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CANCER A DARKER SIDE OF LIFE

 

Clinical courses

 

Clinical courses

About Authors:
PIYUSH PARASAR
SPS I.T.E.R BHUBANESWAR,
INDIA

INTRODUCTION- 
CANCER A DARKER SIDE OFLIFE LITERALLY MEANS A HOPE TO LIVE FURTHER GET DIMINISHED IN THE CASE OF CANCER. MAN HAS BEEN EXPOSED TO THE CHANGING SURROUNDING EVER SINCE HE CAME INTO EXISTENCE.IN THE PROCESS HE IS VULNERABLE TO THE NUMBER OF FATAL DISEASE AMONG WHICH CANCER IS A DREADED MALADY NEXT TO CARDIOVASCULAR  DISEASE. IT IS KNOWN TO ALL OF US THAT DEATH IS INEVITABLE BECAUSE IT IS A VICIOUS CYCLE OF THE NATURE. BUT THIS TYPE OF ESOTERIC DISEASE MAKES OUR LIVES FROM SIMPLE TO COMPLEX. SOME PEOPLE BELIEVE IN THE CONCEPT OF AS YOU SOW SOW YOU SHALL REAP ESPECIALLY IN INDIA. THESE ARE ALL SPECULATIONS OF OUR WAY OF THINKING AND THOUGHTS. IN MAJORITY OF CASES WE HAVE SEEN THAT DUE TO OUR MODERN LIFESTYLE WE GET SUFFERED FROM THESE TYPE OF DISEASE.

