Understand dynamics of cancer treatment

Cancer is abnormal growth of a group of cells in a particular tissue. The abnormality growth of these cells is usually brought about by mutations of the genetic composition of a cell.This is why in cancer management or studies, we consider genetics as a focal point for research. All cancer drugs or chemotherapy is designed based on the genetic literature for a particular cancerous disease.When a pathologist receives a biopsy from the tumor tissue of a patient, they will prepare a slide with various chemical reagents that make the cell contents more visible on a microscope. There are many features analysed here but the ultimate goal is to understand the genetic mutation of the tumor cell. The genetic mutation is the disease. The outcome of analysis will guide oncologists consider or choose the right treatment for the patient.Cancers are grouped into several classes based on the information from their genetic mutations. There are benign cell tumors that are in most cases slow growing and less invasive. Benign tumor cells are less toxic and have been found to have limited capacity to form their own vascular network as it is seen in malignant tumor cells. One of the deadliest characters of the malignant tumor cells or neoplasm’s is their ability to manipulate their own blood supply. They form their own vascular system that becomes a stem for toxicity in the body. Actually, this is why metastasis is a difficult stage for cancer treatment. At this stage, it is difficult to trace and block the vascularisation system of cancer cells. Vascular system is a major route for metastasis. This is how cancer is metastasised or moves from the lungs to the brain or the heart.Now back to the real topic of interest, chemotherapy is a group of anti-neoplastic or cytotoxic drugs. They are drugs that are manufactured to fight the toxicity of cancer cells. This is the reason cancer drugs are toxic. You, therefore, describe chemotherapy as anti-neoplastic that means anti-cancer cells or cytotoxic that means to kill or limit the toxicity of the cancer cells. Treatments like radiation and surgery are considered local treatments. They act only in one area of the body such as the breast, liver or lung and usually target the cancer directly. Chemotherapy differs from surgery or radiation in that it’s almost always used as a systemic treatment. This means the drugs travel throughout the body to reach cancer cells wherever they are. Chemotherapy is used to treat many cancers and there are more than a hundred chemotherapy drugs used for treatment today. These drugs are used as single regimens or in combination with other drugs. Advancements in medical research have given rise to the manufacture of the new drugs and better cancer treatment drugs will be manufactured in a near future. Effective chemotherapies for leukemia and hepatocellular carcinoma of the liver will be on the market in a near future and we shall expect good outcomes from our patients. However, it is important to understand that such drugs vary in their chemical composition, their administration into the body and their usefulness in treating specific forms of cancer.In our clinical practice, we normally treat cancer to achieve three goals of control, cure and palliation. In control; we target to shrink cancerous tumors so as to stop the cancer from further growth and spread. This helps cancer patients feel better and it’s the best way to manage pain. This prolongs life and improves quality of life.Chemotherapy for curative intent brings complete recovery meaning that the cancer disappears and does not return. Though cure might be the goal, there is no guarantee for this goal given the tricky lifestyle of the disease. The genetic coding of the cancer cells is trickier than the DNA in HIV. This is why cancer medications prove more toxic than HIV/Aids medications. When the disease is at its end stage or advanced stage, chemotherapy drugs are used to relieve symptoms and the goal here will be to improve the quality of life but not treat the disease.Dr Joseph Kamugisha is a resident oncologist in Jerusalem, Israel