Lecture 24 Cancer s cure How does cancer develop Underlying cancer is changes in genes Changes that cause unregulated cell division increased chances for mutations Changes that allows proliferation of damaged DNA increased chances for further mutations Changes keep occurring and the environment of our bodies constantly selects for cells with combination of key genetic changes that allow very successful continued growth Cancer is a growing snowball of genetic changes Each time a change allows an advantage in growth those cells and their unique combination of genetic mutations increase in abundance It just keeps going on and on until cancer cells are equipped for optimal growth in their established environment No 2 cancers are exactly alike Standard cancer treatment regime Surgery Radiation Chemotherapy History of cancer treatment 1846 first public demonstration was the extraction of a tumor modern era of surgery begins 1880s radical mastectomy 1903 first treatment of cancer with radiation brachytherapy most commonly used 1947 first remission childhood leukemia using chemotherapy aminopterin 1949 first chemotherapy drug mustard gas approved by FDA Treatments surgical surgical removal of tumor or part of tumor resection total or partial Treatments chemotherapy treatment of cancer with one of more drugs that are cytotoxic and focus on cells in tumors 2 types traditional which kills rapidly dividing cells indiscriminately and targeted antibody therapy original chemo was derivative of mustard gas More chemo details there are over 100 different drugs with each having different properties and functions for destroying cancer cells alkylating agents destroy the DNA of a cell to prevent it from reproducing anti tumor antibiotics destroy the enzyme a cell needs to reproduce its DNA anti metabolites act as analogs to mimic essential nutrients and poison cells mitotic inhibitors prevent cells from obtaining the protein needed for survival combination therapy 3 4 drugs at once is common to reduce drug resistance and efficacy Treatments radiation medical use of ionizing radiation damages DNA of cells and induces apoptosis not specific given in fractionated doses measured in units of Gray effect is cumulative radiation treatment planning is process in which a team of radiation oncologists therapist and medical physicists and dosimetrists plan the appropriate external beam radiotherapy or internal brachytherapy treatment technique for patient with cancer intent in to maximize tumor damage and minimize impacts of healthy tissue radiation affects cancer and normal cells but normal cells recover Treatment intent combined modality drugs other cancer treatments neoadjuvant designed to shrink the primary tumor thereby rendering local therapy less destructive or more effective adjuvant can be used when there is little evidence of cancer present but there s risk of recurrence help reduce chance of relapse palliative given without curative intent but simply to decrease tumor load and increase life expectancy Prevention and management choose lifestyle to optimize bodies natural responses to cancer cells less stress state of mind diet exercise moderation
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