REFERENCE ID: PHARMATUTOR-ART-1183

REVIEW OF LITERATURE
CANCER LITERALLY MEANS CRAB AS THEY ADHERE TO ANY PART OF THE BODY THAT THEY SEIZE UPON IN AN OBSTINATE MANNER. CANCER IS AN AUTOIMMUNE DISORDER IN WHICH BODY BELIEVE THAT ONE OF ITS BODY PART TO BE FOREIGN PARTS.IT IS A CLASS OF DISEASE IN WHICH A GROUP OF CELLS DISPLAY UNCONTROLLED GROWTH.MODERN  DRUGS HAS BEEN ABLE TO CONQUERED MANY DISEASE. BUT IT IS NOT EASY TO VANQUISH CANCER  AS CANCER PROVED TO BE TOO SMART , CLEVER, HOSTILE, AT DECEIVING THE THERAPIES.IT HAS SPREAD ITS TENTACLES VERY QUICKLY OVER THE WORLD IN THE PAST DECADES. THE BRANCH OF MEDICINE CONCERNED WITH STUDY, DIAGNOSIS, AND PREVENTION OF CANCER IS CALLED ONCOLOGY.THERE IS AN DUBIOUS CONCERN ABOUT THE CANCER AS THE ETIOLOGY OF CANCER IS VERY SCANTY FOR US. AFTER DOING THE EXTENSIVE STUDY ON CANCER RESEARCH ARTICLES. I HAVE CAME TO AN CONCLUSION THAT CANCER IS A PROBLEM ASSOCIATED WITH DIFFERENTIATION AND DEVELOPMENT. THE PROCESS WHERE THE EMBRYONIC CELLS ARE BEING CONVERTED INTO SPECIALIZED CELLS FORMING SPECIAL TISSUE CALLED DIFFERENTIATION.IN CANCER THERE IS A BREAKDOWN IN THIS PROCESS. A CELL ESCAPES FROM THE USUAL GROWTH RESTRICTIONS AND IS ABLE TO GROW AND DIVIDE  AND TO MOVE FREELY THAN NORMAL CELLS. THIS RESULTS FREQUENTLY IN THE ABILITY TO INVADE AND DAMAGE NORMAL TISSUE AND TO SPREAD BY WAY OF BLOOD OR LYMPHATIC SYSTEM. CANCER MAY BE DEFINED AS UNORGANIZED GROWTH IN WHICH THE CONTROLLING AND REGULATING MECHANISM HAVE DISAPPEARED. THE CANCEROUS CELLS CONTINUE TO DIVIDE AT AN UNCHECKED MANNER WHICH RESULTS IN THE INCREASED NUMBER OF CANCEROUS CELLS AND THEREFORE THE SIZE  OF TUMOUR KEEPS GROWING.THE OTHER REASON FOR THE CANCER IS THAT DUE TO GENE MUTATION THE CANCEROUS CELLS ABLE TO GROW AT ENORMOUS SPEED. DNA WHICH STANDS FOR DEOXYRIBONUCLEIC ACID UNDERGOES MUTATION UNDER ABNORMAL CONDITIONS  WHICH  RESULTS IN A SUDDEN CHANGE IN THE GENOTYPE OF AN ORGANISM WHICH REFLECTS IN A APPEARANCE OF AN ORGANISM IT IS OF 2TYPES 1)SOMATIC MUTATION- THIS TYPE OF MUTATION CAN GIVE RISE TO CANCER AS THE MUTATION TAKES PLACE IN SOMATIC CELLS AND THE CHANGE IS TRANSMITTED FROM A CELL TO ITS DAUGHTER CELL THROUGH MITOSIS. THIS TYPE OF MUTATION PRODUCE CELLS WITH INCREASED RATE OF DIVISION AND GROWTH.2)GENE MUTATION- IT IS REFERRED TO VICISSITUDE IN THE STRUCTURE OF DNA . IT APPLIES TO A PARTICULAR GENE OF CHROMOSOMAL DNA. IT IS ALSO KNOWN AS A MUTATION AS IT INVOLVES CHANGE IN SEQUENCE OF ONE OR FEW NUCLEOTIDE OF  DNA MOLECULE IN A PARTICULAR REGION OF CHROMOSOMES. GENE MUTATION OCCUR ONLY DURING GAMETE FORMATION.MULTIPLE GENETIC CHANGES OCCUR DURING THE TRANSFORMATION OF A NORMAL CELLS TO CANCEROUS CELLS. THIS PROCESS IS CALLED ONCOGENESIS. GENERALLY THERE ARE TWO TYPES OF GENES WHOSE MUTATIONS RESULTS IN CANCEROUS CHANGES.1)ONCOGENES- ONCOGENES STIMULATE CELL DIVISION, GIVING THE CELLS THEIR NEW PROPERTIES, SUCH AS HYPERACTIVE GROWTH, PROTECTION AGAINST PROGRAMMED CELL DEATH. HOWEVER THESE GENES HAVE NORMAL CELLULAR COUNTERPARTS KNOWN AS PROTONCOGENES WHICH ARE INVOLVED IN NORMAL CELL FUNCTION.2)TUMOUR SUPPRESSOR GENES- SUCH GENES NORMALLY SUPPRESS THE TUMOUR AND DISEASE OCCUR ONLY WHEN THE APPROPRIATE ACTIVE GENES IS LACKING OR BOTH THE ALLELES ARE LOST. THEY PLAYS AN ACTIVE ROLE  IN DNA REPLICATION, CONTROL OVER THE CELL CYCLE. THEIR ABSENCE LEADS TO FORMATION OF SOME CONSTRAINTS.THE MAIN ENIGMA OF CANCER IS THAT IT IS NOT PROPERLY HAS BEEN ESTABLISHED THAT WHICH FACTORS ARE RESPONSIBLE TO REGULATE THE PACE OF CELL DIVISION. BUT HOWEVER IT IS BELIEVE THAT BODY REGULATES THE PACE OF CELL MULTIPLICATION AND SOMETIMES THE CELLS IN CERTAIN TISSUE AND ORGANS EXHIBIT RAPID UNCONTROLLED CELL DIVISION LEADING TO CANCER.
SIGNS AND SYMPTOMS- THESE SIGNS AND SYMPTOMS  WHICH ARE DESCRIBE BELOW IS BASED ON MY EXPERIENCE AS I  SEEN IT VERY CLOSELY.
1)    SLOW FEVER- IN MORNING WE WILL OBSERVED THAT THE BODY TEMP IS NORMAL . BUT IN NIGHT TIME  IT IS ABOVE THE NORMAL.
2)    WHOOPING COUGH WILL OCCUR AT REQULAR  INTERVALS
3)    LOSS OF APPETITE
4)    ENLARGEMENT OF LYMPH NODES
5)    BONE PAIN

