Category Archives: Cancer

Chemotherapy

Chemotherapy is a type of cancer treatment that uses one or more anti-cancer drugs as part of a standardized chemotherapy regimen. Chemotherapy may be given with a curative intent or it may aim to prolong life or to reduce symptoms. Chemotherapy is one of the major categories of the medical discipline specifically devoted to pharmacotherapy for cancer, which is called medical oncology. Chemotherapy is the use of any drug to treat any disease. But to most people, the word chemotherapy means drugs used for cancer treatment. It’s often shortened to “chemo”. Surgery and radiation therapy remove, kill, or damage cancer cells in a certain area, but chemo can work throughout the whole body.

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Chemotherapy drugs that kill cancer cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that kill cancer cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles. Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between cancer cells and the normal cells. The “normal” cells will grow back and be healthy but in the meantime, side effects occur. The “normal” cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body. Chemotherapy (anti-neoplastic drugs) is divided into five classes based on how they work to kill cancer. Although these drugs are divided into groups, there is some overlap among some of the specific drugs. Further sections discuss several different types of chemotherapy in the effort to further explain these important procedures.

Genome Test for Cancer

Cancer:

Cancer is a cluster of diseases involving abnormal cell growth with the potential to invade or unfold to different parts of the body. These distinctions with benign tumours that do not unfold to different parts of the body. Possible signs and symptoms include a lump, abnormal injury, prolonged cough, unexplained weight loss and an amendment in intestine movements. Whereas these symptoms may indicate cancer, they will produce other causes. Over 100 types of cancers have an effect on humans.

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Oncogenomics:

Genomics is a part inside genetic science that considerations the sequencing and analysis of an organism’s genome. The genome is the entire DNA content that’s a gift inside one cell of AN organism. Consultants in genetic science attempt to work out complete DNA sequences and perform genetic mapping to assist perceive sickness. Oncogenomics is a sub-field of genomics that characterizes cancer-associated genes. It focuses on genomic, epigenomic and transcript alterations in cancer. Cancer is a hereditary disease caused by the accumulation of DNA mutations and epigenetic alterations resulting in unrestrained cell proliferation and tumour formation. The goal of oncogenomics is to spot new oncogenes or tumour suppressor genes which will give new insights into cancer diagnosing, predicting clinical outcome of cancers and new targets for cancer therapies. The success of targeted cancer therapies like Gleevec, Herceptin and Avastin raised the hope for oncogenomics to elucidate new targets for cancer treatment.

Genomic testing for cancer:

The test for the BRCA1 and BRCA2 genes is a genetic test that can facilitate to predict your risk for obtaining breast or ovarian cancer. The Oncotype DX carcinoma testicle a genomic test that can facilitate to predict the aggressiveness of your tumour and whether or not you will benefit from chemotherapy. Every cancer, like every patient, is totally different. Genomic tumour assessments facilitate identify the DNA alterations that are driving the expansion of a specific tumour. As we perceive additional concerning these sequence mutations, we are higher able to give cancer treatment therapies that specifically target changes within the tumour’s genomic profile. Since genomic testing may not be right for each patient, your oncologist can help verify if you are a good candidate for the assessments.

Cancer Biomarkers and Targets

Biomarkers or molecular markers are the biological molecule present in the blood, cell lines, and tissues and in other body fluids as an indicator for the normal as well as the abnormal processes of the body and also works as a measurable indicator of any underlying biological condition or disease. Various types of biomolecules such as DNA (genes), RNA, proteins or hormones, can serve as biomarkers, as they all take part in various metabolic processes of the body.

Biomarkers play an essential role in the field of Oncology. It is said that the understanding of Cancer biomarkers is key to developing a right treatment plan for an individual. But notably, Biomarkers are not limited to Cancer. There are several biomarkers for heart diseases, infections, multiple sclerosis, and many other diseases.

Cancer biomarker refers to any molecule or metabolic changes inside the body that is characteristic of the presence of Cancer in the body. It may be produced by the tumors itself or by other cells and tissues, in response to the presence of Cancer in the body.

Cancer biomarkers may include proteins and other biomolecules, gene mutations, missing genes, and various gene rearrangements. Each of them works and reacts differently within the body.

In clinical research, and medicine, Cancer biomarkers are primarily used in three ways:

  • For the diagnosis of the condition as in case of early stage Cancers,
  • To predict how aggressively Cancer will grow and are therefore useful for assessing prognosis, and
  • For the prediction of a patient’s response to the treatment.

