How Chemotherapy Works (in Consumer's Language)
Splitting chromosomes are killed by free radicals, in step 3 in mitosis
Chemotherapy in consumer's language
I will explain how chemotherapy works in plain language of a consumer. I have relatives who died of cancer; had witnessed how they suffered. My sister-in-law had lung cancer. I tried to alleviate her pain when her cancer was already at stage IV, or metastatic lung cancer. The knowledge I gained from literature research and interaction with doctors came too late to help her. My discussion will be tagged as “must reading” that must not be skipped; and “optional reading” that may be skipped. The latter further explains “must reading.”
Chemotherapy drug (must reading)
Chemotherapy is the use of drugs to kill cancer cells. The drug is given either by means of infusion (IV) or by mouth in capsules. The solution is injected to the body; it drips from a bottle or bag, flows down through a flexible tube and a small needle that is inserted to an artery.
The drug is either a single agent or a combination. For example, Adriamycin (doxorubicin) alone or AC that consists of Adriamycin and cytoxan (cyclophosphamide). The dose depends on the severity of cancer.
Active ingredients of the drug is carried by the blood to every cell of the body. That is to anywhere cancer cells had lodged to form a colony. Cancer was formerly a tumor that continued to grow uncontrolled and had breached the cell matrix that confined it. Tumor cells had escaped to the blood or lymph fluid and spread to other cells in a process called metastasis. A kind of cancer maintains its identity. A breast cancer that lodged in the bone will be identified as breast cancer not as bone cancer, which is different.
Adriamycin produces a lot of free radicals (Sharma, H. MD. Freedom from Disease. 1993). The active agents of a chemotherapy drugs are free radicals and their derivatives that kill cancer cells.
What is a free radical? It is an atom or a molecule or a fragment of a molecule with at least one unpaired electron. This unpaired electron is unstable and to stabilize itself grabs one electron from a neighboring molecule that is injured. If the grabbed electron belongs to the DNA (deoxyribonucleic acid) of the heredity material (chromosome), DNA becomes injured. This injury results in mutation that results, in turn, in tumor or cancer. That is for the formation of tumor or cancer. How about the killing of cancer cell?
Free radicals and reactive oxygen species (optional reading)
An atom of oxygen has eight electrons that are supposed to pair up and spin around the nucleus along a path called orbital. Atomic oxygen has three orbitals. Two electrons occupy the first orbital; four electrons pair up and occupy the second orbital. The last two electrons do not pair up. Each spins around the nucleus separately. The last orbital of oxygen is empty that attracts electrons of other elements for oxygen to form a compound like nitric oxide (NO), a compound of nitrogen and oxygen.
The two unpaired electrons in the orbital of atomic oxygen is unique to oxygen. No other atom in the universe has this feature. Each unpaired electron grabs another electron to stabilize in a process called oxidation.
Molecular oxygen is the kind that we breathe. It is composed of two atoms of oxygen with two unpaired electrons. This time, these electrons spin around the whole molecule in parallel direction. Due to this spin molecular oxygen does not react with non-radical molecule like most biological molecules. That is why the body will not spontaneously burn. However, molecular oxygen propagates a reaction that is started by reactive oxygen species like hydrogen peroxide. One result of that propagation is lipid peroxide that adds to the plaque of an artery of a person with heart disease.
Singlet oxygen is another kind of oxygen. It was formerly a molecular oxygen that was hit by ultraviolet rays from the sun also called ionizing radiation. The energy of ultraviolet rays excites one unpaired electron and reverses its spin (Prasad M. Heavy Metals in Plants. 1999). Thus a singlet oxygen has two unpaired electrons that spin in opposite directions.
Singlet oxygen is more destructive than molecular oxygen. The two unpaired electrons of singlet oxygen can grab other electrons at the same time owing to their opposite directions. Unpaired electrons of molecular oxygen can grab other electrons one at a time owing to their parallel direction of spin. To recall, molecular oxygen does not react with a non-radical.
Superoxide is a free radical that was formerly a molecular oxygen. The latter is used in the metabolism of glucose to produce energy whose by-product is superoxide. It has one unpaired electron. One superoxide molecule reacts with another superoxide, catalyzed by superoxide dismutase (SOD), an enzyme. SOD attaches one proton and one atom of hydrogen to the mixture and turns it into hydrogen peroxide with unpaired electrons (Sharma, H. Freedom from Disease. 1993). Hydrogen peroxide is also called reactive oxygen species (ROS) that acts like a free radical. There are more free radicals and ROS, we discuss only a few for demonstration.
