9 Jan, 2025
Cancer: A Review
Pharmacy

Blog Title

Dr. Seema Rohilla

Professor, Geeta Institute of Pharmacy, Geeta University

Introduction

Cancer is a complex and varied group of diseases characterized by the uncontrolled growth of abnormal cells within the body. While cancer can occur in almost any part of the body, the underlying mechanism remains the same: mutations in the genetic material of cells lead to uncontrolled cell division. Over time, these abnormal cells can form tumors, spread to other parts of the body, and disrupt normal bodily functions. In this comprehensive article, we will explore cancer’s types, their effects on the body, diagnostic methods, and treatment options, providing a broad understanding of one of the most significant health challenges of our time.

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Types of Cancer

Cancer is not a single disease but a collection of related diseases. There are more than 100 types of cancer, each named based on the type of cell it originates from and the part of the body where it develops. Cancers are typically categorized into five broad groups based on the type of tissue or organ involved

  1. Carcinomas

Carcinomas are cancers that arise from epithelial cells, the cells that line the inner and outer surfaces of the body, including skin, lungs, and the lining of organs. Carcinomas are the most common type of cancer and make up about 80-90% of all cancers.

  • Adenocarcinoma: This type of carcinoma begins in the mucus-producing glands and can occur in various organs, such as the colon, breast, pancreas, or prostate.
  • Squamous Cell Carcinoma: Originating from squamous cells, this cancer typically affects the skin, lungs, and esophagus.
  • Basal Cell Carcinoma: A type of skin cancer that originates from basal cells in the skin’s lowest layer. It is common but usually non-invasive and treatable.
  1. Sarcomas

Sarcomas are cancers that develop in connective tissues, such as bones, muscles, fat, and cartilage. These cancers includes Osteosarcoma (bone cancer, typically occurring in children and young adults) and Liposarcoma (A cancer of the fat cells, which can develop in various parts of the body).

  1. Leukemia

Leukemia is a cancer of the blood and bone marrow, where the body produces abnormal white blood cells. These cells interfere with the body’s ability to fight infections and carry oxygen.

  • Acute Leukemia: Develops quickly and requires immediate treatment. It includes Acute Lymphoblastic Leukemia (ALL) and Acute Myelogenous Leukemia (AML).
  • Chronic Leukemia: Grows slowly and often has less severe symptoms initially. Common forms include Chronic Lymphocytic Leukemia (CLL) and Chronic Myelogenous Leukemia (CML).
  1. Lymphomas

Lymphomas are cancers that begin in the lymphatic system, which is part of the body’s immune system. Lymphomas are typically classified into two major types:

  • Hodgkin Lymphoma (HL): Characterized by the presence of Reed-Sternberg cells. It is a rarer form of lymphoma but more treatable than non-Hodgkin lymphoma.
  • Non-Hodgkin Lymphoma (NHL): A diverse group of cancers that can affect the lymph nodes, spleen, or bone marrow, with more than 60 subtypes.
  1. Melanoma

Melanoma originates in melanocytes, the pigment-producing cells in the skin. It is less common than other skin cancers but is far more aggressive and prone to metastasizing.

  1. Brain and Spinal Cord Tumors

These cancers develop in the central nervous system (CNS). Brain cancers can be primary, arising in the brain itself, or secondary (metastatic), spreading from other parts of the body.

  • Gliomas: A common type of brain tumor that arises from glial cells.
  • Meningiomas: Tumors originating in the meninges, the protective membranes covering the brain and spinal cord.
  1. Other Cancers

There are numerous other cancers that do not fall into these categories, including cancers of the liver, kidney, bladder, pancreas, esophagus, and stomach.

Causes and Risk Factors

The exact cause of cancer is often unknown, but certain risk factors are known to increase the likelihood of developing the disease. These include:

  • Genetic Factors: Some people inherit genetic mutations that make them more susceptible to certain cancers, such as breast cancer (due to BRCA1 or BRCA2 mutations).
  • Age: The risk of developing cancer increases with age, as the accumulation of genetic mutations over time can lead to cancer.
  • Tobacco Use: Smoking is a leading cause of cancers, particularly lung, throat, mouth, and bladder cancers.
  • Exposure to Radiation: High levels of radiation, such as from radiation therapy or environmental exposure, can increase the risk of cancer.
  • Unhealthy Diet: Diets high in processed foods, red meats, and low in fruits and vegetables can increase cancer risk.
  • Infections: Certain viruses, such as Human Papillomavirus (HPV), Hepatitis B and C, and Epstein-Barr Virus (EBV), are associated with an increased risk of certain cancers.
  • Environmental Toxins: Exposure to carcinogens, such as asbestos, benzene, and certain chemicals, can increase the risk of cancer.
  • Physical Activity and Obesity: Lack of physical activity and obesity are linked to several types of cancer, including breast, colon, and endometrial cancer.