Function of Cancer Biomarkers

  • Risk assessment: Offers a quantitative way to determine predisposal of an individual for the particular type of Cancer. For example- overexpression of the HER2 protein, hypermethylation of MYOD1, CDH1, and CDH13 for cervical Cancer, etc.,
  • Diagnosis: determining the origin of Cancer whether they are primary or metastatic by screening the chromosomal alterations found on the cells.
  • Prognosis and prediction of the treatment: when an individual has been diagnosed with Cancer, certain biomarkers determine the aggressiveness of an identified Cancer. Such biomarkers include HER2/neu gene amplification for breast Cancers, elevated estrogen receptor (ER) and/or progesterone receptor (PR) expression, etc.
  • Pharmacodynamics and pharmacokinetics: As each individual have a different genetic makeup, they respond to treatments, and drug differently. In some cases, a certain drug can result into a dangerous condition, such as in case of Individuals with mutations in the TPMT gene to metabolize large amount of a leukemia drug, potentially causes a fatal drop in white blood count for such patients. Hence, Cancer biomarkers are used to determine the most effective treatment regime.
  • Monitoring treatment response: Such biomarkers shows how a treatment is working overtime and how well an individual is responding to the treatment.

What Are Biomarkers and Why Are They Useful?

Biomarker is short for biological marker, and is used as an indication that a biological process in the body has taken place or is commenced. While some biomarkers are used to show that the body has been exposed to a chemical, toxin or other environmental impact – most related biomarkers with medication. Biomarkers are not medical symptoms such as a high temperature that a patient can use to determine how well they are, but an increased heart rate due to physical exertion is a biomarker. The enlarged heart rate is a biological response to the exercise.

Medical use of Biomarkers

There are many medical uses of biomarkers and the use of biomarkers will be significantly stretched as modified medical care becomes standard. Biomarkers can be used to find out what will happen to you when you use a particular treatment, or not to use it, and the risk of you emerging certain medical conditions. 

Diagnostic use of Biomarkers

An example of diagnostic use of biomarkers is the measurement of biomarkers in blood to determine if you have had a heart attack. Measuring the levels of enzymes, hormones and proteins in your blood allows the doctor to determine the severity of your heart attack and how much damage your heart has suffered.

A simple blood sample can be analyzed and the levels of marker chemicals measured. In the case of a heart attack, a doctor may examine the following:

  • Cardiac troponin is a protein that enters the bloodstream shortly after a heart attack and stays there when other biomarkers return to normal levels.
  • Creatine kinase is an enzyme that increases concentration after a heart attack. A definite type of CK can be measured to determine the damage to the heart.

Biomarker levels can change over time and appear and disappear in different stages after an attack.

Which Medicine should I take?

It is in the area of dealings that biomarkers can have the major potential benefit. Researchers are constantly observing for new and more sensitive biomarkers to help make preventative and personalized treatments.

Defensive biomarkers show the risk of a person getting a particular disease; for example a genetic mutation is currently used to indicate the increased risk of getting breast cancer. To get how researchers advance methods for biomarkers, read this article: Formation of the Saliva Volatomic Profile as an Exploratory and Non-invasive Strategy to Find Potential Breast Cancer Biomarkers.

Grace your valuable presence at International Conference on Biomarkers and Clinical Research during January 21-22, 2019 in Dubai, UAE for more recent updates in Biomarkers and Clinical Research.

CANCER GENOMICS FOR MEDICINAL CHEMISTRY

Malignancy is a hereditary infection. Malignant growth genomics is to methodically arrangement of the genome with the end goal to distinguish repetitive genomics changes in tumors. To date, in excess of 80 kinds of malignant growths are, or have been, sequenced by revolves far and wide. These undertakings have extended the rundown of disease qualities and furthermore uncovered many developing dysregulated cell procedures, for example, those engaged with chromatin and epigenomic control, and also those that are associated with RNA grafting, protein homeostasis, digestion and heredity development.

The quick development in disease genomics research can be to a great extent ascribed to the utilization of novel cuttingedge sequencing advancements and the improvement of new drug discovery approaches.

Computational instruments empower the incredible investigation of expansive volume of malignant growth genomics information to more readily comprehend the systems of disease. ‘Driver’ transformations are those changes in qualities that empower malignant growth cells gain advantage against their encompassing cells. These transformations can altogether impact the key pathways managing cell cycles, survival and genome soundness. Amid malignant growth advance, a considerable measure of ‘traveler’ changes can co-happen with driver transformation because of genome shakiness or brisk multiplication and DNA fix inadequacy of disease cells. In spite of the fact that the Pan-Cancer examination, researchers presently can arrange those driver transformations and further outline their jobs in malignant growth inception, multiplication and relocation. For instance, by the mix of OncodriveFM and Oncodrive CLUST in the IntOGen-changes pipeline, Tamborero et al. recognized a rundown of 291 high-certainty malignant growth driver qualities from 3205 tumors of 12 distinctive disease types.

