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Introduction|ModernConcept|AyurvedicConcept|AyurvedicManagement
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Brief
Modern Concept of Cancer
Introduction, History,
Etiopathogensis,
Epidemiology,
Cause,
Sign & Symptoms, Investigations,
Tumor Marker,
Oncogene,
Supressor gene,
Staging,
Management,
Surgery,
Hormone,
Radiotherapy,
Chemotherapy,
Biologic Therapy
Chemotherapy
During World War II, naval personnel who were exposed to mustard gas as a result of a military action were found to have severe bone marrow depression.
During that same period, the U.S Army was studying a number of agents related to mustard gas in order to develop more effective agents and to develop protective measures. In the course of that work, a compound called nitrogen mustard was studied and found to have substantial activity against a cancer of the lymph nodes called lymphoma. This agent served as the model for a long series of similar but more effective agents (called "alkylating" agents) that killed rapidly proliferating cancer cells by damaging their DNA.
Sidney Farber of Boston demonstrated that aminopterin produced remission in acute leukemia in children. Aminopterin blocked a critical chemical reaction needed for DNA replication. That drug was the predecessor of methotrexate, a commonly used cancer treatment drug today.
Since then, other researchers discovered drugs that blocked different functions involved in cell growth and replication. The era of chemotherapy had begun. The first cure of metastatic cancer was obtained in 1956 when methotrexate was used to treat a rare tumor called choriocarcinoma.
Other cancers that can now be cured regularly with chemotherapy, even when widespread, include acute childhood leukemia, testicular cancer, and Hodgkin's Disease.
Several approaches being studied to improve the activity and reduce the undesirable side effects of chemotherapy. These include:
New drugs, new combinations of drugs, and new delivery techniques
Novel approaches (Liposomal therapy, Monoclonal antibody therapy) to targeting drugs more specifically at the cancer cells to produce fewer side effects
Drugs to reduce side effects, like colony-stimulating factors and chemoprotective agents (such as dexrazoxane and amifostine)
Hematopoietic stem cell transplantation
Agents that overcome multidrug resistance
Liposomal therapy is a new technique that uses chemotherapy drugs that have been packaged inside liposomes (synthetic fat globules). This liposome, or fatty coating, helps them penetrate the cancer cells more selectively and decreases possible side effects (such as hair loss, nausea, and vomiting). Examples of liposomal medications are Doxil (the encapsulated form of doxorubicin) and Daunoxome (the encapsulated form of daunorubicin).
Monoclonal antibodies, a special type of antibody produced in laboratories, can be designed to guide chemotherapy medications directly to the tumor. Monoclonal antibodies (or proteins) bind to tumor-associated cell surface antigens and destroy tumor cells through a variety of methods.
The use of chemotherapy after surgery to destroy the few remaining cancer cells in the body is called adjuvant therapy. Adjuvant therapy was tested first in breast cancer and found to be effective. It was later used in colon cancer, cancer of the testis, and others.
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