History of conventional cancer treatments: a short overview of current methods in conventional medicine

History of conventional cancer treatments

There isn't a single person alive who hasn't experienced how a family member or loved one died because of cancer.
For myself this was most dramatically present in my mom and her sister who both developed breast tumors in the late 70s.
While my aunt chose to get treated conventionally, my mom chose the other path and went to a doctor who practiced an alternative diet-based therapy. In the end both died, my aunt of breast cancer, and my mom of a massive heart attack when her (then considered) atypical symptoms were unrecognized in hospital.
Since then I've been watching with both disgust and admiration how science has ben progressing. Disgust because conventional science kept ignoring the positive impact alternative medicine, along with diet and lifestyle can have on health. Admiration because of the major advances that have been made using ever less disruptive and dangerous approaches.

While it sometimes may seem as if cancer is a modern disease, nothing could be further from the truth. Cancer occurrences have been noted throughout history.

Fossilized bones of the mummies of Egypt show evidence of tumours, and a written description of cancer has been found in an Egyptian papyrus dating back to 3000 BC. The ancient surgical manuscripts describe eight cases of breast cancer and the scripts bleakly note, “There is no treatment.”

Such a bleak outlook is no longer the case for most cancers. Today, in the western world, more than 60% of people diagnosed will live more than five years after diagnosis. And for some cancers, five-year survival rates are nearing 90%.

These statistics are thanks largely to the vast amount of research conducted over the past 50 years. But the foundations of modern day cancer treatment were laid much earlier .

Hippocrates, the father of medicine, coined the term carcinoma, and hypothesized cancer was caused by ‘an imbalance of the four humors’.

Throughout history, countless causes other of cancer have been proposed including: angering the gods, fermenting or acidic lymph, chronic irritation, trauma, and infection.
These theories stood unchallenged until the Renaissance when Galileo and Newton laid the foundations for the modern scientific study of disease.

The 18th century saw the birth of cancer epidemiology when three insightful observations were made.
Firstly, the high incidence of breast cancer in nuns compared to non-celibate women gave the first hint that hormones may play a role in cancer.
Secondly, descriptions of cancer of the scrotum prevalent in London’s chimney sweeps led to public health measures to reduce a person’s cancer risk at work.
And thirdly, a book was published linking tobacco use with cancer, which after many decades, resulted in a 1964 warning by the US Surgeon General that smoking caused lung cancer.
Fast forward to present day and more than 100 different carcinogens are identified.

We now know that cancer is a disease caused by damaged DNA.
During the 1970s, scientists discovered genes that cause cells to grow out of control and become cancer cells (oncogenes).
Thanks to personalised medicine—sequencing a patient’s genome a treatment program can be made, tailored to an individual patient.

Cancer treatment history

Surgery

Humans have always performed surgery on one another. The Roman physicians knew that cancer could be treated with surgery, and remarked, “After excision, even when a scar has formed, none the less, the disease has returned”. But it was not until the discovery of anaesthesia and aseptic techniques that surgery became anything but a terrifying last resort for the cancer patient.

The first radical mastectomy to treat breast cancer was performed in 1880, but more conservative methods were not developed until the 1970s when mastectomy and lumpectomy were shown to be effective for treating early breast cancer.
Eventually a trend emerged for removing less healthy tissue so a cancer of the limb didn't automatically result in amputation. Later on, lymph node biopsies and advances in technology and imaging further reduced the need for excessive removal and instead more precise tumour localisation, biopsy and removal, thereby reducing the risk of postoperative side effects.

Radiation therapy

Shortly after Wilhelm Conrad Roentgen discovered what he called "X-Rays", and the discovery of ‘radioactivity’ in radium and polonium by the Curie couple, two Russian skin cancer patients were already successfully treated with radiation therapy. Radiation therapy remains a mainstay of modern cancer treatment.

Nowadays, with the advances of computer and imaging technology, more precise, targeted radiation therapy is possible.
Radiation beams can be matched to the shape of the tumour and delivered from several directions reducing side effects. For some cancers this provides cure rates equivalent to surgery.