TREATMENT OF CANCER
MYRIAD RESEARHES HAVE BEEN DONE IN THE FIELD OF TUMOUR CHEMOTHERAPHY. SCIENTIST HAVE BEEN ABLE TO COME UP WITH A MASTER MOLECULES WHICH IS VERY HELPFUL IN TREATING DIFFERENT TYPES OF CANCER. THESE LEAD MOLECULES ARE BASED ON EMPRICAL RELATIONSHIP. QSAR  IS A MAJOR CONCEPT WHICH HAVE BEEN PLAYED A VITAL ROLE IN DISCOVERING THE LEAD MOLECULES. QSAR MAINLY STANDS FOR QUANTITATIVE STRUCTURE-ACTIVITY RELATIONSHIP.IT IS A PROCESS BY WHICH A CHEMICAL STRUCTURE IS QUANTITATIVELY CORRELATED WTH A WELL DEFINE PROCESS SUCH AS BIOLOGICAL ACTIVITY OR CHEMICAL REACTIVITY. QSAR HELPED US TO MODIFY A CHEMICAL STRUCTURE TO REDUCE ITS SIDEEFFECTS WITHOUT DECREASING THE MAIN THERAPEUTIC EFFECTS.THE MAIN PROBLEM ASSOCIATED WITH THE TREATMENT OF CANCER IS ITS COST. THIS IS THE MAJOR FACTOR IN INDIA . WE MAY GET A NEW DRUG MOLECULE IN THE PHARMA MARKET BUT SOME OF US CAN AFFORD IT. AND REST OF US CANNOT. THIS TYPE OF INCIDENT I HAVE READ IN MY LOCAL DAILY PRINT MEDIA AT A FREQUENT INTERVALS.TREATMENT OF CANCER CAN BE DIVIDED IN 2 TYPES 1)PHARMACOLOGICAL TREATMENT 2)NON-PHARMACOLOGICAL TREATMENT

NON-PHARMACOLOGICAL TREATMENT-
1)    LACK OF PROPER HEALTH EDUCATION AMONG INDIVIDUALS-THIS CAN BE SEEN ESPECIALLY IN INDIA WHERE IS THE LACK OF AWARNESS AMONG INDIVIDUALS ABOUT THE DISEASE HAS GIVEN RISE TO THE HIGHER DEATH RATES CAUSED BY THE DISEASE
2)    MODIFYING THE LIFESTYLE- 30% OF CANCER ARE CURABLE BY AVOIDING THE CONSUMPTION OF ALCOHOL, SMOKING THE CIGARETTE, CONSUMPTION OF ALCOHOL IS ALWAYS ASSOCIATED WITH ORAL AND BREAST CANCER AND THE SMOKING OF CIGARETTE IS ASSOCIATED WITH LUNG CANCER
3)    CHANGING THE ATTITUDE TOWARDS THE DISEASE-AS THE CANCER IS RETICENT DISEASE SO IT IS CANNOT BE DETECTED EARLY. IF WE ARE NOT INSOUCIANT MEANS CARELESS TOWARDS THE DISEASE THEN WE CAN OVERCOME  THE DISEASE.
4)    AVIOD STRESS AND STRAIN-OUR MODERN LIFE IS FULL OF STRESS AND STRAIN WHICH CAN PLAYS A VITAL ROLE IN GIVING BIRTH TO THESE TYPES OF DISEASE. SO WE MUST AVIOD IT AS MUCH WE CAN.

