Colorado researchers among those leading the way in fight against cancer

Angela Grgic is getting around in the yard of her home, taking care of the flowers and playing with the family dog Rex. Simple things that she savors. But for a time she was incredibly sick.

"I accepted. I said OK. It's my time to go, it's my time to go. I just think maybe I'm too young to go."

She was first hit with bladder cancer at age 50.

"How come from where? What did I do?"

Stage 4 bladder cancer was running amok.

"And they put me on chemo. And four months of chemo, my cancer just ran everywhere."

It spread to her bones, her brain and her liver. The chemo was rough and the radiation even harder. But four years later, she is alive.

"What we can't forget is we've actually made a lot of progress over the last three decades. So we've decreased cancer mortality by about 32% in the last 30 or so years," said Dr. Rich Schulick, director of the University of Colorado Cancer Center and chair of the department of surgery at the University of Colorado.

Yet the incidence of cancer continues to increase, largely due to an aging population. President Joe Biden called this week for a 50% reduction in death rates in 25 years.

"I actually think that is very doable. Remember, we've had a 30% decrease over the last 30 years and, if anything, our decrease has been accelerating over the decades," explained Dr. Schulick.

Schulick talked about four strategies, prevention, screening, treatment and the sequencing of multi-disciplinary care.

Some of the reductions are in a sense, low hanging fruit. The American Cancer Society believes 40% of cancers could be eliminated with prevention like stopping smoking, getting more exercise and improving diet. Earlier screenings are proven to increase survivability. Cancers like colon cancer are 100% curable if caught early with screenings like colonoscopies. Great strides have been made in recent years in treatments.

"The classic examples of treatments are great chemotherapy, great surgery, great radiation therapy. And then there's some new kids on the block like immunotherapy, which you've probably heard a lot about in the last 10 years, and new small molecules, and we're making a lot of progress in that," said Schulick.

Angela Grgic's doctor, Dr. Manojkumar Bupathi at Rocky Mountain Cancer Centers, told her they would try a drug called Balversa, also known as erdafitinib. It is a small molecule inhibitor that is a targeted therapy treatment that can go after a very specific genetic alteration. In a simplified way, explained Dr. Schulick, it interferes with a cancer's on switch and turns it off. Her change was gradual but remarkable.

"After like six months, I was totally different," Angela explained. "That's what saved my life."

At CU, tens of millions of dollars go into research. They are re-engineering immune cells to attack cancer and other diseases.

"We exploit this knowledge by coming up with new molecules or small molecules that interfere with the mechanisms of cancer specifically more so than normal cells to gum them up, to kill them and to slow them down," said Dr. Schulick.

There are even advancements yet to be made with familiar therapies.

"Chemotherapy has been around, you know, for 50, 60 or so years, really, and we're still learning how to best give it, how to minimize the side effects, how to combine it," he noted.

Another aspect of improving care is to better sequence multi-disciplinary care. Part of that is recognizing where there are gaps and failures.

Cancer survivability rates could be raised significantly with better access to screenings and treatments for minorities and people from rural areas.

"I think access and disparities are a huge problem," explained Dr. Schulick. "And you know we have some of the best technologies and abilities in the world. But I don't think our whole population has equal access to it, and that is a huge problem."

Angela Grgic is living with family now as a cancer survivor and enjoying the test results that show no signs of its return.

"I had checkup after a year two weeks ago and my doctor said, 'you're magical,'" she said with a smile.