Cancer refers to a medical condition characterized by uncontrolled division of cells forming tumor. During normal cell cycle, the cells grow, divide and die and new cells take their place, whereas in cancer, the abnormal cells continue dividing and do not die. The cancerous cells may invade other body parts or tissues thereby spreading cancer to those parts which is known as metastatic cancer. On the other hand, the benign cancer does not spread or invade other body parts, it remains located to a specific organ.1, 2
Global prevalence of cancer
As per the estimates of GLOBOCAN 2018, the global cancer burden has increased to 18.1 million new cases and 9.6 million deaths. The global 5-year prevalence is estimated to be 43.8 million which is the total number of people alive within 5 years of a cancer diagnosis.3,4 On combining the global patterns for men and women in 2018, around half of the new cases and more than half of the cancer deaths globally are estimated to occur in Asia.4
Importance of early detection
Early diagnosis of cancer is important as it enhances the chances of successful treatment. Raising the awareness towards early signs and symptoms of cancer can help in targeting this deadliest disease at the earliest. Various tests are available for screening of different types of cancers such as mammography for breast cancer screening; cytology screening methods, including Pap smears for cervical cancer screening.5
Treatment of cancer
Cancer treatment is based on the type of cancer and its stage. It usually involves a combination of various treatment approaches including:6
- Surgery
- Chemotherapy
- Radiotherapy
- Hormonal therapy
- Novel therapies
Latest Advances in the Treatment of Cancer
The advent of novel ideas and techniques of cancer treatment are showing promising results by improving the survival outcomes.7 Below mentioned are some recently introduced treatment modalities for cancer.
1. Nanomedicine
- It has shown promising results in cancer therapy.7
- It utilizes the principles of nanotechnology in which highly engineered nanoparticles (NPs) of sizes less than 100 nm are used to actively or passively target drugs to cancer cells.7
- These are the target-drug delivery systems that utilizes drugs with high solubility, biocompatibility, bioavailability, and multifunctionality.7,8
- They act as multi-target inhibitors and nano-imaging tools (Figure 1).7
- The use of polymeric and lipid based nano systems are one of the best alternatives for the central delivery of drugs in brain tumour.8
- The possible approach of the nanomedicine would be combining drug or gene delivery with external stimuli, like hyperthermal, photothermal, or photodynamic (PDT) treatments, thereby attacking the cancer cells with various mechanisms.7
- Nanomedicine may overcome the common disadvantages of conventional cancer treatment by providing7 –
- High selectivity
- Differentiating among healthy and cancer cells
- Early diagnosis and molecular imaging methods
Figure 1: Nanotechnology in cancer therapy7
2. CAR-T cell therapy
- Chimeric antigen receptor (CAR)-genetically modified T cells (CAR-T cells) have shown significant clinical responses and cancer remission in relapsed or refractory B-cell malignancies.9
- This is a new form of adoptive T cell therapy (ACT), in which an artificial CAR redirects T cells endogenous antitumor activity towards a predefined tumor-associated antigen. This in turn eliminates a specific tumor.9
- The US Food and Drug Administration (FDA) approved the first CAR-T cell therapy in 2017 for the treatment of CD19-positive leukemias and lymphomas.9
- The associated drawbacks of CAR-T cell therapy are:9
- Specific life-threatening toxicities
- Lack of efficacy in the treatment of solid tumors because of strong immunosuppressive tumor microenvironment and lack of reliable tumor-specific targets
3. Radiomics and Pathomics
- It is a systems-based approach developed to provide a better strategy to study and understand the complexity of cancer cell and related parameters.7
- Tools have been developed that utilize computerized feature analysis methods for extracting sub-visual attributes for characterizing disease appearance and behaviour on radiographic (radiomics) and digitized pathology images (pathomics).7
