"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.
Ehrlich elaborated the systematic testing of
chemical compounds as now practiced in the pharmaceutical industry in clinical
Ehrlich's work illuminated the existence of the
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
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 John Harvey.
the victims suggest that profound lymphoid and myeloid suppression occurred
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.
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
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 is a mustard gas-related compound;
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
Cytarabine is an antimetabolite antineoplastic
agent that inhibits the synthesis of DNA with immunosuppressant
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 synthesis.
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
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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