Young Ki Hong, MD

In the past 25 years, cancer care has been transformed by groundbreaking advancements that redefine how we diagnose, treat and prevent the disease. Once anchored to surgery, chemotherapy and radiation, today’s treatments offer better outcomes and more hope than ever – medical breakthroughs are saving lives in ways that seemed unimaginable a generation ago.

“We’re not just managing cancer anymore,” says Young Ki Hong, MD, Head of the Division of Surgical Oncology at MD Anderson Cancer Center at Cooper. “We’re offering cures where none existed before.”

Seeing better & saving lives

Breast cancer detection has reached new heights in recent years, with imaging advancements offering unprecedented early detection and prevention opportunities. These breakthroughs are empowering more women to take proactive steps to reduce their risk of developing invasive cancer, says Rachel Levenbach, MD, a medical oncologist with Regional Cancer Care Associates.

“With tools like 3D mammography and MRI, we’re not just detecting cancer earlier – we’re preventing it altogether for many women,” Levenbach says.

One game-changer has been 3D mammography, which became standard for women over 40 within the last decade. Unlike traditional 2D mammograms, 3D technology creates thin, detailed slices of breast tissue, making it easier to detect abnormalities, especially in dense tissue.

“For women at higher risk, we combine mammograms with breast MRIs or ultrasounds to monitor them more closely,” Levenbach adds. Breast MRI, which uses magnetic fields and radio waves, and advanced ultrasound techniques like elastography have further improved detection accuracy.

These tools have shifted the focus to prevention. “More women who don’t have breast cancer but are considered high risk are being followed closely by oncologists to reduce their chances of developing the disease,” she says.

Rachel Levenbach, MD

The real breakthrough

Immunotherapy may feel modern, but its roots stretch back over a century. In the 1800s, doctors discovered that injecting bacteria into tumors could spark an immune response strong enough to fight cancer.

“It wasn’t standardized or precise,” says Erev Tubb, MD, an oncologist with Inspira Health. “But it was the beginning of what we’re refining today.”

One of the earliest immunotherapies, still in use today, is the BCG vaccine, originally developed to prevent tuberculosis. It was first used against bladder cancer in the 1970s and remains a cornerstone of treatment. “We still use BCG for certain early-stage bladder cancers,” Tubb explains. “By injecting it into the bladder after removing a tumor, we can trigger an immune response that lowers the chance of the cancer coming back.”

By the late 1990s, immunotherapy had evolved into treatments like interferon and IL-2, which broadly stimulated the immune system. These therapies were especially effective for cancers like melanoma and kidney cancer, which didn’t respond well to chemotherapy.

The real breakthrough came in the early 2010s with the advent of checkpoint inhibitors, a class of drugs that block specific proteins that stop your immune system from attacking harmful invaders in the body, like cancer cells. “Cancer is tricky,” Tubb explains. “T-cells are designed to attack harmful invaders, but cancer uses natural signals to hide and stop the immune system from fighting it.”

Checkpoint inhibitors, like Yervoy, approved by the FDA in 2011 for advanced melanoma, release the brakes, allowing T-cells to recognize and attack cancer cells. Yervoy was followed by Keytruda and Opdivo, which became standard treatments for lung cancer and some lymphomas by the mid-2010s.

“Checkpoint inhibitors have transformed the treatment of cancers like melanoma, lung cancer and some lymphomas,” Tubb says. “Immune therapy lets us treat certain cancers – including lung, bladder and colon cancer – without chemotherapy. For patients who aren’t candidates for immunotherapy alone, combining it with chemotherapy improves long-term outcomes. Chemo works while it’s in your system, but immune therapy keeps working around the clock.”

Reflecting on the progress, Tubb says, “We’ve come a long way from those early efforts to stimulate the immune system. Today, we’re giving patients more time and better outcomes, and that’s the goal for all of us.”

Erev Tubb, MD

Treatment that only works for one patient

When Hong was in medical school, the dominant treatment options in cancer care were surgery, chemotherapy and radiation. “That was the framework until immunology and ultrasound therapy opened the door to new worlds,” he says.

One of the most exciting developments in this new era is tumor-infiltrating lymphocyte (TIL) therapy, a personalized treatment that Hong helped bring to Cooper in 2019. TIL therapy is currently available to treat melanoma as well as cancers of the head and neck, cervix and lung – many of which are resistant to chemotherapy and other traditional treatments. 

“These cells are uniquely trained to recognize and fight your cancer,” Hong explains. “It’s the ultimate personalized medicine. It only works for you because your immune cells are tailored to your tumor.”

TIL therapy takes immunotherapy a step further. Unlike checkpoint inhibitors, which broadly remove immune system brakes, TIL therapy harnesses the patient’s tumor-infiltrating T-cells – immune cells that have already identified the cancer as a threat. These T-cells are extracted from the tumor, expanded in a lab into billions, and reinfused into the patient’s bloodstream after chemotherapy clears the body of competing immune cells.

Once the T-cells are reintroduced, the next step is to help them thrive. “We help them expand and grow in the body by giving a growth factor, IL-2, which encourages the immune system to attack the tumor fully.”

Cooper began offering TIL therapy in 2019. “It’s like a bone marrow transplant, but with immune cells that are specifically fighting your cancer,” Hong says.

While TIL therapy works from inside the immune system, another new treatment, histotripsy, offers a non-invasive option for targeting tumors directly, Hong says. Histotripsy is a non-invasive ultrasound technology that liquefies tumors into fragments, triggering an immune response.

“Think of it like putting a tumor in a blender,” he says. “The immune system can finally recognize and attack the cancer.”

Because histotripsy spares nearby structures like blood vessels and bile ducts, it often converts previously untreatable tumors into treatable ones, Hong says.

“Cancer treatment is no longer about just managing the disease,” adds Hong. “With these personalized therapies, we’re finding ways to target and eliminate cancer in ways we never thought possible.”