Cancer and ChemotherapyCancer and Chemotherapy

What is Cancer?What is Cancer?

• Cancer begins when an abnormal cell grows & does not stop dividing. Cancerous cells typically divide more quickly than normal, healthy cells. Once cancerous cells begin, they rapidly invade surrounding tissue.

• A progression toward increasing degree of malignancy from multiple numbers of mutations.

• A shift in the control mechanism that governs cell proliferation and differentiation.

2005 est. US Cancer Deaths2005 est. US Cancer DeathsMale FemaleMale Female

• Lung 31%• Prostate 10%• Colon, Rectum 10%• Pancreas 5%• Leukemia 4%• Esophagus 4%

• Lung 27%• Breast 15%• Colon, Rectum 10%• Ovary 6%• Pancreas 6%• Leukemia 4%

9 Avoidable Risk Factors 9 Avoidable Risk Factors Cause 1/3 of Cancer DeathsCause 1/3 of Cancer Deaths

• Smoking• Urban air pollution• Indoor smoke from coal• Obesity and overweight (high fat diets)• Low fruits and vegetable intake• Physical inactivity• Alcohol consumption• Unsafe sex• Contaminated injections in health-care setting

Life’s BuildingLife’s Building Blocks Blocks

• Proteins

• Recombinant

• Process– Cloning

– Harvesting– Incubation

• Economics

Development of CancerDevelopment of Cancer

• Mutations• Genes• Heredity• Sporadic• Familial• Congential

• Sites– Primary

– Secondary

• Solid Tumor• Diffuse Tumor

Bone Marrow

Scanning Electron Micrograph of Stem

Cell from Human Bone

Marrow

How Does Cancer Start?How Does Cancer Start?

• Cell mutates causing division instead of resting

• Cells look

different

IN SITU

INVASIVE

• Breast CA Cell

• Melanoma & Basal cell carcinoma

Cell DivisionCell Division

• Mitosis

• Cell division,

• growth

• and repair

• Stop Signal

• RUN AWAY Cell

• Metastasis•

Run Amuck destroysOrgan- Malignancy

Cancer cells enter

lymph system &

blood stream

Immune system has some ability to kill, but CA overpowers

What is Chemotherapy?What is Chemotherapy?

• Method of treating cancer using various chemicals administered either IV or PO

• Almost all chemotherapy drugs destroy cancer cells by disrupting the cell cycle

• This stops the cell from proliferating and the cell dies

• Unfortunately, healthy cells die causing nasty side effects

Anti Cancer TreatmentAnti Cancer Treatment

• Early diagnosis

• Surgery

• Radiation

• Chemotherapy

• Palliation

• Hospice Care

The Ideal DrugThe Ideal Drug

• Schedule Agents for cell division and growth cycle

• Cell cycle non-specific drugs

• Cell cycle specific drugs

• Resistance !

Designer DrugCocktail

CA Drug StudyCA Drug Study

Last Resort – dose,

reactions, reoccurrence

Determine tumor signal,

growth rate, survival rate

Compare drug

outcomes with

Known treatments

Combination

Drugs, Surgery,

Radiation

How do drugs How do drugs work?work?

Interfere with cell division

Affects DNA-genetic code

* bind wrong AA

* separate helix

Antimetabolites:Fraudulent building blocksIncorporate into normal cells making themNonfunctional or inhibit the normal functionOf a key enzyme

Masquerades as neededingredient

Alkylating Agents —irreversible

cross links DNA so cell cannot reproduce

Topoisonpoisonmerase I inhibitors —lead

to DNA damage Hormones —inhibit adrenal steroids

in target neoplasms (prostate, breast)

Anti Tumor Antibiotics --inhibit

DNA-dependant RNA synthesis or delay mitosis

Biological ResponseModifiers –BRM’sInterferon, Monoclonal Antibodies,Tumor Vaccines, Immunotherapy,Attack tumor, slow growth,Cell Death

Plant Alkaloids —inhibitFormation of spindle fibersDestroy cell division

Genetic EngineeringGenetic Engineering

• Virotherapy– Turning viruses loose on CA cells, invades

tumor without inflicting disease in humans.– Right virus, right place

• Penetrate CA cell, replicate, kill the cells and invade adjacent cells

• Outwit bodies defense mechanism

Bugs in RehabBugs in Rehab

Infectious microbes

like this measles

virus are being

retrained to attack

tumor cells instead

of healthy ones

• C.botulinum the bacterium that causes food poisoning also thrives in O2 deprived depths of tumors, where it delivers a cancer killing toxin

• Salmonella has a natural affinity for tumor cells & is genetically altered to a powerful anticancer agent

• Epstein-Barr a virus

triggers production of killerimmune cells that can bedirected to destroy any number Of differentcancer cells

Breast CancerBreast Cancer

Therapeutic AgentsTherapeutic Agents

• Alkylating Agents– busulfan (Myleran)

• Antibiotics• Antimetabolites

– flurouracil (Efudex)

– mercapopurine (Purinethol)

– methotrexate

Therapeutic Agents cont.Therapeutic Agents cont.

• Hormones– Bicalutamide

(Casodex)

– Tamoxifen (Nolvadex)

• Nitrogen Mustard– Chlorambucil

(Leukeran)

• Plant Alkaloids

• Miscellaneous– Taxol

• Rescue Agents– Cytoprotectives

• Folic Acid

Complications of Cancer & Complications of Cancer & ChemotherapyChemotherapy

• Pain– Insomnia– Reduced appetite– Fear and anxiety

• Oral Complications– Mucositis/Ulcerations ( Magic Swizzle,

Mouthwash)

• Nausea & Vomiting

MarijuanaMarijuana

End of LifeEnd of Life

Who Decides?Who Decides?