The Cancer genomics information has additionally uncovered new disease subtypes and gave new disease models to anticancer medication explore. Human malignant growth cell lines have been broadly utilized in disease science and medication disclosure. The Cancer Cell Line Encyclopedia (CCLE) venture has hereditarily portrayed in excess of 1000 human malignant growth cell lines for their DNA duplicate number, mRNA articulation and changes. With these information, therapeutic scientists can distinguish reasonable models of cell lines to test their medications for focused malignancy treatments. These cell lines show attractive hereditary highlights that all the more nearly look like related malignancy profiles and can even be from various disease types. Since some articulated contrasts in atomic profiles between normally utilized disease cell lines and malignancy tests from patients have been accounted for, quiet determined cell lines and patient-inferred xenografts, as an in vitro and an in vivo-models, separately, have been considered more solid to foresee systems of medication obstruction and educate remedial procedure plan.

In spite of the fact that the advances in malignant growth genomics look into have created an amazingly huge volume of data on potential helpful pathways and focuses, there is as yet a hole in the interpretation of information from seat to bedside. Restorative physicists are urged to bridle these significant devices and assets to objectively structure novel mixes for those recently recognized targets or to improve their leads by decisively focusing on the disease types with unmistakable hereditary highlights.

Gene Silencing Technology

Year 2018 welcomes the novel family of FDA approved drugs for inherited diseases. These drugs which are backed by a Nobel Prize and 2 decades of research have the ability to cure inherited diseases without actually editing the delicate genome. It is said that they are powerful enough to give a backseat to CRISPR based gene therapy. One such drug is “Patisiran” developed by biopharmaceutical company-Alnylam for treatment of genetic nerve damage. It works on RNA interference (RNAi) technology.

As we all know that DNA along with messenger RNA (mRNA) produces proteins via transcription and translation process. RNAi does the work of shooting down the messenger and erasing the message for protein production. Scientists believe that this will be greater method for treatment of inherited genetic or immune disorders than gene therapy or immunotherapy. Gene therapy involves cutting out the mutated gene region and replacing it with the new gene but this tampering may have certain risks like ethical regulations, unspecific gene region cut and unpredicted changes in gene silently leading to cancer activation. However RNAi ensures that no bad disease is developed and no bad protein is produced by shooting down the compilation of the message by mRNA.akk

RNAi not just works on inherited diseases but also on non-inherited diseases like stroke too. In Stroke, group of proteins get activated together to kill the brain cells. RNAi can stop such activation thus protecting the brain cells. Sometimes even good proteins can turn bad upon being faced by any pathogenic situation leading to a disease. As RNAi are reversible when compared to gene therapy, RNAi can be used to silence the proteins temporarily in such circumstances and restore them back to their normal functional state after the change in situation.

So the question arises. If function of RNAi is really that great and it was discovered long back in 1998, what’s stopping this RNAi or RNA technology developed drugs to enter the market? It seems that the production in this technology is easy but the real problem lies in targeting and delivering the therapy to the specified tissue in question. RNAi works by addition of small snippets of synthetic nucleotides which homes the RNAi, delivers it to the disease-causing RNA to silence it. The problem that arises is host immune system gets triggered upon the introduction of these nucleotide snippets in the body and the activation can lead to massive inflammation and even death. To avoid the immune system risk these snippets can be coated in nanoparticles but they will just end up in liver or kidney thus making the RNAi treatment difficult to reach brain, heart or lungs.

Patisiran was successful and approved by FDA for treatment of rare disease called hereditary transthyretin-mediated amyloidosis (hATTR) by targeting the liver itself. The drug doesn’t encounter the delivery problem as the drug wrapped in nanoparticles will be delivered to patients through infusion. As Alnylam Company is focused on the discovery, development and commercialization of RNA interference therapeutics for genetically defined diseases, this approval has given a huge leap for the company to go forward with the technology. The company is seen developing other RNAi-based candidate therapies that aim to treat high cholesterol, bleeding disorders, and Parkinson’s disease.

