Originally published on amolife.com
Cancer, an affliction that has plagued humanity for millennia, may finally be on the ropes thanks to modern medicine. In the last 250 years, medical research and therapeutic techniques have painstakingly propelled our understanding of the disease and treatment well beyond the surgical knife. The progress has been slow and muddled with strife to be sure, yet doctors are now equipped with a diverse therapeutic arsenal. The most common treatments, chemotherapy, surgery, and radiation, have matured in recent years and remain essential tools. Still, hope does not end there. Immunotherapy has already revolutionized cancer treatment, and cutting-edge therapies await on the horizon.
Dr. Kevin Dalby, a professor and researcher at the forefront of cancer research at the University of Texas at Austin, is currently studying the mechanisms of cancer cell signaling to develop targeted therapeutics. His work is supported by the Cancer Prevention and Research Institute of Texas (CPRIT) and the National Institutes of Health. He hopes his research can help improve diagnoses and treatment through targeted pharmaceuticals for a variety of cancers.
In this article, Dr. Kevin Dalby explores the history of cancer treatment and examines the outlook for modern approaches to combat the disease.
Surgical
The year is 1846. American surgeon, William T. G. Morton, becomes the first doctor to utilize general anesthesia for surgery publicly. Consequently, surgical innovation surged, including the removal of cancerous tissue, a progressive procedure for the 19th century. For example, in 1882, William Halsted developed the standard operation to treat breast cancer when he performed the first radical mastectomy. Bold surgical techniques continued into the early 20th century, and by the 1960s, surgery was seen as a pillar for tumor treatment.
Radiotherapy
Radiotherapy (aka radiation therapy) uses ionizing radiation to either control or kill cancerous cells. Its origins date back to 1895 when Wilhelm Roentgen took the first X-ray picture. By 1903, S.W. Goldberg and Efim London developed radiation therapy to treat skin cancer. Fast-forward to 1960. Ginzton and Kaplan spearheaded technological advancements in radiotherapy to concentrate X-rays deeper, thus reducing adverse effects on the skin. Further down the timeline, the introduction of the modern computer significantly improves scanning and precision in radiotherapy. Current procedures are now capable of incorporating Computed Tomography (C.T.) scans for three-dimensional X-ray therapy and even record a tumor’s movement during a patient’s breathing with four-dimensional conformal radiotherapy.
While radiation is an effective treatment, it kills healthy cells in addition to cancer cells. Thankfully, the accelerated division rate of cancer cells makes them more susceptible to radiation therapy. Still, more targeted techniques are essential to advance patient care and increase curability rates.
Chemotherapy
Chemotherapy drug treatment is quite effective in killing cancer cells and preventing further cell division. Though common practice today and successful in many scenarios, it is also extremely invasive to the human body. In 1949, the Food and Drug Administration approved nitrogen mustard, a drug based on the poisonous gas from World War 1, for cancer treatment. Like radiotherapy, chemotherapy targets healthy cells as well as cancer cells, resulting in adverse effects. However, its success rate in early treatments is often worth the risk. From 1958 onwards, doctors discovered combining chemotherapy drugs drastically helped survival and remission rates.
Progressive Treatments and Outlook
Collaborative research, accessible databases, and advancements in technology have helped scientists understand and exploit vulnerabilities of cancer cells in new and innovative ways. Among the most promising is immunotherapy. This tactic enhances the immune system’s ability to identify cancerous cells and launch an attack. With CAR T-cell treatment, we can now modify T cells to be superior soldiers in the war on cancer. Additional therapies include anti-angiogenic agents that diminish tumors’ entry to the blood circulatory system.
The future of cancer treatment also calls for a mental shift in how we define and perceive cancer as a disease. Dr. Robert Gatenby, head of radiology at the H. Lee Moffitt Cancer Center in Tampa, Florida, is exploring radical methods to manage cancer as a chronic illness rather than an enemy to be eradicated. In other words, as long cancer is kept from spreading, a patient may forego more invasive treatments. Dr. Gatenby’s approach is certainly not mainstream, but the American Cancer Society does acknowledge that some cancers are already managed as chronic illnesses. His plan hopes to eliminate any guesswork and treat his patients with medication intermittently instead of a constant barrage of drugs and radiotherapy. As a result, cancer cells may mutate less, maximizing the effects of the medicine.
About Dr. Kevin Dalby:
Dr. Kevin Dalby is a professor of chemical biology and medicinal chemistry, currently working on cancer drug discovery. At the College of Pharmacy at The University of Texas, he is examining the mechanisms of cancer to develop new treatments, while also teaching and motivating students to conduct research. Dalby is optimistic about the future of cancer treatments.