Medical science as a field has developed tremendously in advancements and has found cure to a lots of diseases and illnesses which otherwise were never thought to be cured. While these advancements have always been supported with effective and evident success, some diseases have yet not been found to have a complete treatment. One such disease is Cancer. Globally the non communicable diseases account for 71% of total deaths. In an estimation, it was found that, non-communicable diseases in India itself account for 63% of all deaths with cancer being one of the leading causes. The disease alone had contributed to 9% of these deaths. This article will be superficially covering the aspects of the disease, while trying to explain the lesser known topics.
What is Cancer?
Our body is a complex machine with every functionality associated with a specific type of cell. The human body is made up of trillions of cells, all work in a very organised and regulated manner. These cells are the structural and functional unit of an organism with a robust mechanism of division and renewal machinery. Normally the cells undergo division when it is required, but in case of cancer, an abnormal division of cells is observed. This is one of the hallmarks for cancer. This phenomenon of uncontrolled division violates the laws of normal division and sequenced apoptosis (natural death of cell). The aggregated mass of cell that accumulates as a result of uncontrolled division creates a non-regulated traffic inside the body, thus hampering the livelihood of normal cells. This aggregated mass of cell is known as tumor. Tumors can be further classified into two categories: Benign and Malignant tumors. While benign tumors are confined to a specific location, malignant tumors can easily spread in the entire body and thus spread the disease to other tissues and organs. This property of spreading in the body by malignant tumors is called as metastasis.
There are many types of cancer differentiated on the basis of their origin. Cancer can evidently develop anywhere in the body and is thus named for the part of the body where it started. For instance, breast cancer that starts in the breast is still called breast cancer even if it spreads (metastasizes) to other parts of the body. Based on these factors, there are two main categories of cancer:
- Hematologic (blood) cancers: These are the cancers of the blood cells (example leukemia, lymphoma, and multiple myeloma).
- Solid tumor cancers: They are the cancers of any of the other body organs or tissues. The most common solid tumors are breast, prostate, lung, and colorectal cancers.
History of cancer
The origin of the word cancer is credited to the Greek physician Hippocrates (460-370 BC), who is considered the “Father of Medicine.” Hippocrates used the terms carcinos and carcinoma to describe non-ulcer forming and ulcer-forming tumors respectively. In Greek, these words refer to a crab, most probably applied to the disease because of the finger-like spreading projections that occur from a cancer cell which resembles the shape of a crab.
However, the oldest description of cancer (without using the word cancer itself) was discovered in Egypt and dates back to around 3000 BC. It’s called the Edwin Smith Papyrus and is a copy of part of an ancient Egyptian textbook on trauma surgery. It describes eight cases of tumors or ulcers of the breast that were removed by cauterization (a medical practice or technique of burning a part of a body to remove or close off a part of it) with a tool called the fire drill. The writing defined the disease, “There is no treatment.”
Cancer in the Sixteenth to Eighteenth Centuries:
During the Renaissance, that is the beginning of the 15th century, scientists developed much advanced and accurate understanding of the human body. Pioneers like Galileo and Newton had already the journey easier by using scientific methods for the study of diseases. In the later years, around 1628, Harvey made his contributions via introducing autopsies. His contribution further led to a better and more specific understanding of the circulation of blood through the heart and body that had until then remained a mystery.
In 1761, Giovanni Morgagni of Padua was the first who started performing routine autopsies to relate the patient’s illness to pathologic findings after death. This laid the foundation for scientific oncology, the study of cancer.
Cancer in the nineteenth century:
The 19th century saw the birth of scientific oncology with use of the modern microscope in studying diseased tissues. Rudolf Virchow, often called the founder of cellular pathology, provided the scientific basis for the modern pathologic study of cancer. As Morgagni had already linked autopsy findings seen with the unaided eye to the clinical course of illness, Virchow summingly correlated microscopic pathology to illness. This method not only allowed a better understanding of the damage cancer had done, but also aided the development of cancer surgery. Body tissues removed by the surgeon could now be examined and a precise diagnosis could be made.
Cancer in the Twenty-First century:
The growth in our knowledge of cancer biology has led to remarkable progress in prevention, early detection, and treatment of cancer. Scientists have learned more about cancer in the last two decades than we been learned in all the centuries preceding. This doesn’t change the fact, however, that all of our scientific knowledge is based on the experiments and foundation created by the hard work and discovery of our predecessors – and we know that there’s still a lot that is yet to be discovered.
Cancer research is advancing on various fronts. While it’s not easy to define and mention all of these, we’ll mention a few of the most significant examples:
- Nanotechnology: New technology for producing materials that form extremely tiny particles is leading very promised imaging tests that can more accurately identify the location of tumors. It is also aiding to the development of new ways of delivering drugs more specifically and effectively to cancer cells.