Chemotherapy

The chemotherapy era began during World War II when it was discovered that soldiers accidentally exposed to mustard gas (that was being carried on their ship despite the Geneva conventions to not allow the use of mustard gas), died because their bone marrow was destroyed.
Subsequent research found mustard gas compounds killed rapidly dividing cells such as bone marrow, but also cancer cells by destroying their DNA.
Interfering with cell division by damaging DNA causes cells to commit suicide (apoptosis) remains the underlying principle of chemotherapy. However, during the 50s up to the 60s, the compounds that were tested in the unique Cancer Chemotherapy National Service Center (CCNSC) program were unable to cure cancer. This led to disbelief chemotherapy could ever cure cancer.

Another reason why there was so much hostility against chemotherapy stems from the observation that nearly everyone involved in the early cancer drug development program was working for Chemical Warfare Service during WWII and of course because of the initial research done on mustard gas compounds, once used to kill so many soldiers in WWI.

Despite advances in chemotherapy during the 1950s and 60s, surgery and radiotherapy continued to dominate oncology until it became clear that cure rates plateaued at about 33%. The realisation that chemotherapy could be used in conjunction with surgery and/or radiation was pivotal in improving patient survival.

Finally in the late 1960s and early 1970s survival rate improved upon the use of several different chemical drugs at the same time, or cycled after another.

Chemotherapy could be described as “beating up a patient with a baseball bat in the hope that you get the cancer on the way.” Chemotherapy has benefits, but the side effects can be traumatic. These side effects arise because of “off-target toxicity,” where drugs attack healthy cells as well as disease cells.
For a long time, we thought our only chance was to attack quickly growing cells, and accept the collateral damage to normal cells that divide quickly; loss of healthy gut, immune system, hair, the devastating side effects of aggressive chemotherapy.

Fast forwards to today, chemotherapy is tailored to a cancer’s molecular profile, stage, response to previous treatments, and often to the patient’s specific genetic profile. Dozens of combinations of drugs are proven to improve patient survival. Newer therapies are capable of being programmed to find and attack cancer and leave healthy cells alone.

The last few decades of research have revealed that many cancers have special features that make them different from normal cells, and these differences provide us with cancer-specific drug targets.

One such example is the use of a drug called herceptin, which was developed to specifically attack a protein called HER2, which is present in large amounts in 1 out of 4 breast cancer cells. Herceptin, drestroys cells with high HER2 rates. However, herceptin doesn’t work on every breast cancer as it only works on cancer cells with HER2.

Another success story is how 70% of breast cancers are dependent on estrogen to survive, and many of these cancers which would have been invariably fatal thirty years ago are now completely cured, by drugs which block estrogen from being made, or interfere with its action.

Immunotherapy

In the 1850s, physicians noticed that tumours would occasionally shrink if they became infected. This led to the idea that the patient’s immune system could be harnessed to fight cancer cells. Progress in immunotherapy was slow until Cambridge scientists first synthesised antibodies in the 1970s.
Antibody synthesis together with expanding knowledge of the immune system, eventually led to the development of modern immunotherapy protocols for cancer.

Modern day survival rates

Until the last few decades, cancer was a death-sentence. During the 1970s, only about one of two people diagnosed with cancer survived up to five years.
We have seen incredible success in cancers such as breast cancer, whose survival rates have risen from around 30% 30 years ago to about 80% today. A similar high success rate of up to 90% can be seen for many other tumours.

For rarer cancers, however, the outlook is still ‘bleak’. Brain cancer survival rates, for example, have barely changed in the last 30 years, and are as low as 5% for some forms.
Yet, when we look at the progress that was made in the past decades, the future holds great promise.

There will NEVER be one single “cure for cancer” because “cancer” is a very large family of very different diseases. Anyone telling you something else, is living in a phantasy world and should be distrusted.

On the bright side, unlike what we thought for a very long time, genetics aren't as important for development of cancer as environmental factors and lifestyle. By living a healthy lifestyle and eliminating avoidable carcinogens it is very well possible to diminish the chances of tumor development.
Also, by being as fit as you can be, it is possible to have an advantage over others who start the war against cancer in an unfit and unhealthy body.

This means there is a lot that can be done in order to prevent cancer in your body. Even when you are struck by cancer, there should be a place for both conventional (and advanced) treatment as well as for a non-pharmaceutical approach.
In any case, more time and money should be allocoated to research on the effects of diet, lifestyle and herbal therapies, both to prevent and cure cancer in addition to conventional therapies.

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