PHARMACOLOGICAL TREATMENT
THIS TREATMENT INCLUDES THE USE OF  DRUGS TO DIAGNOSIS AND PREVENT THE DISEASE. IN THIS AREAS THERE IS A FAIR PROGRESS  IN DEVELOPMENT OF DRUGS HAS BEEN DONE.AS THE TENTATIVE  RESULTS  SHOWS.IN COMPARISON TO PAST DECADES THE SUCCESS RATE IN DIAGNOSIS AND PREVENTION  OF CANCER HAS GONE HIGH BY THE HELP OF MODERN TARGETTED THERAPY. CLINICAL STUDY ACTS AS BLESSING IN DISGUISE IN THE FIELD OF ONCOLOGY. VARIOUS TYPES OF MYSTERIOUS DISEASE CAN BE DEMYSTIFY WITH THE HELP OF CLINICAL STUDY.

1)RADIATION- IT IS A PROCESS OF USING UV LIGHT AS AN IONISING RADIATION TO DESTROY THE CANCEROUS CELLS WHICH INFECTED OUR BODY PARTS OF A PARTICULAR REGION. THE MAIN AIM OF THE RADIATION THERAPY IS STOP THE MUTATION OF GENES WHICH OCCUR IN THE DNA REPLICATION   UNDER ABNORMAL CONDITIONS. IT IS GIVEN IN A PARTICULAR DOSE FORM RECOMMENDED BY ONCOLOGISTS. IT IS MAINLY SEEN IN THYRIOD CANCER AND IN LUNG CANCER.

2)CHEMOTHERAPHY-
IT IS A PROCESS OF USING CHEMICAL AGENTS TO DESTROY THE CANCEROUS CELLS. IT IS MAINLY APPLIED WHEN THE CANCER FAILS TO RESPOND TO RADIATION AND WHEN THE CANCER CANNOT BE REMOVED SURGICALLY. THE GROUP OF CHEMICAL AGENTS COLLECTIVELY KNOWN AS ANTINEOPLASTIC AGENTS.ANTINEOPLASTIC AGENTS ACTS AS A EPIPHANY IN THE FIELD OF TUMOUR CHEMOTHERAPY. THE VARIOUS CATEGORIES OF DRUGS HAVE BEEN ABLE TO ACHIEVE A DEGREE OF SUCCESS WHILE DIAGNOSIS THE DIFFERENT TYPES OF CARCINOMAS AND LYMPHOMAS. ANTINEOPLASTIC AGENTS BLOCK THE BIOSYNTHESIS OF NUCLEIC ACIDS TO CHECK THE CELL DIVISION THROUGH DIRECT INTERFERENCE WITH THE MITOTIC SPINDLES.A TREATMENT REGIMEN MUST BE FOLLOWED WHILE ADMINISTERING THESE DRUGS. THESE DRUGS ARE TARGET SPECIFIC SO IT HAS GOT SEVERE SIDEEFFECTS WHICH INCLUDES G.I COMPLICATIONS AND BONEMARROW DEPRESSION. THESE DRUGS ARE BEEN DISCOVERED ON EMPRICAL BASIS SINCE THERE IS QUALITATIVE AND QUANTITATIVE DIFFERENCES BETWEEN HUMAN CELLS AND CANCEROUS CELLS.

CLASSIFICATION OF DRUGS
1)ALKYLATING AGENTS:
a)NITROGEN MUSTARDS-CYCLOPHOSPHAMIDE,  CHLORAMBUCIL.
b)ALKYL SULFONATES-BUSULFAN
2) ANTIMETABOLITES IS FURTHER CLASSIFIED INTO:
a) FOLLIC ACID ANTAGONIST-METHOTREXATE
b)PURINE ANTAGONIST-AZATHIOPURINE, 6-MERCAPTOPURINE
c)PYRIMIDINE ANTAGONIST-5-FLUOROURACIL
3) MISCELLANEOUS:
a) VINCA ALKALOIDS- VINCRISTINE, VINBLASTINE
b) ANTIBIOTICS- ACTINOMYCIN-D, MITOMYCIN-C
c) HORMONES- ANDROGEN , ESTROGEN,  PROGESTINS.

