With a fear strangling his heart, he runs towards his enemy with a gun in his hands and scream in his throat. Bullets rained from the sky and blood sprayed throughout the field making up the garden of hell. What good can come out of that? Well a good that can save millions of lives.
It was World War I, one of the worst memories of humankind and the memory gets even hazier when the yellow cloud entraps you within its deadly range. Yellow cloud; also known as mustard gas is a prototypical substance of the sulfur-based family which was used in World War I as a chemical warfare agent against the enemy. Whoever was exposed to it, it made the air impossible to breath, burned their eyes and caused blistered on exposed skin. It was worst then the scariest part in a horror movie. Scientist tried hard to develop an antidote to this vicious weapon of war and during the process; they discovered that the gas was damaging the bone marrow in a way that cannot be reversed, halting the effected soldier’s ability to make blood cells. But aside from the harmful and devastating effects of the mustard gas, scientist found a positive use for it. One of the worst weapons of war became a remedy that saved millions ahead.
Bone marrow shares characteristics with cancer cells, both replicate rapidly. The long search for treating cancer began in 1930s when scientists started injecting compounds from mustard gas into the cancer patients and after the end of World War II in 1947, scientists eventually discovered what became known as the first chemotherapy drugs.
There are more than 100 chemotherapy drugs out today which are delivered through pills and injections and use compounds that are toxic to living cells (cytotoxic agents). This means that chemotherapeutic drugs causes some level of harms to all the cells in the body whether healthy or not, but they reserve their most powerful effects for rapidly-dividing cells like of cancer. Although there are six classes of chemotherapy drugs, we will discuss only two of them.
Let’s take examples of the first and most used chemotherapy drugs known as Alkylating Agents. They are injected into the bloodstream which delivers them through all around the body. Inside the body, when cells try to copy it by exposing their DNA, they damage the building blocks of DNA’s double helix structure and as a result cells die, if not repaired. Because cancer cells replicate rapidly, they take a high concentration of alkylating agents, so they die off most often then other cells.
Another form of chemotherapy involves compounds called Microtubule Stabilizers. Cells have small tubes that assemble to help with cell division and DNA replication, than break back down. When microtubule stabilizers get inside a cell, they don’t let those tubes from disassembling. That results in incomplete cell replication which leads to its death.
Although chemotherapy has some disadvantages because it affects the healthy cells in the body too but its outcome is more beneficial. In 2018 alone, over 17 million people world-wide received a cancer diagnosis. If we look at testicular cancers, up to 95% of individuals survive due to its treatment. Even people with an aggressive blood cancer (Acute myeloid leukemia), chemotherapy saves up to 60% of the individuals.
Although we have treatments like surgery following up with radiation and chemotherapy, hormone therapy, immunotherapy, and targeted treatments for specific types of cancer, we don’t have one golden bullet that can cure all of them. For stepping up in the race of curing cancer, we have to find new and better ways to study the cancer cells. For now, we make treatments by studying cultures of human tumor inside a lab which has given us critical insight about cancer genetics and biology but they’re very different from an actual tumor inside a living body. That’s why new drugs that work on lab grown cells fail in clinical trial with real patients. To make things worse, cancer cells are really complex with their clonal heterogeneity (means they have genetic mutations in their own cells giving rise to unique sub-clones and the drugs that works on one sub-clone may have no effect on another) and also because tumor is not just a simple disease but a dynamic interconnected ecosystem where they interact with the body’s system including immune system and suppress their functions. If we can somehow cancel these lines of communication between cancer cells and the environment, cancer will be a thing of the past.
We surely are advancing in the treatment of cancer by only targeting the cancer cells which will increases the survival rates and reduce the harm. A compound meant to kill thousands became the best tool for the treatment of cancer that saved millions just by using it in a proper way. In our lives we also have too many things that are meant to hurt, that are meant to torture and push you against the ground. But by just changing the way you look at something and using it in a different way, you can also make those atrocities of your life make the base of your success and well-being.
It’s Jabir… See you around.
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