THE last decade has seen many changes and hopes in better treatment of Cancer. While the health department is on the verge of making starting pilot projects for early screening of cancer in 100 districts across the country – five are in Karnataka – on the curative side, newer treatment options are coming up.
On World Cancer Day, Deccan Herald takes a look at how stem cells have found itself in the thick of research action.
“Lots of changes have taken place in understanding of cancer. Latest research suggests that cancers originate from cancer stem cell, a root cell, that hides from the immune system of the body and proliferate,” said Dr N K Venkataramana, Vice chairman and chief neurosurgeon, BGS Global Hospitals.
The research has also found that the cancer stem cells, which hide in bone marrow, recruit the bone marrow cells and send them to different parts of the body to hunt for a good environment to proliferate. So, currently research was going on to find how the stem cells became cancerous, with thrust on targeted therapy, informed Dr Ashish Dixit, Hemato Oncologist, Manipal Hospital.
“If the key cancer stem cell is identified and target drugs on this cell, the other cells will disappear.
“The research indicates that the cancer stem cells can multiply but these are in limited numbers,” said Dr Radhysham Nayak of HCG Hospital.
Bone Marrow transplant
Among the plethora of stem cells that are found to have curative properties, bone marrow transplant (BMT) is the only established stem cell therapy that has an established protocol of treatment. BMT has been used for various blood cancers and some solid tumours in the body. Testicular cancer, small cell lung cancer, certain bone cancers have also be known to be treated with BMT.
However, owing to the high cost and risk of infection, this therapy is usually given as a salvage therapy – when the conventional chemotherapy and radiotherapy fail. Also, not every patient could be eligible for the transplant. “The patient needs to be in good condition after the regular therapy to stand the transplant, as mortality rate is at least 10-15 per cent,” said Dr Nayak.
“BMT does not kill the patient but any kind of infection, which occurs during the 10-12 day period when the patient’s antibodies are growing, can become lethal,” explained Dr M Vijayakumar, director in-charge, Kidwai Institute of Oncology.
Besides this, the treatment cost is high not because of the transplant but the antibiotics that are to be given to the patients after the BMT, he added. Hence, there was a need to include the treatment under medical insurance since the cost of BMT had not changed much in the last 10 years, said Dr Dixit.
The Kidwai Institute is resorting to harvesting of stem cells from peripheral stem cell, in other words, collecting the stem cells from the blood instead of BMT.
“We have been doing peripheral stem cell transplant for the last six years since it is one-fifth of the cost of BMT and the mortality occur after such transplant is unheard of,” Dr Vijayakumar said. The Institute has conducted peripheral stem cell transplant on 15 adult patients till now, all of whom failed to respond to regular treatment. The transplant has been done for lymphomas (solid tumours) and myelomas (blood cancer). In Manipal Hospitals, umbilical cord blood stem cells have also been used.
However, contrary to the claims made by some cord blood banks, cord blood stem cells are of value only if the bone marrow of the sibling does not match or is of partial match.
Therefore, said Dr Dixit, there was need for public stem cell banks where relatives also donated their cord blood stem cells.
(Published in Deccan Herald on 3rd February, 2010)