Cancer prevalence and its chemotherapeutic measures in Pakistan

Cancer is one of the most common diseases in the world. When cells in our bodies grow out of control, aberrant cell aggregates form, obstructing normal body functioning and leading to disease. It had been a significant source of death worldwide, particularly in Pakistan. According to the World Health Organization, the risk of having cancer before the age of 75 in Pakistan is 11.9 per cent, while the risk of mortality is 8.3 per cent, which is concerning for us. Depending on the type and severity of cancer, there are a variety of treatments available. Researchers have been attempting to build particular target base medications to avoid potential adverse effects. These medications' nanoparticles are one way to increase drug delivery while lowering systemic toxicity. Light-activating chemotherapeutic compounds have also been developed for targeted therapy.

What is Cancer?

Cancer is one of the most occurring diseases worldwide. When the cells in our body grow uncontrollably, they lead to abnormal cell masses that hinder normal body functions and lead to a diseased state. These cell masses are called tumours that can be benign or malignant. Benign tumours stay at the place of origin and do not travel to other parts of the body. In contrast, malignant tumours can travel to other parts of the body through body fluids and can be a reason for secondary tumours caused by metastasis. In several cases, secondary tumours may be more fatal than primary ones due to metastasis. According to the World Health Organization (WHO), cancer can develop as a result of genetic factors interacting with several external agents. Physical carcinogens, such as ultraviolet and ionizing radiation, chemical carcinogens, e.g. asbestos, components of tobacco smoke, aflatoxin (a food contaminant), and arsenic (a drinking water contaminant) and biological carcinogens, such as infections from certain viruses, bacteria, or parasites can give birth to the tumour mass anywhere in the body.

Occurrence in Pakistan

It has been a significant cause of deaths worldwide and especially in Pakistan. According to WHO, the risk of developing cancer in Pakistan before the age of 75 is 11.9 per cent, while the death risk is 8.3 per cent, which is alarming for us. In 2020, there have been 178,388 new cases reported, and it engulfed 117,149 lives. Breast cancer is one of the most prevailing types of cancer in women in Pakistan. Twenty-five thousand nine hundred twenty-eight women have been diagnosed with breast cancer. Among men, lip, oral cavity, and lung cancer have a higher number due to the possible reason for smoking and tobacco products. Leukaemia, also known as blood cancer, also has a higher occurrence.

Treatments

Cancer can be treated through a number of treatments depending on the type and severity of the disease. In the recent last two decades, a number of different therapies have been introduced to reduce the mortality rate and increase the quality of life. Chemotherapy, radiations therapy and surgery are among the most used treatments to fight cancer and are often used in combination. Radiation therapy and surgery are most effective to eliminate benign tumours, while chemotherapy is used to kill the malignant tissues. The combination allows killing the maximum number of cancer cells to avoid metastasis or secondary tumours. Chemotherapy is one of the most used treatments against cancer.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells. It halts the growth and division of cancerous cells. Chemotherapeutic drugs mainly act on the cell DNA and thus cease cell division through multiple actions. For example, cisplatin is a widely used chemotherapeutic that acts by breaking the cell DNA. It is being used widely in Pakistan to treat various types of cancer. Carboplatin, Capecitabine, Bleomycin, Etoposide and cyclophosphamide are some other drugs mainly prescribed to treat lymphoma, breast cancer and leukaemia. Chemotherapy can be used alone or in combination with surgery, radiation, hormonal therapy and targeted therapy. It is one of the most effective ways to prolong life expectancy and reduce symptoms. It is considered a systematic therapy in which drugs reach all parts of the body through the bloodstream and thus poison the rapidly gowning cancerous cells. We have a variety of chemotherapeutic drugs based on the type and stage of cancer. It is efficient for malignant cancers, e.g. leukaemia, thalassemia etc. but cannot be used for local tumours that can effectively be removed through surgery. 

Advantages 

Chemotherapeutic agents are the most pungent chemicals used against the cell, and therefore they have high efficacy. As they kill the living cells, they are called cytotoxic drugs. The drugs used in chemotherapy act only on the rapidly dividing cells; that is the characteristic of cancer cells. Thus, due to this, the body's normal functions are not affected that much.

Disadvantages  

As we get a lot of benefits from the strong cytotoxic activity of those drugs, we also have to face side effects there. These side effects can vary from mild to severe depending on the dose and duration of administration of the drugs. As these drugs act on rapidly dividing cells to target cancerous cells, other fast-dividing cells of the body also get affected by that. The most common side effect is hair fall because hair follicles are fast dividing cells and chemicals also affect that. Also, blood cells, cells in mouth, stomach and intestine get affected by that and due to this, swollen of the internal organs is often seen. Immunity is also decreased due to which the possibility of other infections arising. Sometimes due to prolonged administration of the drugs, these molecules accumulate in different organs and cause toxicity. To solve these problems, other drugs are used to manage the side effects of chemotherapy. Other than that, we often see a resistance of cancerous cells against a single drug or a group of drugs, and because of that, the choice of drugs may be narrowed for the treatment.

Future of chemotherapy

Researches have been trying to formulate the specific target base drugs to avoid the possible side effects. Nanoparticles of these drugs are one of those methods which increase the drug delivery and decrease the systematic toxicity. Besides that, light activating chemotherapeutic molecules have been designed for targeted therapy.