At the end of 2020, her doctors put her on immunotherapy drugs for six weeks and chemotherapy for six months to destroy the cancer.

The search for smarter — better, shorter and less toxic or damaging — cancer treatments, with better outcomes, such as TAD is now a holy grail of cancer research.

The search for smarter — better, shorter and less toxic or damaging — cancer treatments, with better outcomes, such as TAD is now a holy grail of cancer research.

The first real breakthrough in this ‘de-escalation’ or ‘optimisation’ approach was a British trial published in The Lancet in 2005, which found a single dose of chemotherapy was just as effective — and less toxic — for treating early-stage testicular cancer post-surgery as three weeks of radiotherapy, the treatment offered for nearly 50 years.

Professor Cameron explains: ‘What we are doing is changing the focus of research to see if we can get the same outcomes with less treatment and to improve the experience for cancer patients so they suffer fewer side-effects, can preserve their fertility or don’t develop heart muscle damage, in the case of breast cancer, as a result of their treatment.’.

As well as reducing side-effects, de-escalation trials are about finding more effective treatments for patients with less intervention.

The study, published in the journal The Lancet Oncology in February 2021 found that patients who had 20 high doses of radiotherapy over four weeks instead of the standard 32 doses over six and a half weeks, had a 29 per cent lower risk of cancer returning after five years.

From lower doses to less surgery, here are some of the ways cancer treatments are becoming kinder to patients. .

Lower doses of chemotherapy are as effective at controlling advanced cancer of the stomach or oesophagus (the gullet) in elderly or frail patients, leading to fewer side-effects such as diarrhoea and lethargy, according to research presented at the American Society of Clinical Oncology conference in 2019.

But when the participants were given just two drugs at full strength, medium or low doses, the researchers, funded by Cancer Research UK, found that medium and lower doses of just two drugs was as effective as the full-strength dose of the three drugs for controlling the cancer.

The treatment options for these women are limited and the UK trial found that the chemotherapy drug carboplatin was both ‘kinder’ than the existing treatment docetaxel and more successful at delaying disease progression — increasing the length of time before the disease progressed by 54 per cent (6.8 months compared with 4.4 months), according to the results published in the journal Nature Medicine.

Treating women with ductal carcinoma in situ (DCIS) — abnormal cells in the milk ducts in the breast — with three weeks of radiotherapy is just as good as having it for five weeks, according to an international study published in the journal Cancer Research last year.

Meanwhile, halving the amount of time breast cancer patients spend on the drug Herceptin significantly reduces side-effects —and is just as effective, according to a major trial in 2019.

Herceptin targets a protein called human epidermal growth factor receptor 2 (HER2) on the surface of cancer cells, stopping them growing and dividing.

In a study involving more than 4,000 women with early stage, HER2-positive breast cancer, six months of treatment was as effective as the standard 12-month course, The Lancet reported, with significantly fewer heart problems, aches and pains and fatigue.