Changing Nature of Diagnosis and Treatment of Cancer
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 10, Issue 4
Abstract
Traditionally, cancer has been diagnosed / classified by pathologist under the microscope. Different types of cancers have been identified in relation to the location where they are first observed. Also, treatment and prognosis of cancer has been in relation to its histopathology and pathology analysis. Misdiagnosis and mistreatment have resulted from this approach which has increased the suffering and death of patients. Newer diagnosis and treatment methods are based on the molecular analysis of the tumor genes and identification of mutations which are directly related to the tumors. Under the new system, tumors are classified and treated according to their mutation type and not based on their location. Among the treatment options, immunotherapy relies on such approach.The immune system oversees body's protection against internal and external maladies. As we age, the immune system undergoes changes that are brought about through signals that are produced within the body itself. These changes affect the immune system's ability to protect the body against the diseases. On occasions, even the signals that are sent t through alterations in the genes to the cells in various body organs, weaken or get misinterpreted, directing the cells to become diseased including cancerous. The alterations in the genes include addition or deletion of DNA pieces or changes in the number of DNA copies. The tumors that result from such alterations may contain certain segment of DNA, or multiple copies of the whole gene. Alternatively, a single base in the DNA may be chemically modified via methylation or other reactions. At the end, in a single tumor, an average of 50 different mutations may be created through various processes which compared to the total number of genes in the body is very few. Our body has 3 billion bases in its genes of which only a few may be modified, replaced, or deleted due to such mutations. Throughout our life, many spontaneous mutations also occur in our genes. All and all, only a few of the all the mutations may lead to serious conditions like cancer [1].When created, each tumor type carries specific mutations, some with higher number of mutations and some with lower number [2]. In a series of high-throughput sequencing (HTS) studies, four genes were found to be altered in over 20% of the tumors [3,4]. Of course, all mutations do not lead to cancer. Cancer results only when mutated cells can circumvent the normal defensive mechanisms of the body. These defensive mechanisms catch and correct most replication mistakes, leaving only some mutations to lead to cancer. Some common defensive mechanisms that prevent formation of cancer include: TP53 tumor suppressor gene, DNA damage gene, and checkpoint genes, but other genes including anti-oncogenes, and caretaker genes may also participate. Most often, mutations are corrected by specific enzymes controlled by tumor suppressor genes [5]
Authors and Affiliations
Jahangir Emrani
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