"Discuss the possible treatments for cancer, evaluating the effectiveness of each treatment in comparison to the others.

Here are some possible treatments for cancer 1. Angiogenesis inhibitor What it is: it inibits angiogenesis, the growth of new blood vessels. It could be a possible treatment for cancer as it would also inhibit cells from undergoing metastasis. It is these inhibitors of angiogenesis which keep metastasis in a nonproliferating quiescent state. For a number of tumors, it is proven that this dormant state is mediated through inhibition of angiogenesis. This dormant state is characterized by normal proliferation and increased apoptosis. Case Study: Roche is an example of a firm that has developed such an angiogenesis inhibitor. It currently holds the patent for Avastin. It is the first antiangiogenic agent approved for use in cancer, shows impressive 30% increase in survival in colorectal cancer. Evaluation of effectiveness: A new Avastin study in recurrent, platinum-sensitive ovarian cancer showed women lived significantly longer without their disease getting worse. However, such angiogenesis inhibitors also have its own disadvantages. The main disadvantage of Avastin is short duration of the therapeutic effect and the requirement of reinjections. It costs patients about $80,000 per year. Avastin didnt extend lives and triggered side effects including high blood pressure and bleeding when used for the disease in the treatment of breast cancer.

From: http://www.ncbi.nlm.nih.gov/pubmed/15015566 http://www.roche.com/inv-update-2004-06-03 http://www.foxnews.com/health/2011/05/18/big-pharma-ignoring-potential-cancercure/ http://www.medicalnewstoday.com/articles/215988.php http://www.bloomberg.com/news/2011-11-18/roche-s-avastin-drug-revoked-forbreast-cancer-treatment-in-u-s-fda-says.html

2. DCA (Dichloroacetate) What it is: Evangelos Michelakis, a cancer researcher at the University of Alberta who, three years ago, discovered that a common, nontoxic chemical known as DCA, short for dichloroacetate, seems to inhibit the growth of cancerous tumors in mice. It kills most types of cancer cells by disrupting the way they metabolize sugar , causing them to self-destruct without adversely affecting normal tissues. Evaluation: Only one in 10,000 compounds studied by researchers ends up as an approved drug. To get to the approval phase, drugs must undergo seven to 10 years of testing at a total cost averaging $500 million all of which can be for naught if the drug doesn't receive Food and Drug Administration approval. Even if it does, "only three out of every 20 approved drugs bring in sufficient revenue to cover their developmental costs."It would be nearly impossible to make a profit on a drug like dichloroacetate. "If DCA proves to be effective, then it will be a ridiculously cheap drug," Michelakis said. "Profit is the incentive for the risk that the company takes," "Without the promise of a reasonable profit, there is very little incentive for any company to develop new drugs." Read more: http://www.foxnews.com/health/2011/05/18/big-pharma-ignoringpotential-cancer-cure/#ixzz25Jc9dqpm 3. Radiation Therapy
What it is: Radiation therapy uses high-energy radiation to shrink tumors and kill cancer cells such as X-rays, gamma rays, and charged particles are types of radiation used for cancer treatment. It may be delivered by a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses radioactive substances, such as radioactive iodine, that travel in the blood to kill cancer cells. About half of all cancer patients receive some type of radiation therapy sometime during the course of their treatment. Evaluation: How it is effective: Radiation therapy kills cancer cells by damaging their DNA. Radiation therapy can either damage DNA directly or create charged particles (free radicals) within the cells that can in turn damage the DNA.Cancer cells whose DNA is damaged beyond repair stop

dividing or die. When the damaged cells die, they are broken down and eliminated by the bodys natural processes. Flaws: Radiation therapy can also damage normal cells, leading to side effect, both early (acute) and late (chronic) side effects. Acute radiation side effects are caused by damage to rapidly dividing normal cells in the area being treated. Acute side effects include:

skin irritation damage at regions exposed to the radiation beams. damage to the salivary glands or hair loss when the head or neck area is treated, or urinary problems when the lower abdomen is treated. Late side effects would include:

Fibrosis (the replacement of normal tissue with scar tissue, leading to restricted movement of the affected area). Damage to the bowels, causing diarrhea and bleeding. Memory loss. Infertility (inability to have a child). Rarely, a second cancer caused by radiation exposure. Increased risk of breast cancer (in females)