RECENT MARKETED   DRUGS  FOR BREAST CANCER- LAPATINIB HAVE BEEN  RECENTLY LAUNCHED BY GSK PHARMA TO STOP THE PRODUCTION OF HER2 PROTEINS. AND OTHER DRUG MOLECULE IS HERCEPTIN MARKETED BY GENENTECH PHARMA IN THE USA BY THE JOINT COLLABORATION WITH ROCHE INTERNATIONAL. HERCEPTIN IS FIRST ARTIFICAL ANTIBODY APPROVED FOR BREAST CANCER.

MONOCLONAL ANTIBODIES-
THE PRODUCTION AND USE OF ANTIBODIES HAS BECOME A AREAS OF INTEREST FOR THE RESEARCH FIELD AS WELL AS FOR THE ACADEMIC PURPOSES  FOR ITS DIVERSIFIED APPLICATIONS. ANTIBODIES ARE OFTEN ISOLATED BY CONVENTIONAL METHOD OF SACRIFICING ANIMALS AFTER HYPERIMMUNIZING THEM WITH ANTIGENS.ANTIBODY PREPARATION BY THIS METHOD ARE USUALLY HETEROGENEOUS BECAUSE THE CELLS ARE KEEP ON PRODUCING A VARIETY OF ANTIBODIES. SINCE THESE ANTIBODIES ARE IDENTICAL MOLECULES SPECIFIC FOR ONE TYPE OF ANTIGEN ARE CALLED Mabs. MABS ARE NOW  BEEN EMPLOYED IN HUMAN DISEASE THAT ARE CAUSED BY AN SUDDEN ATTACK OF IMMUNE SYSTEM ON THE TISSUE OF THE BODY. THE MOST WIDELY USED MABS IS OKT-3 WHICH HAS BEEN LICENSED FOR CLINICAL USE. MABS HAVE BEEN DESIGN TO FORM CARRIERS OF CYTOTOXIC SUBSTANCES WHICH ARE TERMED AS IMMUNOTOXINS. USING MABS IT HAS BEEN POSSIBLE TO SEPARATE  AND REMOVE TUMOUR CELLS FROM NORMAL CELLS OF BONE MARROW.IN CASE OF GASTROINTESTINAL CANCER IT IS USED ALONE SINCE THE ANTIBODIES HAVE THE TENDENCY TO ATTRACT THE CELLS OF IMMUNE SYSTEM TO ACT AGAINST THE PREVAILLING CANCEROUS CELLS.THE AVAILABILITY OF MABS THAT RECOGNISE IMMUNE CELL ANTIGENS HAS RESULTED IN IMPROVED DIAGNOSIS OF PARTICULAR TYPE OF LYMPHOMAS AND LEUKAEMIAS.

GENETIC ENGINEERING- IT IS A PROCESS BY WHICH THE GENETIC MATERIAL IS MANIPULATED TO HAVE A DESIRED RESULT IN A PREDETERMINE WAY.IT IS ALSO KNOWN AS DNA RECOMBINANT TECHNOLOGY. THE MAIN AIM OF GENETIC ENGINEERING IS TO ADD , REMOVE OR REPAIR THE PART OF THE GENETIC MATERIAL BY CHANGING THE QUALITIES OF AN RECIPIENT ORGANISM IN AN USEFUL PREDICTABLE AND IN A PERMANENT MEANS. IT ALSO INVOLVES  THE ACTUAL PLANNED SYNTHESIS OF TOTAL NEW GENES  DESIGNED IN ADVANCE TO POSSESS EXACTLY THE RIGHT COMBINATION OF DESIRED PROPERTIES.

