Chemotherapy for cancer, how it works

According to the World Health Organization, cancer cases are expected to rise a whopping 57% worldwide in the next 20 years. You probably know or are related to someone who has fought cancer and you may have seen them go through chemotherapy. But…what is it? Hey guys Julia here for DNews Currently a diagnosis of cancer leaves patients with three main options for treatment: surgery, radiation, or chemotherapy. Of the three, chemotherapy can be the most debilitating. It’s a pretty barbaric treatment. Technically, chemotherapy is poison, but it’s a poison that ultimately saves lives. The original chemotherapy drug was a derivative of mustard gas. During WWII, scientists noticed poison gas exposure shrunk the lymph nodes and along with it, it shrunk lymphoma, a malignant tumorous growth of the lymph nodes.

Even though it’s a poison, it proved extremely successful in treating cancers throughout the mid 20th century. Today, chemotherapy is used to dramatically improve survival rates for breast cancer, it is the primary form of treatment for cancers of the blood, and has great success in the early stages of Hodgkin’s lymphoma. It’s often used before or after other treatments for other types of cancers. For example, when cancerous cells are left behind after surgery or radiation adjuvant chemotherapy is used, whereas neoadjuvant chemotherapy is used to shrink a tumor before a surgery. Chemotherapy works by targeting cells that divide rapidly, one of the hallmarks of malignant tumors and other cancers. Like the chemotherapy drug, Etoposide is used frequently to treat diseases like lung cancer, Ewing’s Sarcoma, and lymphoma. According to a study published in the journal Chemistry and Biology, the drug attacks the topoisomerase II enzyme which cancer and other rapidly dividing cells depend on to unwind DNA. By inhibiting this enzyme, the cell can’t make DNA as well and thus the cell gets programed for death, which in medical speak is called apoptosis.

But unfortunately, these kind of drugs don’t target just cancer cells, they effect other rapidly dividing cells in the body as well. Like hair follicles, which is why chemo patients often lose their hair. Other common side effects, I’m sure you’ve heard of include nausea and fatigue. As common as nausea is, it affects people differently, perhaps because of their expectations. A study published in the journal Cancer found that patients who think nausea is a “very likely” side effect, experience it 5 times more often than those who think it’s less likely. According to the National Cancer Institute up to 96% of chemotherapy patients experience fatigue. People describe it as feeling “jet lagged all the time.” Chemotherapy makes people tired because it changes the endocrine system, circadian rhythms, metabolism, and serotonin production. There is some evidence that antidepressants and weirdly, exercise helps fight fatigue.

Chemotherapy can also cause diarrhea, hearing loss and even decreased sex drive. But will we one day treat cancer without chemotherapy? Well, new treatments are paving the way. One study published in New England Journal of Medicine found that molecularly targeted drugs work just as well as chemotherapy without many of the negative side effects. Rather than suppressing all fast growing cells, targeted therapy works by honing in on specific mechanisms cancer cells use to grow. Basically it’s like hitting the bullseye rather than spraying the wall full of bullets. As Dr. George Demetri, at the Dana-Farber Cancer Institute told Time, the future lies with personalized medicine where therapies are targeted towards an individual’s cancer. When planning a strategy to fight against a cancerous tumor, it’s helpful to know what a tumor is. I explain more in this episode right here?.

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