Heading Symptoms of Cancer

Cancer symptoms vary significantly depending on the type and location of the disease. However, there are some common signs that may indicate the presence of cancer:

  • Unexplained weight loss: Sudden and unexplained weight loss may be a sign of cancer, especially with cancers like pancreatic, stomach, or lung cancer.
  • Fatigue: Persistent fatigue, even after adequate rest, can be a sign of cancer, particularly blood cancers like leukemia or lymphoma.
  • Pain: Tumors may cause pain as they press on nerves or organs. Bone cancer, for example, can lead to localized pain, while tumors in the abdomen may cause discomfort.
  • Changes in the skin: Unexplained skin changes such as the appearance of new moles or the change in shape, color, or size of existing moles may suggest melanoma.
  • Changes in bowel or bladder habits: Persistent changes in bowel movements or urination, such as blood in the stool or urine, may indicate cancers of the digestive tract or urinary system.

Persistent cough or hoarseness: A persistent cough or voice changes could signal lung cancer or other cancers of the respiratory system.

Diagnosis of Cancer

The early detection of cancer is crucial to improving treatment outcomes. Diagnosing cancer typically involves a combination of tests and procedures to confirm the presence of cancer, determine its type, and assess its stage.

  1. Medical History and Physical Exam

A doctor will take a thorough medical history and conduct a physical exam. This may include palpating the body for lumps, changes in organ size, or abnormal skin patches.

  1. Imaging Tests

Imaging techniques allow doctors to view inside the body and detect tumors or abnormalities:

  • X-rays: Often the first imaging technique used to detect tumors, especially in the lungs or bones.
  • CT Scan (Computed Tomography): Provides detailed cross-sectional images of organs and tissues. It is helpful in locating and staging tumors.
  • MRI (Magnetic Resonance Imaging): Uses magnets and radio waves to produce highly detailed images of the brain, spinal cord, and soft tissues.
  • Ultrasound: High-frequency sound waves used to detect tumors in soft tissues, such as the liver or kidneys.
  • PET Scan (Positron Emission Tomography): Detects cancerous cells by measuring their higher metabolism compared to normal cells, useful in detecting metastasis.
  1. Biopsy

A biopsy is the gold standard for cancer diagnosis. A small sample of tissue from the suspected tumor is removed and examined under a microscope. The biopsy can be performed using a needle, endoscope, or surgically.

  1. Blood Tests

Blood tests can provide valuable information about the body’s overall health and can reveal certain biomarkers associated with cancer, such as prostate-specific antigen (PSA) for prostate cancer or carcinoembryonic antigen (CEA) for colon cancer.

  1. Genetic Testing

Genetic tests can help identify inherited mutations that predispose individuals to certain cancers, like BRCA1 and BRCA2 for breast cancer. They can also help in determining the best treatment options by analyzing the genetic makeup of cancer cells.

Treatment of Cancer

The treatment of cancer varies depending on the type, stage, and location of the cancer, as well as the overall health of the patient. Common approaches include a combination of the following methods:

