This lesson will have us consider the medications used to treat cancer. Because this is such a specialized area and is rapidly changing, our conversation will be limited to a review of general cancer disease concepts and an introduction of the broad categories of antineoplastic medications.

Considering cancers

Let’s be precise for a minute: All cancers are neoplasms, but not all neoplasms are necessarily cancers. For example, the harmless raised mole on your cheek or the extra skin hanging off of grandpa’s neck are both neoplasms-but not cancers. That being said, we are referring to anticancer effects when we talk about antineoplastic medications. Keep your dictionary handy because each cancer’s name gives a clue. For example, leuk (white blood cells) emia (blood) refers to abnormal amounts and types of white blood cells. Likewise, sarc (muscle) oma (tumor) indicates a tumor in muscles.

Cancer is not a rare phenomenon. The American Cancer Society (ACS) estimated there would be 1,339,790 new cases of cancer and 564,830 deaths in 2006.

Did you know: The ACS also estimates that approximately half of all American men and one-third of American women will develop some form (ranging from relatively harmless to lethal) of cancer in their lifetime! It’s easy to see why there is such an extraordinary interest in new and more effective cancer treatments.

What is cancer? Cancer cells don’t undergo normal proliferation and differentiation; they fail to “play nice” with other cells. The dangerous ones share a cluster of characteristics:

• They are undifferentiated and bear little resemblance to the normal tissue from which they arose
• They grow and infiltrate or destroy surrounding tissue
• Growth rates are variable, with the least differentiated growing at the fastest rate
• Cells can break off from primary sites and migrate to distant locations through the blood or lymph circulation
• Cancers can cause non-specific or generalized effects such as anemia, weight loss, and weakness
• Cancers frequently cause death because of their uncontrolled growth

The goal of antineoplastic medications, or chemotherapy, is to kill the cancer without killing the patient. This is a huge challenge due to the significant anatomic and physiologic characteristics that are common to both normal host cells and malignant cancer tissue. Remember, as always, that up-to-the-moment information is not likely to be found in books. You can find some great information on the Internet:

Click: The U.S. Food and Drug Administration Center for Drug Evaluation and Research’s oncology tools page is a great starting point.

Click: Select the name of a particular drug, and you will find comprehensive information on MedlinePlus MedLinePlus that you can share with your patients using lay language rather than professional terminology:

Click: Cancer Care Ontario is another comprehensive site that provides practical information for both consumers and healthcare providers:

Editor’s note: This excerpt is adapted from our new book, Stressed Out About Pharmacology, which is set to release next month. Every Wednesday until its release, we will feature a new section. To read last week’s excerpt, click here.