are cancers the same?

To many, cancer is thought of as a single disease. But in reality, it’s a diverse collection of diseases with distinct behaviors and outcomes. For example, consider a small, early-stage breast cancer that may not even require chemotherapy, versus pancreatic cancer, which often carries a poor prognosis regardless of the stage.

What truly defines a cancer is not just where it originates, but the changes that occur within the cell—specifically, the pathways it hijacks to fuel its growth, enhance its ability to spread, and increase the risk of recurrence, even after surgical removal.

Historically, cancers were treated based on their site of origin, with each organ system having its own set of chemotherapy regimens. But over the past few decades, advances in genomic technologies have transformed our understanding. We can now identify the specific genetic and molecular alterations driving a cancer’s behavior. This has led to the discovery of shared pathways across cancers from different organ systems—such as those in the gastrointestinal (GI) and genitourinary (GU) tracts—making them candidates for targeted therapies like immunotherapy.

This shift marks a new era in cancer care: one where treatment is guided less by location and more by the underlying biology of the disease. It’s the future of oncology and the guiding principle for the next generation of cancer drug development.