You  probably already know Patrick Swayze succumb to cancer this week.  We can add his name to the list of notables, Farrah Fawcett. Tony Snow and Peter Jennings (to name a few) who have lost their battle with this disease over the last few years.  The sad truth is that there are some 1,500 deaths per day that are attributed  to this disease.  My question here is weather it is the cancer that is killing these people or the treatment?

While chemotherapy has prolonged lives, it is running up against limits. Lung, colon, breast and prostate cancers, the four main killers, essentially ”remain incurable by standard chemotherapy” once they have spread to other parts of the body, said Dr. Lawrence N. Shulman, chief medical officer of the Dana-Farber Cancer Institute in Boston.  More target therapies are under development however they are in the infant stages in terms of research and development.  Even if these targeted therapies do happen to show promise in the future they are still years down the road from being considered as accepted effective therapies.

We all know that chemotherapy is a drug treatment that uses powerful chemicals to kill fast-growing cells in your body. Chemotherapy is most often used to treat cancer, since cancer cells grow and multiply much more quickly than most cells in the body.  The agents (drugs) that are used (mimic immune system response) identify and attack the cells in the body that grow rapidly.  This also includes fast growing non cancerous cells such as those found in hair, bone marrow and crypt cells of the lining of the small intestine and cells lining the reproductive tract to name a few.  The destruction of the bone marrow cells may very well be an important factor in the cure being equally as detrimental as the disease.   As we know leukocytes are produced in the bone marrow and are reasonably fast growing cells (especially in times when the body perceives that it is under attack).  Among these leukocyte cells are the lymphocyte type  (B cells, T cells {CD4 & CD8} & NK {natural killer cells}) which are critical in dealing with the mechanisms of disease.  These cells are the core members of the immune systems response to cancer.  Chemotherapy subsequently leaves the body totally unprotected against any cancer cells that remain in the body after the Chemo & Radiation treatments have been given.

The effects of the chemotherapy is not seen during the onset of treatment rather in the latter stages.  Many white blood cells grow and divide rapidly to deal with an illness and have a very short life span (hours to days).  In the case of Leukocytes however, although they do tend to grow rapidly and have a much longer life span (months to years) and they do not divide rapidly.  Basically this means that the extra cells needed to fight disease must come from the production of new cells and not from (cell division) the existing cells.  It is this slow cell division combined with the severely diminishes capacity of production that is the main problem with this type of therapy.

The fact is that both chemotherapy and radiation therapy are both carcinogenic, which means that they can cause cancer.  Many times, months or years after the treatments, patients develop secondary cancers.  Chemotherapy destroys cancer cells by disrupting cell division. However, normal cells are also affected, especially if the dose is too high or if certain drugs are used. For example, etoposide is associated with an increased risk of acute leukemia compared to other chemotherapy drugs. Furthermore, secondary cancers are more frequent in patients who receive radiation therapy and chemotherapy compared to either treatment alone.

How can secondary cancers be prevented?

Define the risk of recurrence and tailor the intensity of cancer therapy: Over the past decade there has been great progress in defining risk groups for various cancers.  The importance of defining risk groups is that less treatment can be given to those who have a low risk of recurrence of cancer with standard treatments and more treatment can be given to those at high risk. Lowering the dose of treatment for low risk groups is probably the most important way to prevent secondary cancers since these cancers occur more often in intensively treated patients.

Avoid radiation therapy: Another way to decrease the incidence of second cancers is to avoid radiation therapy.  This has been successful in childhood ALL where intrathecal (into the spinal fluid) chemotherapy has been substituted for radiation therapy.  Radiation therapy is also being used less in the treatment of Hodgkin’s disease and non-Hodgkin’s lymphoma where certain groups of patients have been found to survive just as well with chemotherapy alone as with chemotherapy plus radiation therapy.

Avoid drugs with high carcinogenic potential: This is difficult to do since all chemotherapy drugs are carcinogenic.  However, etoposide is associated with a relatively high incidence of myelodysplasia and acute myeloid leukemia and in some instances other drugs could be used instead.

Again,  I can’t state this enough and will continue to pound it into you, the BEST way to prevent any illness is to unsure that your immune system if functioning at optimal levels at all times.  Your body is designed to deal with any invader on it’s own.  I agree that early detection is the key to fighting this disease.  However I also believe that if your immune system, as well as the rest of your body, is functioning properly at the cellular level the risk of getting cancer is greatly diminished.

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