CD-8 cells to fight Cancer and Chronic Infections

Immune system has several components like cytokines, lymphocytes, macrophages etc. CD-8 cell is one major component produced by the host immune system to fight pathogens like bacteria, virus etc. Upon exposure to any invading pathogen like virus, CD8 cells multiply rapidly. At the initial stage they are effector cells, acting like foot soldiers and killing the pathogen. Once the pathogen is destroyed, most of these effector cells suicide to not continue attacking the body’s own cells. Few effector CD8 cells that survive become memory cells guarding the host from the respective pathogen and enacting faster combat reaction upon exposure to same pathogen.1

CAR T cell therapy gathered lot of attention from the public for its effective use in immunotherapy against cancer and chronic infections like HIV. Application of CD-8 cells in immunotherapy has been discussed recently. The usual problem encountered is that CD8 cells get exhausted or stop functioning properly in cancer and HIV infections.  However recent research by Shomyseh Sanjabi and her team have discovered a great finding which could offer a greater option against cancer and chronic infections.

The team identified 2 molecules namely Sprouty 1 and Sprouty 2. These molecules are known to modify the survival and development of effector and memory CD8 cells respectively. Upon animal model research, the team found that in absence of these molecules in CD8 cells, the CD8 effector cells survived in larger numbers and became memory cells. The memory cells without these molecules had better protective capacity against bacterial pathogens than normal CD8 memory cells with Sprouty molecules.

In tumors, as tumor cells consume lot of glucose the effector CD8cells get killed due to glucose deprive however the CD8 cells without Sprouty 1& 2 molecules can survive and function in a tumor environment upon consuming less glucose. Also the memory CD8 cells without Sprouty molecules can tackle cancer cells and also cells activated with latent virus in viral infections. Hence the memory plays a good role in immunotherapy and the future engineering of CAR Tcells in combination with genome editing technique like CRISPR can help in future to eliminate the Sprouty molecules and employ CD8 cells against cancer and infected cells.

IUDs and Cervical cancer

5Cervical cancer is the third most common threat among women around the world. A stunning number of women within the developing world are on the skirt of entering the age run where the hazard for cervical cancer is the most noteworthy — the 30s to the 60s. Indeed in case the rate of cervical cancer remains relentless, the real number of women with cervical cancer is balanced to explode.

Preventing and avoiding human papilloma virus (HPV) introduction with secure sex practices and HPV immunization are the finest ways to decrease risks of cervical cancer. HPV may be a viral disease that’s responsible for about all cervical cancers — as well as a few cancers of the vagina, vulva, penis, anus, rectum, and oropharynx (cancers of the back of the throat, counting the tongue and tonsils). The vaccine is most compelling when given some time recently conceivable exposure to HPV — in other words, before becoming sexually active. Children ordinarily get the immunization around age 11 or 12, but in case you missed it, you’ll be able still get it through age 26.

Intrauterine devices are the foremost commonly utilized reversible contraceptive strategy around the world. Present day devices are secure, exceedingly effective for contraception, and have acknowledged non-contraceptive benefits. Heavy menstrual bleeding and related anemia can be controlled by levonorgestrel-containing IUDs, and women who have utilized non-hormonal IUDs encounter lower endometrial cancer incidence. Considered a secure and profoundly successful contraception strategy, intrauterine devices (IUDs) may too be discreetly offering protection against the third-most common cancer in women worldwide. A non-significant decreased risk of cervical cancer was related with copper IUD use, but for all intents and purposes, no impact was found for inert IUD utilize. The decreased risk with increased duration of copper IUD utilizes underpins a conceivable defensive impact of copper IUD use on the improvement of invasive cervical cancer.

However, the mechanism of action behind the defensive effect of IUDs is yet not understood. A few researchers conjecture that the placement of an IUD stimulates a resistant response within the cervix, giving the body an opportunity to fight an existing HPV contamination that might one day lead to cervical cancer. Another possibility is that when an IUD is evacuated, a few cervical cells that contain HPV contamination or precancerous changes may be scratched off.3

Access to preventative services such as cervical cancer screenings and the HPV immunization is driving down rates of cancer in a few parts of the world, but rates are rising in others. Research shows that IUDs showed up to have the strongest effect on populaces that had less access to these services.

Rehabilitation for Breast cancer

The decrease in the level of estrogen during breast cancer treatments leading to decrease in bone density, thus effecting the physical functioning of the body is one of the major reasons for Oncology rehabilitation for breast cancer. Breast Cancer rehabilitation is recommended for those who have undergone lumpectomy, mastectomy, or breast reconstructive surgeries, who are undergoing or finished radiation and or systemic chemotherapy, who are dealing with after effects of treatments, who are at the end of life and their family members want to find easier ways to help care for them etc… Cancer treatments affect each individual differently, and so rehabilitation therapists individualized treatment methods to regain one’s highest level of functioning by analysing their current functional abilities.

