer,” stated Rebecca Siegel, head of surveillance research at the cancer group. She anticipates survival statistics will keep climbing, though cancer will likely stay the second leading cause of death behind heart disease as it becomes more frequent with aging.
The recently completed American Society of Clinical Oncology conference in Chicago featured research demonstrating cancer fatalities among 15 to 49-year-olds decreased 25% since 1990, alongside trial outcomes for innovative life-prolonging treatments for pancreatic, skin and blood malignancies.
Cancer emerges when DNA mutations cause cells to multiply and spread without control. Environmental exposures like tobacco or ultraviolet radiation can trigger these changes, though inherited mutations account for fewer cases.
New treatments must prove safety and effectiveness for regulatory clearance, often measured by tumor reduction rather than extended lifespan. Fewer than one-third of recently approved cancer medications demonstrated life extension benefits.
Trial success rates are advancing partly because studies selecting participants based on particular genetic markers or mutations have nearly doubled the effectiveness of non-selective trials.
Emerging treatments like Revolution Medicines’ daraxonrasib, which targets a RAS gene variant driving cancer progression, enable patients to overcome resistance to conventional therapies, explained Dr. Vincent Chung, pancreatic cancer specialist at City of Hope, a national cancer research and treatment organization.
“This is how you have patients that are living with cancer… if you’ve been on a targeted therapy, you’re going to be probably more sensitive to the older chemotherapy again,” he stated.
Smithwick, who served as a management consultant in Silicon Valley before retiring following a second ovarian cancer return four years ago, received her breast cancer diagnosis in 2005. Her tumor showed positive results for HER2 protein — present in approximately 25% of breast cancers — leading to treatment with Roche’s Herceptin, among the first antibody medications designed to block cancer-promoting proteins.
BRCA1 gene mutation testing occurred only after her sister’s breast cancer diagnosis years later.
Following surgery in 2010, Smithwick faced ovarian cancer diagnosis. When her cancer developed drug resistance, alternative treatments began, but an allergic response to platinum-based chemotherapy eliminated that option.
Currently taking an estrogen-blocking medication, she will undergo biopsy testing for additional genetic markers if tumor growth occurs, with doctors at Kaiser Permanente planning comprehensive marker analysis.
“They will test for all available markers,” said Smithwick, who completed a 4-mile Himalayan climb in Bhutan last November and plans her fourth Kenya trip this summer. “Meanwhile I am living my life.”
Vacca, an office manager in Orange County, California, who never smoked, discovered her early-stage lung cancer through an unrelated chest x-ray.
Post-surgery biopsy revealed an EGFR mutation, leading to treatment with AstraZeneca’s tyrosine kinase inhibitor Tagrisso, though the cancer returned.
Another medication caused an infected rash. City of Hope identified her cancer’s EGFR 20 insertion mutation, found in roughly 2% of lung cancers, resulting in enrollment three years ago in a CLN-081 drug trial.
“It’s still working for me,” Vacca said. “I don’t really have any side effects… It hasn’t stopped me from traveling to K-pop concerts.”
Dr. Saro Armenian, director of City of Hope’s survivorship program, said the center is “doubling down on research to understand the journey of cancer survivors,” while recognizing patients may still face serious prognoses.
Dr. Julie Gralow, the organization’s chief medical officer, stated: “We’re going to have to look at the full genomic profile of every cancer.”
