Cancer has been a deadly disease afflicting man from ancient times. Described in the Edwin Smith Surgical Papyrus that recounted Egyptian literature dating 3000 to 2500 BC, and by Hippocrates, who considered cancer to be a growth, swelling or ulcer that caused great suffering and death.
"Egyptology, A page of the Edwin Smith Payrus, late 17thC BC Wellcome M0008142" by http://wellcomeimages.org/indexplus/obf_images/b2/aa/134cde1b9de3d9a0bc53344f3092.jpg
Gallery: http://wellcomeimages.org/indexplus/image/M0008142.html. Licensed under CC BY 4.0 via Wikimedia Commons.
Despite a long history, cancer has proved to be unmanageable. It affects more people now than ever before and remains recalcitrant to various forms of therapy. Moreover, patient survival rates, which are calculated as a percentage of the affected individuals that continue to survive five years after diagnosis, have only marginally improved in the last fifty years or so.
Considering the history, persistence and increasing number of deaths attributable to cancer the disease seems to deserve the title THE EMPEROR OF ALL MALADIES popularized by an insightful book by Siddhartha Mukherjee.
And yet on closer consideration, the title seems undeserved. The biological behavior of this age-old disease remains the same, as evidenced by the consistent five-year survival rates which continue to correlate closely with the stage at diagnosis. The increasing number of cases and deaths in the last century has resulted from changing human activities that expose individuals to an ever-increasing number of carcinogens while simultaneously reducing health-promoting dietary and lifestyle factors. Last but not the least our constant failure in managing the disease, has been a result of our unchanging treatment goals while dealing with cancer rather than the changing aggressiveness of the disease.
Cancer therapy has been consistently aimed at destroying the affected tissue and eradicating all transformed cells in a manner reminiscent of treating infections. Eradication of cells that are morphologically similar to the cells of origin and similar to other rapidly multiplying cells in terms of DNA synthesis and mitosis is bound to fail, considering the inevitable destruction of healthy cells. Surgical excision aimed at removing all affected tissue has not been very satisfactory either since even the most complete excision cannot ensure the removal of all malignant cells or those that although not malignant at the time are in various pre-transformation stages.
The molecular discoveries of the last 30 years have improved our understanding of the pathobiology of cancer. It is now easy to recognize that cancer is not a new growth as implied by the term neoplasia. Instead, it results from a complex aberration of cellular mechanisms involved in maintaining tissue integrity by cellular turnover and response to injury. The complexity provides several possible mechanisms for prevention, delay and even reversal of the molecular changes that lead to cancer. While therapeutic modalities based on a contemporary understanding of cancer are for the most part in experimental stages, the day is not far when we will successfully treat or at the very least favorably modify the disease outcomes and dethrone the false emperor.
#Cancer