- Robotic surgery: Robotic surgery refers to manipulation of surgical instruments remotely by robot arms and other devices controlled by a surgeon. Robotic systems have been used for several types of cancer surgery; radical prostatectomy being the most frequently practiced in surgical oncology. With the improvement in mechanical and computational technology, some researchers expect future systems to be able to remove tumors more accurately and with less surgical trauma.
- Expression profiling: Expression profiling allows scientists to determine relative output of hundreds or even thousands of molecules at a single time. Identifying proteins present in the cells can help scientists in predicting a lot about the cell’s behaviour. In cancer, it can help distinguish more aggressive cancers from less aggressive ones, and can often help predict which drugs the tumor is likely to respond to.
- Proteomics: Proteomic methods are also being tested for cancer screening. Measurement of only one type of protein in blood is not considered reliable enough to describe the early stage of cancer. But researchers are hopeful that comparing the relative amounts of many proteins may be more useful, and that finding comparative amounts of proteins can provide accurate and useful information about cancer treatment and its outcomes. Proteins (and other types of molecules) are even found in exhaled breath, which is now being tested to find out if it can show early signs of lung cancer. This is an exciting area of research and early results in lung and colorectal cancer studies have been promising.
Women Pioneers in cancer biology
Kamal Ranadive (1917-2001)
Kamal Ranadive was an Indian biomedical researcher who is known for her research in cancer about the links between cancers and viruses. Kamal was born in Pune on 8 November 1917. Her father wanted her to study medicine and also to marry a doctor. But she had other options considered for her. She started her college education at the Fergusson college with Botany and Zoology as her main subjects. She got her Bachelor of Science (B.Sc) degree with distinction in 1934. She then moved to the Agriculture College at Pune where she pursued her master’s degree (M.Sc.) in 1943 with cytogenetics of annocacae as the special subject.
It was because of her tireless efforts that ICRC (Indian Cancer Research Centre) soon boasted of having the first tissue culture laboratory in the entire country. Ranadive also founded the experimental biology laboratory and integrated new research units in carcinogenesis, cell biology and immunology. Infacts, she was the first in the nation to propose the correlation between breast cancer occurrence and heredity.
Satyavati M Sirsat (1925-2010)
Satyavati Motiram Sirsat was born on 7 October, 1925 in Karachi. Due to her father’s post at shipping venture, her family was generally not stable at a particular location and was thus roamed to various countries. This exposed Sirsat to various cultures and contributed to her rich personalities. She worked in the fields of cancer research pathology, wound healing and regeneration, viruses and human cancer for more than 50 years.
Sirsat took microbiology as the main area of study, for which she completed her bachelor’s and attained a degree from St. Xavier’s College in 1947. She then associated herself with the Tata Memorial Hospital for Cancer as a senior doctoral student, where she got involved at the Department of Pathology. It was later developed by the government into an independent Cancer Research Institute. After completing her PhD in 1958, Dr. Sirsat went for further studies in electron microscopy to the Chester Beatty Research Institute in London, after which she established an electron miscroscopy lab at Indian Cancer Research Centre in India. Her contribution gave Indian researchers the first insight into the detailed cellular structure, and offered multiple ways to diagnose diseases through the examination of molecules within organs. This led to the first study of molecular aspects of cancer, thus opening new pathways in cancer diagnosis.
Sirsat then founded The Electron Microscope Society of India, where she served as President from 1967 to 1972. She also started India’s first hospice called Shanthu Avedna Ashram in Mumbai, where terminally ill cancer patients could come to attain their end in peace. She served such cancer patients until she could, and then left her souls at the age of 85 in the year 2010.
Dr. Vishwanathan Shanta (1927-2021)
Dr. V Shanta was an Indian oncologist and the chairperson of Adyar Cancer Institute, Chennai. She had made her uncomparable efforts in providing quality and affordable cancer treatment accessible to all patients in India. She dedicated her life in organizing care for cancer patients, study of the disease, research on its prevention and cure, spreading awareness about the disease, and developing specialists and scientists in various subspecialties of oncology. Her remarkable work in the field of oncology won her several awards, including the Magsaysay Award, Padma Shri, Padma Bhushan, and Padma Vibhushan, the second highest civilian award given by the Government of India.
She was deeply involved in the most important and pioneering research in paediatric cancer in India, which led to a tripling of the patients’ chances of disease-free survival. Dr. Shanta died in Chennai early on January 19, 2021. At 93, she was active until the last day of her life despite being aware of the condition of her health.
“The best protection is an early detection…”
Reference: The American Cancer Society ; Avigna Clinical Research Institute
Well written
Thanq so much ma’am. Your suggestions have helped us in improving.