How a free radical or ROS kills a cancer cell (must reading)
When a free radical or ROS grabs an electron it causes injury to the molecule whose electron had been grabbed, thus an injury to the tissue made up of injured molecules. In overdose, free radicals and ROS kill any cell, whether that of tumor, or cancer, or a healthy cell. It mutates or changes the nature of the cell. That mutation is in the form of shortening, deletion, thickening, or thinning of the chromosome. A tumor or cancer cell that sustained mutations cannot assemble proteins with which to grow. This cell may be able to revitalize its capability to undergo apoptosis or programmed cell death. Except brains cells, nerve cells and cardiovascular cells, all other cells undergo apoptosis. In apoptosis, the nucleus of cell shrinks, no inflammation. Healthy neighboring cells engulf the dead cells. In a way, apoptosis throws away damaged cell. The effect of chemotherapy is either halt in the growth of cancer cell or regress (die back).
We said that free radicals or ROS kill both cancerous cell and healthy cell. That is why chemotherapy should be highly targeted. But that is easier said than done.
Chemo drugs kill red blood cells, white blood cell, and platelets and lower blood count. That is why chemo sessions are scheduled far apart to allow these blood cells to replace those killed ones. It is essential that a fellow being given chemo has a high blood count. Chemo kills the fast growing cells, bone morrow, including hair cells; that is why a fellow undergoing chemo losses hair (Schiller, J. H. MD et al. 100 Questions & Answers about Lung Cancer. 2010).
A cell grows by dividing. One cell duplicates itself in a process called mitosis. This has four phases. In one phase, the one chromosome duplicates itself then the duplicates split. The new chromosomes get together and form a new daughter cell. The chromosome is vulnerable to free radicals and ROS when the duplicates are splitting. (See illustration above) So, one cell duplicates itself resulting in two cells; two cells duplicate resulting in four cells; four cells duplicate resulting in 16 cells, and so forth and so on until a limit is reached. Cell duplication is cell growth. Mutated cell continues duplicating beyond the limit and does not undergo apoptosis. That is why it is immortal that makes for tumor or cancer.
What happens to irreplaceable cells? (optional reading)
What happens to damaged but irreplaceable cardiovascular cell, like artery or heart valve? The damaged inner wall of the artery accumulates deposits of collagen, elastin, fibrinogen, bad cholesterol and calcium apatite. The damaged cell is never thrown away by apoptosis. That is why conventional medicine says that there is no cure for heart disease (hardened heart artery). However, the plaque can be eroded by means of chelation therapy. Stem cells help the artery in its recovery. The endothelium progenitor stem cell that circulates with the blood rebuilds damaged cells once the plaque had been eroded away.
What happens to the damaged nerve cells? They graduate into motor neuron disease (MND) also called amyotrophic lateral sclerosis or multiple sclerosis (MS). Fortunately, the first and the only time that nerves are formed, a lot of them are formed. But not all of them are put to use; some are held in reserve. These take the place of damaged ones. That is why it is important to protect nerve cells. If no enough nerve cells are left after damage inflicted by free radicals and ROS, MND and MS may arise.
What happens to the heart valve damaged by free radicals? The bacterium Streptococcus pyogenes causes rheumatic fever and also attacks the heart muscle, particularly valves like the mitral valve. The macrophages, components of immune system, shoot the bacteria and infected cells with nitric oxide (NO), a free radical produced by the inducible endothelium nitric oxidase (iNOS). NO/iNOS is used like bullets that also hit healthy cells of the mitral valve that sustains scars. These scars remain then graduate into stenosis that interfere with the closure of mitral valve resulting in the backflow of blood. And you have rheumatic heart disease. Prolapse that occurs during adult age can be remedied by chelation therapy, according to Dr. Arturo V. Estuita, MD a Filipino internist and chelationist. A damaged mitral valve can be replaced with an artificial valve. The valve from a pig heart is suitable but not used because pig is host to virus.
Why does cancer cell continue growing? (optional reading)
.A cell has signals or switches that control duplication of cells. One of them is the gene p53 that is also called a suppressor gene. However, free radicals and ROS also mutate p53, so mutated, p53 cannot do its work like a street stop light. It is always switched green, meaning “GO.”
If normal, p53 can stop cell growth in two points in the interphase of mitosis; that is, before duplicates split up. I have a Hub on how colon cancer develops from polyps where I discuss this matter.
