Sunday, December 3, 2017

Chemotherapy Helping Tumors to Grow?

Researchers at Harvard Medical School recently studied the remains of tumor cells that were killed by chemotherapy or other cancer treatments. What they discovered is was quite alarming. These treatments or therapies can stimulate the growth of the tumor. This is done by triggering an inflammatory reaction. Chemotherapy is just supposed to kill cells not package them up and transport them out of the body. The dead cells that re left behind have the ability to stimulate the productions of proimflammatory cytokines. These cytokines are signaling molecules that promote tumor growth.
            In their study, they killed laboratory cultured cancer cells with different types of cytotoxic or targeted drugs. They then injected the debris into mice containing a small amount of living cancer cells that were not able to proliferate on their own. The results showed that the treatment contributed to cell growth. More research showed that the dead cancer cells have phosphatidylserine, a lipid, exposed on their surface. This lipid triggers the proinflammatory cytokines.
            This group went on to test if clearing out the debris would help this situation. The results can be read in the paper below. The question that is burning in the back of my mind while reading this is “Why are we continuing to administer chemotherapy and other cancer treatments if there is research showing that it helps the tumors grow?”
            Chemotherapy is known for its ability to make the patient extremely sick, cause loss of hair, and make them extremely susceptible to infection. Patients have a hard time eating due to the extreme nausea. On top of everything, 15%-25% of patients with cancer are diagnosed with depression. It brings up the ethical value of non-maleficence and not wanting to cause more harm than is already done. If we know the cancer could or is trigger the proinflammatory cytokines and allowing the tumor to grow, then should we be giving the patients chemotherapy in the first place?
Obviously, each patient is an individual case and cost to benefit is examined on an individual basis.  Finally, it is always the patient’s decision. 
Megan L. Sulciner, Charles N. Serhan, Molly M. Gilligan, Dayna K. Mudge, Jaimie Chang, Allison Gartung, Kristen A. Lehner, Diane R. Bielenberg, Birgitta Schmidt, Jesmond Dalli, Emily R. Greene, Yael Gus-Brautbar, Julia Piwowarski, Tadanori Mammoto, David Zurakowski, Mauro Perretti, Vikas P. Sukhatme, Arja Kaipainen, Mark W. Kieran, Sui Huang, Dipak Panigrahy. Resolvins suppress tumor growth and enhance cancer therapyThe Journal of Experimental Medicine, 2017; jem.20170681 DOI: 10.1084/jem.20170681 


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