Prospect of Anticancer Therapy

Abstract

Despite advances in the early detection, active treatment and focus on survivorship of cancer patients, the unfortunate reality is that many will still die of cancer. Cancer is the most common cause of death in Korea, with approximately one fourth of all deaths, 59,000, in 2001, and is increasing annually. In the past, cancer treatment focused on control of the disease, but nowadays, oncology professionals concerns are about the quality of life as well as treatments. Multidisciplinary approaches have been performed by super specialization, with remarkable advances in therapeutic modalities. Also, the continuum from cancer prevention to cancer treatment is a very important issue in this era. What treatment is best for each patient? Which methods have proven to be most effective, and how they are used to fight cancer? In general, the most common forms of treatmentare surgery, radiation as both a local therapy and as chemotherapy, hormonal therapy, biological therapy, immunotherapy, antiangiogenesis therapy, and gene therapy as a systemic therapy. Conventional treatments are not adequate for the majority of cancer patients. Many patients fail to respond to conventional therapy because their tumors are remarkably resistant to chemotherapy or radiation, both of which work by damaging the DNA of the rapidly dividing tumor cells. Attempts to overcome resistance with higher doses of radiation and chemotherapeutics inevitably result in an unacceptable degree of toxicity and damage to normal tissues. But, cytotoxic therapy still remains the mainstay therapy. For the past 20 years, oncologists have been trying to assess the utility of systemic therapy in the management of solid tumors using single agent and combination chemotherapy regimens, based on the dose schedule and intensity, by the alternating or sequential use of combinations and also adjuvant and neoadjuvant therapies. In the past, most advanced cancers were usually incurable, but due to the recent molecular advances cited in the context of the field of oncology, many patients can now be offered a better chance of cure from metastatic or advanced diseases in some solid cancers, such as testicular and ovarian cancers, lymphomas and leukemia. Our ability to keep many metastatic solid tumor patients alive for much longer, while preserving a good quality of life, also represents a major advance.