- It considers a large number of interrelated variables to identify a specific disease phenotype, such as:7
- Gene expression profile
- Tumour cellular architecture, and microenvironment (seen through histological image features)
- Three-dimensional tissue architecture and vascularization (seen through dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI))
- Metabolic features (seen through magnetic resonance spectroscopy (MRS) or PET)
- Radiomics extracts high-dimensional information from clinical images and clinical data, with or without associated gene expression to support evidence-based clinical decision-making.10
- Radiomics’ analyses can be performed in tumour regions, metastatic lesions, as well as in normal tissues.10
4. Advancements in radiotherapy
- Radiotherapy has been a mainstay in cancer treatment. However, studies reported resistance to radiotherapy in some cancer cells which is found to be related to altered mitochondria structure and the size. 7
- The therapies that can regulate mitochondria function and metabolism and induce apoptosis may be the most effective anti-cancer agents.7
- A novel radiosensitizer with dual anti-metabolic and anti-angiogenic activity for oesophageal (OAC) cancer resistance has been identified and patented that can significantly reduce both metabolic and anti-angiogenic activity in real time and in parallel with increasing radio sensitivity in an isogenic model of radioresistance.7
5. Cancer treatment vaccines
- Cancer treatment vaccines act by strengthening the body’s natural defenses against the cancer.11
- They are designed to be used in cancer patients where they act against cancer cells.11
- Cancer cells are comprised of tumor-associated antigens which are not present in normal cells. Treatment vaccines recognize and interact with these antigens thereby destroying the respective cancer cells.11
- Sipuleucel-T is a vaccine used for prostate cancer.11
- T-VEC is used to treat some patients with melanoma that relapses after surgery.11
- These vaccinations are associated with some serious side effects which can vary from person to person. For e.g. Sipuleucel-T can lead to stroke. It is deemed important to know about the side effects and what to do if they occur.11
- The common side effects associated with cancer vaccine are flu-like symptoms such as Fever, weakness, chills, dizziness, muscle or joint pain, nausea/vomiting, low or high blood pressure, fatigue, headache, difficult breathing.11
We, at Turacoz Healthcare Solutions join hands to fight against the cancer by spreading the awareness about timely diagnosis and treatment of cancer. If cancer is detected at an earlier stage, there are high chances of successful treatment which in turn increases the chances of survival compared to diagnosis at advanced stages. Let us be aware, strong and brave – life is beautiful, and cancer can’t change it.
If you have any queries, email us at hello@turacoz.in
References
- Available at https://www.who.int/news-room/fact-sheets/detail/cancer . As accessed on Feb 03, 2020.
- What is cancer. Available at https://www.cancer.gov/about-cancer/understanding/what-is-cancer . As accessed on Feb 03, 2020.
- Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians 2018;68:394-424.
- WHO: latest global cancer data. Available at https://www.who.int/cancer/PRGlobocanFinal.pdf . Last accessed on Feb 03, 2020.
- Early screening of cancer. Available at https://www.who.int/cancer/detection/en/ . Last accessed on Feb 03, 2020.
- Cancer treatment. Available at https://www.cancer.gov/about-cancer/treatment . Last accessed on Feb 03, 2020.
- Charmsaz S, Prencipe M, Kiely M, Pidgeon GP, Collins DM. Innovative Technologies Changing Cancer Treatment. Cancers (Basel). 2018;10(6):208.
- Cano A, Espina M, GarcÃa ML. Recent advances on anti-tumor agents-loaded polymeric and lipid based nano-carriers for the treatment of brain cancer. Curr Pharm Des. 2020 Jan 16.
- Abreu TR, Fonseca NA, Gonçalves N, Moreira JN. Current challenges and emerging opportunities of CAR-T cell therapies J Control Release. 2019 Dec 30;319:246-261.
- Rizzo S, Botta F, Raimondi S, et al. Radiomics: the facts and the challenges of image analysis. Eur Radiol Exp. 2018;2(1):36.
- Cancer treatment vaccines. Available at https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/cancer-treatment-vaccine . Last accessed on Feb 03, 2020.