From: http://www.cancer.gov/cancertopics/factsheet/Therapy/radiation

4. Chemotherapy
What it is: Chemotherapy (also called chemo) is a type of cancer treatment that uses drugs to destroy cancer cells. Chemotherapy works by stopping or slowing the growth of cancer cells, which grow and divide quickly. Chemotherapy keeps cancer from spreading, slows its growth, or destroys cancer cells that have spread to other parts of your body.
Limitations:

Chemotherapy is designed to kill fast-growing cancer cells. But it can also affect healthy cells that grow quickly. These include cells that line your mouth and intestines, cells in your bone marrow that make blood cells, and cells that make your hair grow. Chemotherapy causes side effects when it harms these healthy cells. In the case of leukaemia, it can induce a relapse How long side effects last depends on your health and the kind of chemotherapy you get. Most side effects go away after chemotherapy is over. But sometimes it can take months or even years for them to go away.

Sometimes, chemotherapy causes long-term side effects that do not go away. These may include damage to your heart, lungs, nerves, kidneys, or reproductive organs. Some types of chemotherapy may cause a second cancer years later.

5. Gene Therapy
What it is: Gene therapy is an experimental treatment that involves introducing genetic material (DNA or RNA) into a person's cells to fight disease. Gene therapy is being studied in clinical trials (research studies with people) for many different types of cancer and for other diseases. It is not currently available outside a clinical trial. In one approach, researchers replace missing or altered genes with healthy genes. Because some missing or altered genes (e.g., p53 tumor suppressor gene) may cause cancer, substituting working copies of these genes may be used to treat cancer. Scientists are investigating the insertion of genes into cancer cells to make them more sensitive to chemotherapy, radiation therapy, or other treatments. In other studies, researchers remove healthy blood-forming stem cells from the body, insert a gene that makes these cells more resistant to the side effects of high doses of anticancer drugs, and then inject the cells back into the patient. In another approach, researchers introduce suicide genes into a patient's cancer cells. A prodrug (an inactive form of a toxic drug) is then given to the patient. The pro-drug is activated in cancer cells containing these suicide genes, which leads to the destruction of those cancer cells. Evaluation: Genes must be delivered to the cell using a carrier, or vector. The vectors most commonly used in gene therapy are viruses. Viruses have a unique ability to recognize certain cells and insert genetic material into them. Applying Lessons learnt from previous virus chapter: (Flaw) Viruses can usually infect more than one type of cell. Thus, when viral vectors are used to carry genes into the body, they might infect healthy cells as well as cancer cells. Another danger is that the new gene might be inserted in the wrong location in the DNA, possibly causing harmful mutations to the DNA or even cancer. Any studies involving humans must be reviewed with great care. Gene therapy in particular is potentially a very powerful technique, is relatively new, and could have profound implications. Thus, it could be a very long time before gene therapy is approved. There are also social and ethical issues associated with gene therapy: Humans playing God?

Why is the cure for cancer so elusive till today? The cure for cancer till today could still remain elusive despite our many technological advances.
There will never be a single cancer cure because cancer refers to a family of more than 100 different diseases characterized by abnormal cell growth. These diseases arise from numerous causes, such as ionizing radiation, chemicals or even viruses. Different cancers call for different treatments. Moreover, as discussed earlier, each cancer treatment each have their own flaws, of which are pretty substantial. In the case of chemotherapy, it could cause a relapse. When a normal cell divides, the cell's DNA is copied more or less perfectly. But each division of a cancer cell brings about new changes in the DNA. So a drug might be able to kill some but not all

Tumor cells of a particular kind of cancer can vary not only throughout a particular patient's own body, but even within a single tumor. So while a given treatment might hit some of these targets, others are left unscathed, and the cancer remains. By analyzing these samples, they found that cancer cells within a single tumor and at places where the cancer had spread showed a large amount of variation, with 60 percent of tumor mutations not uniformly detected in every part of the tumor. This has implications not only for treatment, but for diagnosis as well.
of the cancer because each cell is a little different. More disconcerting is the ability of a cancer stem cell to hide. Chemotherapy might effectively kill an entire tumor, but cancer stem cells might evade the drugs and cause a relapse of the cancer years later.

In conclusion, even though there have been many possible treatments for cancer, they each carry rather significant flaws that could make the cure for cancer elusive. This is coupled with the fact that cancer stem cells have the ability to hide and that in tumors, the cancer cells in it show large variations making it difficult to cure and to diagnose the cancer precisely.