The Challenging of Chemotherapy among the Cancer Treatments: The Fact and Meth of the Alternative

ABSTRACT


RADIOTHERAPY
The hypothesis of radiation induction suggests that the low levels of ionic radiation have an induction in its action for cellular biological processes such as the stimulation of DNA repair systems, which benefits many of the repair genes (Oliver, et al. 2004;Hickson, 2006) and also for the effectiveness of detoxifying enzymes by destruction the harmful ionic roots resulted from the radiation (Loken &Fenen, 1993). In addition to these benefits, there are side effects of treatment such as decomposition of stem cells parenchymal tissue, intestinal and lung fibrosis as well as hair loss (Suit &Todorok, 1995). The more innovative Radiological sensors techniques by utilizing Misiodozole and Nitroimidgole, came to be a very useful in the treatment of some cancers, which cause cell toxicity As a result of decreased blood flow in the capillaries feeding the tumor (Fertile and Malaie, 1995,).

CHEMOTHERAPY
It includes three types of chemicals with the important therapeutic role of cancer: 1 -To inhibit the activation of primary carcinogens to intermediate carcinogens, such as antioxidants (1996, eta Kornhauser), which include vitamins dissolved in water, fats, mineral elements and plant -derived chemicals. 2-Inhibitors of cancer initiation factors or factors that prevent cancer from interacting with vital centers in the cell (Siess. , etal 1992) 3-Inhibitors : factors that inhibit the late stages of the progress of cancer and include more than 1000 compound classified into 25 plant-derived compounds (Federall Register, 1993;Dragsted et al., 1993) Types of chemotherapy There are many types of drugs that can be included in the chemotherapy group, the most prominent of which are the following: 1. Alkylating agents This type of drug works to destroy the DNA inside cancer cells while they are in the resting phase of cell. There are several of them: Mustard gas derivatives It is used in most types of tumors, which include: Cyclophosphamide, Chlorambucil, Melphalan and Ifosfamide.

Alkylsulfonates
Used in the treatment of leukemia in particular, such as: Busulfan.

Nitrosureas
Which is unique and distinguished from most other types of chemotherapy in its ability to cross the blood-brain barrier, so it is used in the treatment of brain tumors, such as: Carmustine, Lomustine, and Streptozocin.
Metal salts Corresponding Author: Dr. Chateen I. Ali Pambuk Which are used in the treatment of bladder, testicular, ovarian, and other cancers, such as: Carboplatin, Cisplatin, and Oxaliplatin.

Plant alkaloids
This group is extracted from some types of plants: Vinca alkaloids This group is extracted from the so-called sea snail, such as: Vincristine, Vinblastine, and Vinorelbine.

Taxanes
It is extracted from the yew plant of the coniferous family. This group is used to treat breast and uterine cancer, such as: Paclitaxel and Docetaxel.
These two groups are inhibitors of cell tubules that transport proteins and organelles and play an important role in cell division and proliferation, which leads to cell paralysis and prevents its proliferation when using one of these two groups drugs.

Podophyllotoxins
It is extracted from the leprosy plant. It is used as an antiviral in viral warts. It has properties that disrupt the stability of cell microtubules, disrupting their work and increasing the decomposition of their genetic material by inactivating the enzyme topoisomerase II inhibitors that enter the work of DNA, such as: Etoposide and teniposide (Tenisopide).

Antitumor antibiotics
This group is so named because it is extracted from a family of bacteria similar to Streptomyces. This group affects cells during certain phases of their cycle via free radicals that break down the cell's DNA.
Despite its serious side effects, such as its effect on the heart, kidneys, and lungs, it is one of the most effective chemical treatments to date. Examples include the following: Anthracyclines, such as: Daunorubicin and Doxorubicin, used in most types of solid tumors, leukemia and lymphoma. Dactinomycin, which is used in pediatric tumors. Bleomycin, commonly used in testicular cancer.

4.Antimetabolites
The action of this group is based on its symmetry or similarity with basic substances that enter into the formation of the cell's DNA, replacing them to nullify its work, which leads to the inhibition of the DNA and thus prevents the proliferation of cancer cells.
Among these basic substances are folic acid, purines, and pyrimidines, which are replaced by the following drugs: Methotrexate. 5 -Fluorouracil, used in the treatment of colon cancer, and as an ointment for the treatment of basal cell carcinoma.
Azathioprine, which is converted in the body to 6mercaptopurine, used to treat leukemia. Chemotherapy properties The main characteristics of chemotherapy are as follows: 1. It is used to reduce or destroy the growth of carcinogenic cells The most prominent uses of chemotherapy are in destroying cancer cells, but unfortunately it also destroys healthy cells, especially cells that divide more quickly than other cells, such as: hair follicles and blood cells. 2. Chemotherapy drugs differ in how they work Chemotherapy is not a single drug, the effect of each of these drugs on cancer cells is separate from the effect of others, and its effect on a particular tumor differs from its effect on another tumor. Even the side effects of one chemotherapy drug are different from the side effects of other drugs.
4. Not all tumors respond to chemotherapy Some of them respond greatly, close to complete recovery, some respond to a lesser extent, and some of the cancerous tumors do not respond at all, depending on the type, classification and degree of the tumor.
Also, sometimes chemotherapy is used only to reduce symptoms or to try to prolong the patient's life.

