"Breast cancer is the
most common indication for chemotherapy among women in the United States, and
chemotherapy drugs are the leading cause of serious drug-related adverse
effects among women with
breast cancer." -
Michael J. Hassett, A. James O'Malley, Juliana R. Pakes, Joseph P. Newhouse,
and Craig C. Earle1885 Paul
Ehrlich, a German physician and scientist working in the fields of hematology,
immunology, and antimicrobial chemotherapy develops the first chemical to
target a specific pathogen.
Ehrlich developed the precursor
technique to Gram staining
bacteria making it possible to distinguish between
different types of
blood cells leading to the capability of diagnosing numerous blood
His laboratory discovered arsphenamine (Salvarsan), the first
effective medicinal treatment for syphilis, thereby initiating and also naming
the concept of chemotherapy.
Paul Ehrlich popularizes the concept of 'a
Ehrlich reasoned that if a compound could be made that
selectively targeted a disease-causing organism, then a toxin - a "magic
bullet" - for that organism could be selectivity delivered.
elaborated the systematic testing of chemical compounds as now practiced in the
pharmaceutical industry in clinical trials.
Ehrlich's work illuminated
the existence of the blood-brain
1942 Two pharmacologists from the Yale School of Medicine,
Louis S. Goodman and Alfred Gilman, are recruited by the DoD to create a less
volatile mustard gas.
They exchanged a nitrogen molecule for sulfur
creating a more stable compound in nitrogen mustard.
1943 A German air raid in Bari, Italy leads to the exposure of
more than a thousand people to a secret cargo of mustard gas bombs on the SS
Autopsies of the victims suggest that profound lymphoid
and myeloid suppression occurred after exposure.
Dr. Stewart Francis
Alexander theorizes that since mustard gas all but ceased the division of
certain types of somatic cells whose nature was to divide fast, it could also
potentially be put to use in helping to suppress the division of certain types
of cancerous cells.
The British and US governments cover up the
presence of mustard gas and its effects on victims of the raid.
Mustard Gas disaster in Bari harbour
oncologists take it for granted that response
to therapy prolongs survival,
an opinion which is based on
a fallacy and which is not supported by
clinical studies." -
carmustine, cisplatin, cytarabine
Carmustine is a mustard
Carmustine, also called BCNU
(1,3[bis]-2-chloroethyl-nitrosourea), decomposes spontaneously into a
chloroethyl hydroxide that can alkylate the DNA and into
an isocyanide molecule, which may
produce carbamylation of proteins. Cytotoxicity is caused by DNA
Cisplatin is a platinum-based compound;
Cisplatin, mode of action has been linked to its ability to crosslink
with the purine bases on the DNA; interfering with DNA repair mechanisms,
causing DNA damage, and subsequently
inducing apoptosis in cancer cells.
Cytarabine is an
antimetabolite antineoplastic agent that inhibits the synthesis of DNA with
Cytarabine is metabolized
intracellularly into its active triphosphate form (cytosine arabinoside
triphosphate). Cytosine arabinoside interferes with the synthesis of DNA. Its
mode of action is due to its rapid conversion into cytosine arabinoside
triphosphate, which damages DNA when the cell cycle holds in the S phase
(synthesis of DNA). Rapidly dividing cells, which require DNA replication for
mitosis, are therefore most affected. Cytosine arabinoside also inhibits both
DNA and RNA polymerases and nucleotide reductase enzymes needed for DNA
Lymphoma Treatment Regimens
selection, dosing, administration, and the management of related adverse events
can be a complex process that should be handled by an experienced health care
team. Clinicians must choose and verify treatment options based on the
individual patient; drug dose modifications and supportive care interventions
should be administered accordingly. The cancer treatment
regimens below may include both U.S. Food and Drug Administration-approved and
unapproved indications/regimens. These regimens are provided only to
supplement the latest treatment strategies. These Guidelines are a work in
progress that may be refined as often as new significant data become available.
The NCCN Guidelines® are a consensus statement of its authors regarding
their views of currently accepted approaches to treatment. Any clinician
seeking to apply or consult any NCCN Guidelines® is expected to use
independent medical judgment in the context of individual clinical
circumstances to determine any patients care or treatment. The NCCN makes
no warranties of any kind whatsoever regarding their content, use, or
application and disclaims any responsibility for their application or use in
side effects of systemically administered chemotherapy
of Possible Side Effects for Commonly-Used Oncology Drugs
overall contribution of curative and adjuvant cytotoxic chemotherapy to 5-year
survival in adults was estimated to be 2.1% in the USA . It is clear that
cytotoxic chemotherapy only makes a minor contribution to cancer survival." -
Graeme Morgan, Robyn Ward, and Michael Barton
2006 Chemotherapy impairs the brain, killing crucial
neural cells and
causing key parts of the
brain to shrink.
New findings add to a growing body of evidence
suggesting that the mental fuzziness,
memory loss and
cognitive impairment often reported by cancer patients but often dismissed by
oncologists - is a serious problem.
Key areas of the brain including the
prefrontal, parahippocampus and cingulate gyri shrink during chemotherapy.
The damage continues for several
months after chemotherapy is stopped.
MRI scans show cause of chemobrain
"Nearly every chemotherapy
patient experiences short term problems with memory and concentration.
But about 15% suffer
prolonged effects of what is known medically as chemotherapy induced cognitive
The symptoms are remarkably consistent:
a mental fogginess that may include
problems with memory, word retrieval, concentration, processing numbers,
following instructions, multitasking and setting
priorities." - Jane E. Brody
"Those of us on the front lines have known
this for a long time, now we have neuropathological evidence that
what we are seeing involves an
anatomic change." - Dr. Stewart Fleishman*, director of cancer supportive
services at Beth Israel Medical Center and St. Luke's-Roosevelt Hospital
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