War on Cancer

An emerging field of science called metabolomics offers a law cost way to develop largescale screening methods for a variety of diseases as we monitor blood glucose or cholesterol to assess the risk of diabetes and cardiovascular diseases, respectively. Historically, there had been periods of rejection and skepticism by the establishment before such revolutionary ideas became accepted. These modern technologies are no exception. Science has delivered the armaments to fight the war on cancer, but the outcome will depend on the decisions we make.

- BY GEEWANANDA GUNAWARDANA, PH.D.

Cancer incidence is increasing worldwide, but at the same time, the death rate due to cancer has been decreasing thanks to advances made in cancer therapy and diagnosis (Another side of cancer, The Island 25-06-09).

Even though battles have been won, the war against cancer continues. A fascinating account of this centuries-old war can be found in the Pulitzer Prize winning 2010 book 'The Emperor of all Maladies' by Siddhartha Mukherjee, which was also made into a television series by Ken Burns, the renowned documentary film maker. What follows are some recent developments in cancer therapy.

Surgery remains the common and often crucial first-line treatment for many cancers, especially solid tumors. However, in case of inoperable cancers such as blood cancers, and when surgery fails to remove all cancer cells, other treatments like chemotherapy, radiation, and targeted therapies can also be primary treatments, depending on the type of cancer and its stage.

As cancer results from uncontrolled cell division, the goal of treatment is to stop uncontrolled cell division. And that is what chemotherapy, the use of a class of drugs commonly known as cytotoxic drugs, does. However, there is a major drawback: cytotoxic drugs do not see the difference between uncontrollably dividing cancer cells and healthy dividing cells. Recall that it is necessary to replace some three hundred billion cells every minute, and cell division remains an essential function of the normal healthy body. The death of healthy cells causes many side effects: the major ones are decrease in blood cells causing anemia, weakened immunity, hair loss, nausea, and fatigue. Despite this shortcoming, chemotherapy continues to play a key role in cancer therapy, and researchers in both academic and industrial labs are earnestly searching for alternatives, the elusive 'magic bullet' that can kill cancer cells without harming normal cells.