Chemotherapy is used alone or as a supplement
Chemotherapy is used in conjunction with radiotherapy or surgery. Chemotherapy is either used before radiotherapy or surgery to reduce the size of the tumor before the operation (Neoadjuvant), or after surgical removal to eliminate the remaining small-sized cancer cells (Adjuvant).
6. The mechanism of chemotherapy varies from one drug to another The chemotherapy protocol governs the use of more than one drug of different duration of action and the goal is to reduce the resistance of cancer cells.
Some treatment protocols have introduced the use of modern methods that may improve the therapeutic outcome, such as electro-chemo-therapy or thermal-chemo-therapy.
So that a certain amount of high-voltage electrical pulses is applied to the tumor or a certain amount of heat increases the amount of chemotherapy passing through the membranes of cancer cells, and thus chemotherapy achieves higher effectiveness on the one hand, but on the practical level, these methods did not show any differences in the lifespan of patients.

IMMUNOTHERAPY
Immunodeficiency is one of the leading causes of cancer the proliferation of natural and cancerous cells depend on molecules produced from immune cells known as immunokines e.g Cytokines, Interleukins and Interferons . (Rosenberg, 1997) Corresponding Author: Dr. Chateen I. Ali Pambuk The immunosuppressant and anti-inflammatory prednisone, which may act on programmed cell death, is used as part of chemotherapy rather than alone. Monoclonal antibodies, which are used in the treatment of cancer, are directed against the enzyme tyrosine kinase, which is the key to opening and closing biological processes in the cell and is linked to the formation of oncogenes that prevent the formation of antibodies. Trastuzumab is an antibody that blocks the action of tyrosine kinase (HER-2), whose overtranslation in the body leads to breast cancer. Rituximab is an antibody to the immune receptor used in the treatment of lymphoma.

HORMONAL THERAPY
It involves the use of a drug that replaces or interferes with endocrine functions that leads to tumor inhibition of induced or non -induced mammary glands (Oklsborne et al., 2000;Weisch, et al., 1998). Act as inhibitors for biosynthesis of estrogens and other classes acting as inhibitors or inducers of the biosynthesis of milk hormone like Bromo cryptine (Weisch, etal 1990 ;Weisch & DeHoog, 1993) It is usually used alongside chemotherapy in certain cases of tumors, as some tumors use hormones to grow in the body. If the percentage of hormone increases, the tumor grows with it, and if its percentage decreases, the tumor shrinks, and here lies the role of hormonal therapy, such as breast cancer, endometrial cancer, and cancer Testicular, prostate cancer, ovarian cancer and others.
Prostate cancer in men is associated with a high level of testosterone, so it may be used as direct and indirect inhibitors of male hormones, including Leuprorelin, Goserelin, and others.
As for breast cancer, its growth may be sensitive to the level of the female hormone estrogen or progesterone, or both.
One of the most popular hormonal drug treatments for estrogen-sensitive breast tumors is tamoxifen, which blocks estrogen binding in the breast and is also approved as a preventative treatment for breast cancer.
There are many other drug treatments that reduce estrogen by inhibiting the enzyme that converts part of the fat into hormones, and there is also something that works to reduce the secretion of hormones from the source of control, which is the pituitary gland in the brain.

OZONE THERAPY
Ozone stimulates the effectiveness of antioxidant enzymes and stimulates the secretion of interferon and tumor necrosis factor TNF (Pryor and Lightsey, 2003;Kennedg etal, 1999) , but with Some negative aspects as it inhibits enzyme inhibitors (Cycolxygenase) necessary for bio-synthesis of prostaglandins which leads carcinogenic increase (Schelyle, etal 1997).

SURGICAL THERAPY
This technique is the one for treating solid tumors and involves the removal of Carcinogenic tissue. (bourgaize , al et 2000), including blood vessels feeding tissue and lymphatic glands. This technique is considered effective for treating various cancers as prostate and uterine cancers and breast cancer.
Plant ingredients have been known to be the effective source of many diseases, as most of the medicines currently known and used are plant constituents (Craig, 1999,) . And that many of these components are important in the treatment and reduction of cancer (Ghersi , et al 2005), and that one of these compounds is proteoglycan isolated from a plant it works to inhibit the growth of cancer tumors in rats Lewis lung strain by up to 77% of the weight of the tumor (Meng , et al 2002) , and the lycobetaine is a calcoidal compound found in the grass, Lycaris radiate, which has the ability to treat cervical, ovarian and stomach cancer. Soybeans also contain high concentrations of Genistein, a flavonoid, and there is evidence that this substance Depresses a number of cancers such as stomach, pancreas and stomach cancer and also liver and Prostate by preventing the growth of new blood vessels in tumors (Duke , 1993