Conventional medicine that uses chemotherapy will not mention free radicals in chemo drugs. It says only that a disturbance in the DNA or mutation starts cancer. I have several Hubs like “Chemotherapy of Conventional Medicine Unintentionally Gives Evidence for Alternative Medicine” where I discuss the reasons.
Editing as of July 4,2012.
"....Chemotherapy or hormone-blocking drugs are given to relieve symptoms and improve quality of life rather than to prolong life...." (The Merck Manual of Women's and Men's Health. 2003:232). Merck is a big pharmaceutical company.
Some ways to treat cancer
Immunotherapy applied by conventional medicine is one way to treat cancer, particularly skin cancer (Kaufman, H. The Melanoma Book. 2004). It kills cancer cells. It does not kill healthy cells.
Parts of the plant noni (Morinda citrifolia L.) in the form of tea, capsule, fresh fruit extract at concentrations as low as 2.5% kills colon cancer cells. This was found in a research done by staffs of the University of the Philippines, Manila campus that also runs the Philippine General Hospital.
The pink periwinkle or tsitsirika contains vinealeukoblastine that can kill cancer cells in leukemia. I have several Hubs on how medicinal plants prevent cancer.
Cord blood, obtained from the newborn and cryopreserved in a blood bank can be used to cure cancer. This method is called stem cell. i have Hubs on this topic.
New method to cure cancer
New entries as of Feb. 15,2013
These new entries serve two purposes. One, they add to evidences that free radicals kill cancer cells. Two, they give glimpses on a new technology that will cure cancer.
An experiment on mice was done. It showed that nitric oxide, a free radical, kills cancer cells. It kills healthy cells as well; however, its delivery can be very precise that it will not affect healthy cells. (I have a Hub on how this new technology is better that chemo that indiscriminately kills cancer and healthy cells).
Gene therapy. Our body produces very small amount of inducible nitric oxide synthase (iNOS) that produces nitric oxide (NO). So production of iNOS must be induced with the use of the gene that controls iNOS. This gene, when located, is cloned. NO kills cancer cells. iNOS gene must be delivered precisely to cancer cells. Delivery is done by means of a courier, the protein envelop of a RNA virus whose production is controlled by another gene. This gene can also be cloned. (Production of protein envelop is already being done in hepatitis B vaccine). Cancer cells exude markers called carcinoembryonic antigen (CEA). To enhance the specificity of delivery of iNOS to cancer cells, surfaces of cancer cells must be modified such that they accept only the protein envelop. This modifier is the antibody whose gene can also be cloned.
The genes of iNOS, protein envelop and antibody are mixed in a test tube, bound together with the use of hydrogen bonds then sewed up with the use of the enzyme ligase. The result is recombinant DNA that can be administered to the cancer patient like a vaccine.
Once the genes of iNOS are incorporated into the chromosomes of cancer cells, they produce nitric oxide that kill cancer cells. It is not necessary that all cancer cells will receive the iNOS gene because the cancer cells that received iNOS will affect the bystanders. iNOS can last for a generation. Eventually all the cancer cells will recover their ability to apoptose. That is why all cancer cells will be thrown away by apoptosis or programmed cell death. .
“The inducible nitric oxide synthase (iNOS) gene product yields nitric oxide (NO), which directly induces autotoxicity and cytolysis of bystander cells (Kuroki, M. “Gene Therapy in Cancer Via Use of a Retrovector Having a Tumor Specificity and Expressing Inducible Nitric Oxide Synthase.” Nitric Oxide Protocols. Hassid A. Editor. Second edition. 2004:201-211.
Autotoxicity means production of poisons; cytolysis means break up of cell membrane resulting in cell death; bystander cell means any abnormal neighboring cell.
"Our specifically targeted killing approach has several features that make it attractive for clinical gene therapy. First, the recombinant retrovirus obtained specifically bound to CEA-expressing cells. This prevents the uptake of virus by nontarget cells or CEA-nonexpressing cell, resulting in lesser side effects. Second, the targeted cells were directly killed by the biological product (NO/iNOS) of the therapeutic gene ...." (Same source as above, parenthetical supplied).
The delivery of genes on humans is already a common practice; it is called gene therapy. What remains to be done are the setting up of enterprises that grow the genes on virus and formulation of the solution that contains the virus like vaccine.
Then the application of this technology must be approved by the Food and Drug Administration, in the case of USA, or some such agency in other countries.