(RECENT ADVANCED TECHNIQUES IN THE TREATMENT OF CANCER)
STEM CELL THERAPY-THE STEM CELL THERAPY HAS PLAYED THE ROLE OF EPIPHANY IN THE FIELD OF ONCOLOGY. WITH THE HELP OF STEM CELL THERAPY A HOPE TO LIVE FURTHER GET BRIGHTER IN THE CASE OF CANCER PATIENTS.STEM CELL IS AN UNDIFFERENTIATED CELL THAT IS ABLE TO RENEW ITSELF AND PRODUCE ALL THE SPECIALIZED CELLS WITH AN ORGAN. STEM CELLS OCCUR IN MANY TISSUE AND ORGAN.SCIENTIST HAS BEEN ABLE TO MODIFY THE STEM CELL TAKEN FROM A BONE MARROW OF A PATIENT AND THEN BY THE HELP OF GENETIC ENGINEERING THE SCIENTIST ARE ABLE TO INCOPORATE THE STEM CELL WITH THE DRUGS WHICH RELEASE THE THERAPEUTIC PROTEINS TO KILL THE BRAIN TUMOUR.

DIFFERENT TYPES OF CANCER:
1)    CARCINOMAS- WHEN MALIGNANT GROWTH OCCURS IN EPITHELIAL TISSUE COVERING THE BODY ORGANS- EXAMPLES: LUNG CANCER AND STOMACH CANCER
2)    SARCOMA- THESE ARE MALIGNANT GROWTH DEVELOPING IN SUCH TISSUE WHICH ARE DERIVED FROM MESODERM- BONE CANCER
3)    LEUKEMIA-IT DEVELOPED FROM ABNORMAL PROLIFERATION OF WBC PRESENT IN BLOOD AND THEIR PRECURSOR IN THE BONE MARROW. WBC COUNT INCREASES WHICH SUPPRESS THE PRODUCTION OF RBC AND PLATELETS- EXAMPLE: MYELOBLASTIC LEUKAEMIA.

EPIDEMIOLOGY-
CANCER CAN BE CURED IN A HIGH PERCENTAGE IF IT IS DETECTED IN EARLY STAGE. LATE DIAGNOSIS INCREASES THE HAZARDS OF CANCER.BUT RECENT STUDIES SHOW SURVIVAL RATES GOES UP IN CERTAIN TYPES OF CANCER.
MOUTH OR ORAL CANCER SURVIVAL RATES GOES UPTO 53% IN COMPARISON TO PAST DECADES. PROSTRATE CANCER SURVIVAL RATES GOES UPTO 99% AND IN THE CASE OF BREAST CANCER THE SURVIVAL RATES GOES UPTO 89%.

CONCLUSION-
HUMAN WANTS ARE COUNTLESS. IF ONE WANT IS FULFILLED THEN HE WILL CRAVE FOR OTHERS. IN THIS PROCESS HE IS ABLE TO PERCEIVE THE BAD IMPACTS ASSOCIATED WITH THIS CYCLE.SO HUMAN BEINGS ARE FALLING AS AN PREY TO THESE TYPE OF RETICENT AND LETHAL DISEASE.SO THE TIME HAS COME FOR ALL OF US TO WAKE UP AGAINST THE DISEASE. BEFORE IT BECOMES TOO LATE FOR US TO REACT.IT IS BETTER TO KILL THE BABY WHEN IT IS IN MOTHER WOMB BEFORE IT SPREAD ITS TENTACLES TO KILL US.

REFERENCES:
1) CONCISE TEXT BOOK OF BOTANY BY A.K NANDA, KITAB MAHAL.
2) TEXT BOOK OF PHARMACEUTICAL CHEMISTRY BY HARKISHAN SINGH.
3) SCIENCE REPORTER  VOL 2  A NEW TREATMENT OF CANCER.
4)A BOOK OF MEDICINAL CHEMISTRY BY ASHUTOSH KAR.
5)INDIA TODAY MAGAZINE  2003 EDITION.

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