Cancer is a major human health problem worldwide, between 100 and 350 of each 10,000 people die of cancer each year. It affects people at all age's rises steeply with age. Cancer is a variety of different disease and that defective gene causes this disease. It is expensive disease to diagnose, investigate and treat. It is caused due to genetic damage, the loss of cellular regulation, known as mutation. There two causes of mutation, first is when proto-oncogens are activated to become oncogens by mutations, they cause gene to become excessively active in cell proliferation; Second, are tumour suppressor genes control the growth, the damage caused allows them to grow inappropriate (Martinez et al., 2003), progressively and divide rapidly eventually the cell grow into a tumour. The tumour is provided with nutrients and oxygen for survival and growth. The malignant tumour cells have the ability to metastasize. Usually what really kill patients with cancer is metastasize of cancer cells to grow tumours at multiple sites (Thomas, 2006).
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This essay will look at different types of cancer therapies and discuss on couple of therapies which are most effective and more impact in treating cancer.
Cancer types can be grouped into a broader category. Main categories are carcinomas, sarcoma, and myeloma and central nervous system cancers. Carcinoma cancers are cancers that are initiated on the lining of the tissue that cover the internal organ or in the skin, basement of the epithelial cells. Sarcoma cancers are cancers that begin in different types of connective tissue such as blood vessel, muscles and bones, they spread rapidly. Myeloma cancers are cancers that begin in the cells of immune system. All types of cancer are named for the cell or organ that it initiated. (Lecture notes)
Most cancers diagnosed by either symptoms, signs or through screening. An understanding of every cancer disease needs an understanding of the disease, treatment and care are can only come by attention to the details of disease stage and type. Surgery and radiotherapy were the main methods in treating cancer for many years, recent years it is been treated with combination of chemotherapy, surgery and radiotherapy. In recent advances in radiotherapy and chemotherapies have led to more general awareness of the importance of approach to management of patients (Souhami and Tobias, 2005). Specific treatments are given for variety of cancers and there has been great progress in the improvement of chemotherapy drugs to minimise the normal cell damage (Wikipedia, 2010).
Different therapies have different effects on different cancers, such as chemotherapy has not been great benefit to patients with such as squamous lung cancer and adenocarcinoma of pancreas. Improvement in chemotherapy of some cancers has greatly increased in difficulty of management. The treatment must be validated, since the toxicity and dangers of some treatments indicates that the treatment has been established correctly. There are various chemotherapeutic drugs include, alkylating agents, anti-metabolites, anthracycline and other antitumor agents. These drugs are known to affect cell division or DNA synthesis and function. It was evidently that alkyalting agents damage DNA synthesis, the double helix length was unwound and by disrupting the hydrogen bonds and damage the single chains then fell into fragments, through alkylation of its exposed phosphate group (1957). Whilst, the new recent drugs do not interfere with DNA directly, they specifically target a molecular abnormality in certain types of cancer (Wikipidea, 2010).
In the last decade the progression of treating metastatic breast cancer has been limited with the outcomes having deteriorated. A combination of chemotherapy and hormonal therapy has shown a favourably influences the outcomes in both node-negative and node-positive primary disease. Nevertheless, significant number of patients still succumbs to their disease and nearly patients die with metastatic breast cancer despite the surgery, chemotherapy radiotherapy and hormonal therapy (Peters et al., 2000). Drugs including taxanes and biological therapies such as Herceptin has shown a little primarily changes, with improvements measured in weeks of median outcome and showed a little increase of duration of complete remissions. In the late 70's chemotherapy became a standard treatment for high risk premenopausal patients with breast cancer. High dose chemotherapy showed significant due to the use of high dose chemotherapy in treating metastatic breast cancer and primary disease. Further studies of high dose chemotherapy may be critical importance in defining its role in treating metastatic breast cancer. It is clear that high dose chemotherapy alone will not completely solve the problem of breast cancer but should be considered as part of an overall therapeutic plan for the patients with disease (Peter et al., 2000). For some other type of cancer a combination of chemotherapy and radiation is need to maintain or reduce the size of tumours. However, chemotherapy can influence radiation risks and can be difficult to untangle the role of these different factors.
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Ever since the discovery of X-rays by Roentgen in 1895 it has been in biological sciences and in variety of human illnesses. Most of the world radiation comes from radon and other natural sources. 15% of the radiation that is artificial, almost all of it is due to medical radiation. Radiation is a high energy rays that destroy cells and is known to be used to cure cancer, to reduce the chance of recurrence of cancer after the surgery. Epidemiologic studies are needed to quantify the risk from the past exposure to predict lifetime risks. Thus, epidemiologic study findings have an impact on radiology and radiotherapy practice. Different types of radiation are used in medicine, e.g. X-ray and alpha particles and various other type of radiation (Elaine, 2002).
Most cancer can be induced by radiation, linear dose is available for solid cancers, and higher doses are used to treat malignant disease. Bone marrow, breast, thyroid gland and lung appear to be sensitive to radiation and are associated with high radiation-related risks (Elaine, 2002). Despite the affect it has, radiotherapy has been important and its effectiveness is more critical and specific because it is often targets the specific organ or on the specific location on the organ, however a low dose can spread to other parts of the body. Women appear to have a high risk at developing radiation-related cancers. For example when treating cervical cancer, some of the radiation low dose exposure spread to the thyroid glands. Therefore, cancer can develop in neighbouring organ or tissue of the treatment spot (Elaine, 2002). From the Epidemiologic studies a large amount of data have been collect, although are not reliable, but they help to understand the tumorigenic effects at low dose (Elaine. 2002).
British Columbia in 1978 conducted a randomised trial to test the hypothesis that adding radiation to adjuvant systemic therapy improves the outcome in patients with breast cancer. The chemotherapy consisted of cyclophosphamide, methotrexate and fluorouracil (CMF regimen) and the radiation therapy was administered between four and five cycle of chemotherapy. The study showed that locoregional radiotherapy reduces the rates of locoregional and systemic relapses and the deaths from breast cancer. The collected database on a 15 years follow up indicated that radiation can offer substantial protection from systemic relapse to node-positive patients (Ragaz et al . 1997). Early Breast Cancer Trialists Collaborative Group which has analysed all the randomised radiation trials begun before 1985 found 67 % reduction in rates of locoregional relapse and 6 % reduction in mortality. From breast cancer but no improving in overall survival. The routine use of radiation in all node-positive patients would represent a substantial shift in treatment for breast cancer. (Ragaz, 1997).
Radiation treatments have been successful, patients live longer to develop long-term sequel from their radiation exposure. The main advantage is that radiation dose can be estimated from available radiotherapy records and accurate dose estimate allow us to quantify cancer risk.