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Rehabilitation becomes an inevitable part of treatment when it comes to breast cancer patients who had mastectomy. Swelling in the arm, Lymphedema, due to fluid filling in the lymph nodes, on the same side as the surgery had done cause pain and patients feel effected arm heavier making it more burdensome.  Studies suggest that structured strengthening exercises can help to improve this condition.

Rehabilitation can fix the pains and aches and helps to prevent and face problems with lymphedema, weakness and neuropathy and thus brings them back to their normal healthy life.

Cancer and Treatment

Cancer is the collection of diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues. Cancer can start almost anywhere in the human body. When cancer develops, cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors. Cancerous tumors are malignant, which means they can spread into, or invade nearby tissues. Unlike malignant tumors, benign tumors do not spread into, or invade nearby tissues.

There are many types of cancer treatment. The types of treatment that you receive will depend on the type of cancer you have and how advanced it is. Your treatment depends on where your cancer is, how big it is, whether it has spread, and your general health. There are different types of treatment you might have. Understanding your treatment and the side effects can help you to cope. Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy.

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Surgery :

When used to treat cancer, surgery is a procedure in which removes cancer from your body. Surgery means removing tissue from the body. Surgery is not used for some types of cancer of the blood system (leukemia) and also some types of cancer of the lymphatic system (lymphoma). Sometimes surgery is not possible because of the position of the tumor. For example, if the tumor is near a blood vessel or other delicate tissue.

Radiation Therapy

Radiation therapy is a type of cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. Radiotherapy means the use of radiation, usually X-rays, to treat illness. Radiotherapy destroys the cancer cells in the treated area by damaging the DNA within these cells. Although normal cells are also affected by radiation, they are better at repairing themselves than the cancer cells.  Cancer cells whose DNA is damaged beyond repair stop dividing or die. When the damaged cells die, they are broken down and removed by the body. Mainly two types -

a) External Beam Radiation Therapy

b) Internal Radiation Therapy.

Chemotherapy

Chemotherapy is a type of cancer treatment that uses drugs to kill cancer cells. Chemotherapy works by stopping or slowing the growth of cancer cells, which grow and divide quickly. Chemotherapy can be used to cure cancer, lessen the chance it will return, or stop or slow its growth. Chemotherapy can be used to shrink tumors that are causing pain and other problems. They work throughout your body and are called a systemic treatment.

Immunotherapy

Immunotherapy is a type of cancer treatment that helps your immune system fight cancer.  Immune system is made up of white blood cells and organs and tissues of the lymph system. Immunotherapy is a type of biological therapy. Biological therapy is a type of treatment that uses substances made from living organisms to treat cancer. Which includes Checkpoint inhibitors, Adoptive cell transfer,  Monoclonal antibodies, Treatment vaccines, Cytokines, and BCG.

Targeted Therapy

Targeted therapy is the foundation of precision medicine. It is a type of cancer treatment that targets the changes in cancer cells that help them grow, divide, and spread.  Small-molecule drugs are small enough to enter cells easily, so they are used for targets that are inside cells.  Monoclonal antibodies are drugs that are not able to enter cells easily. Instead, they attach to specific targets on the outer surface of cancer cells.

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Hormone Therapy

Hormone therapy is a cancer treatment that slows or stops the growth of cancer that uses hormones to grow. Hormone therapy is also called hormonal therapy, hormone treatment, or endocrine therapy.  Hormone therapy can lessen the chance that cancer will return or stop or slow its growth.  It may also be used to reduce or prevent symptoms in men with prostate cancer who are not able to have surgery or radiation therapy.

Stem Cell Transplants

Stem cell transplants are procedures that restore blood-forming stem cells in people who have had theirs destroyed by the very high doses of chemotherapy or radiation therapy that are used to treat certain cancers. Blood-forming stem cells are important because they grow into different types of blood cells. The main types of blood cells are WBC, RBC, and platelets.

Bone Marrow transplants

Bone marrow transplant is a way of giving very high dose chemotherapy, sometimes with whole body radiotherapy. This treatment aims to try to cure some types of blood cancer such as leukemia, lymphoma, and myeloma.

Precision Medicine

Precision medicine is an approach to patient care that allows doctors to select treatments that are most likely to help patients based on a genetic understanding of their disease. This may also be called personalized medicine. The idea of precision medicine is not new, but recent advances in science and technology have helped speed up the pace of this area of research. Currently, if you need treatment for cancer, you may receive a combination of treatments, including surgery, chemotherapy, radiation therapy, and immunotherapy.

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Other Treatments

Radiofrequency ablation, Laser treatment, High intensity focused ultrasound(HIFU), Photodynamic therapy, Cryotherapy, Ultraviolet light treatment, Gene therapy.