HDT Compass

Ever wonder what the compass of an oncologist might look like? Cancer doctors target actively growing, unregulated cells. When these cells are localized in a discrete area of the body, surgical removal is the method of choice. Blood cancers differ from their solid counterparts by circulating in the blood and lymph supply, occasionally stopping in a lymph node to set up shop.

So how do you stop a malignancy that floats throughout the body? Chemotherapy melts most naive lymphomas. Responses can be strong enough to create a syndrome where lysed cells release their cytoplasmic contents into the blood, dramatically changing blood chemistry. While sensitivity to chemotherapy is an important predictor of outcome, this is not the whole story. Within a given disease, a patient might have multiple cell lines generating the overall clinical condition.

And this is where an oncologists needs a compass. Since the root source of disease is unregulated cellular growth, the compass of an oncologist charts the cell cycle. Cell cycles are four (G1,S,G2,M) in number and describe the essential activity of the cell. A mature cell does its normal work (G1), duplicates its nuclear (DNA) (S), accumulates sufficient metabolites in preparation to divide (G2) and then divides (M). Since cells may be in any one of these four states, oncologists chose chemotherapies that will attack cells in all four stages. Which is why you gotta getta a cocktail, Jack.

The preparatory regime for autologous (self) transplant mixes four cocktails daily for 6 days with the goal of killing any dividing cells. Each chemical targets a cells in a different cycle. In addition to attacking the cancer, the therapy attacks those cells of the body that are actively growing - hair, mouth, intestine, skin cells generating most of the side effects of treatment.

Although the basic approach of chemotherarepy is similiar to when first discovered >50 years ago, newer formulations of cytotoxic drugs and better support to damaged body areas is improving the conditions of patients in treatment.