  1. Surgery
  • Purpose: To remove the tumor and nearby tissues.
  • Types:
    • Curative surgery: Removes all cancer.
    • Debulking surgery: Removes part of the tumor to ease symptoms or make other treatments more effective.
    • Palliative surgery: Alleviates discomfort caused by tumors.
  1. Radiation Therapy
  • Purpose: Uses high-energy rays to destroy cancer cells or shrink tumors.
  • Types:
    • External beam radiation.
    • Internal radiation (brachytherapy).
  • Side Effects: Skin irritation, fatigue, localized pain.
  1. Chemotherapy
  • Purpose: Uses drugs to kill or slow the growth of cancer cells.
  • Application: Can be given orally, intravenously, or through injections.
  • Side Effects: Nausea, vomiting, hair loss, fatigue, weakened immune system.
  1. Immunotherapy
  • Purpose: Boosts the body’s immune system to fight cancer.
  • Examples:
    • Checkpoint inhibitors (e.g., PD-1/PD-L1 blockers).
    • CAR-T cell therapy.
  • Side Effects: Inflammation, flu-like symptoms, and immune-related side effects.
  1. Targeted Therapy
  • Purpose: Focuses on specific genes, proteins, or the environment that contributes to cancer growth.
  • Examples:
    • HER2 inhibitors for breast cancer.
    • EGFR inhibitors for lung cancer.
  • Side Effects: Skin rash, diarrhea, liver problems.
  1. Hormone Therapy
  • Purpose: Blocks hormones that fuel certain cancers, such as breast and prostate cancer.
  • Examples:
    • Tamoxifen for breast cancer.
    • Androgen deprivation therapy for prostate cancer.
  • Side Effects: Hot flashes, bone thinning, fatigue.
  1. Stem Cell Transplantation
  • Purpose: Restores blood-forming stem cells destroyed by high doses of chemotherapy or radiation.
  • Types:
    • Autologous (using patient’s cells).
    • Allogeneic (using donor cells).
  • Used For: Blood cancers like leukemia or lymphoma.
  1. Palliative Care
  • Purpose: Focuses on improving the quality of life for patients with advanced cancer.
  • Approach: Manages symptoms such as pain, fatigue, and nausea.

 

Emerging and Experimental Treatments

  • Gene Therapy: Reprogramming cells to fight cancer.
  • Nanotechnology: Targeting cancer cells with nanomedicine.
  • Cancer Vaccines: Preventing or treating specific cancers (e.g., HPV vaccine).
  • Ayurvedic therapy: Ayurvedic treatment for cancer is a complementary approach that focuses on holistic healing, balancing the body’s energies, and improving overall well-being. While Ayurveda does not replace conventional cancer treatments (such as surgery, chemotherapy, or radiation), it can be used alongside them to manage symptoms, boost immunity, and improve quality of life.

Ayurvedic Principles in Cancer Care

  1. Restoring Balance (Tridosha):
    • Ayurveda believes cancer arises from an imbalance in the three doshas (Vata, Pitta, and Kapha).
    • Treatments aim to restore harmony among these energies.
  2. Detoxification (Panchakarma):
    • Detox procedures cleanse the body of accumulated toxins (Ama).
    • Methods include: Virechana (purgation therapy), Basti (medicated enemas), Abhyanga (oil massage) and Swedana (steam therapy).
  3. Herbal Remedies:
    • Ashwagandha: Enhances immunity and reduces fatigue.
    • Turmeric (Curcumin): Known for its anti-inflammatory and antioxidant properties.
    • Guduchi (Tinospora cordifolia): Boosts immunity and detoxifies the body.
    • Tulsi (Holy Basil): May help protect against oxidative stress.
    • Neem: Purifies blood and combats infections.
    • Guggul: Reduces inflammation and balances hormones.
  4. Rasayana Therapy (Rejuvenation):
    • Promotes tissue repair, boosts strength, and slows disease progression.
    • Includes herbal preparations like Chyawanprash and Brahmi.
  5. Diet and Nutrition:
    • A sattvic diet is recommended: fresh, whole, vegetarian foods.
    • Foods like leafy greens, fruits, whole grains, and spices (turmeric, ginger) are encouraged.
    • Avoid processed foods, fried foods, and red meat.
  6. Mind-Body Practices:
    • Yoga: Improves flexibility, reduces stress, and enhances energy flow.
    • Pranayama (Breathing Exercises): Supports mental clarity and oxygenates tissues.
    • Meditation: Helps reduce anxiety and improve mental resilience.
  7. Specific Ayurvedic Formulations:
    • Kanchanar Guggulu: Used for tumors and lymphatic cleansing.
    • Varunadi Kashaya: Balances Kapha and aids detoxification.
    • Triphala: Acts as a gentle cleanser and antioxidant.
  8. Individualized Treatment Plans:
    • Tailored therapies based on the patient’s constitution (Prakriti) and stage of disease.

Multidisciplinary Approach

Cancer treatment often involves a team of specialists, including:

  • Oncologists (medical, radiation, surgical).
  • Pathologists.
  • Nurses and social workers.
  • Nutritionists and physical therapists.

Conclusion

For best outcomes, an integrative approach combining Ayurveda with modern medicine is often recommended. Open communication with oncologists and Ayurvedic practitioners ensures safety and effectiveness. In conclusion, anticancer drugs are a cornerstone of modern oncology, continually evolving to provide hope and improved outcomes for patients worldwide. Their success underscores the importance of an integrative approach that combines pharmacological innovation, patient-centered care, and holistic treatment strategies.

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