Deciphering the genetics of cancer "Precision Cancer Medicine", planning precise treatment



By...Dr. Vikrom Gennetisin, internist specializing in oncology and chemotherapy, Vejthani Hospital


from the National Cancer Institute. Found that new cancer cases in 2021 are as many as 139,206 people per year and of these 84,073 deaths per year. The 5 most common cancers in Thai people are liver and bile duct cancer and breast cancer. Lung cancer, colorectal cancer and cervical cancer

Cancer treatment today has evolved in terms of screening technology. chemotherapy That can reduce side effects and receive treatment that is more specific to each individual patient.

The most important thing in cancer treatment is to find out the cause of each person's cancer. The search can be done by examining the patient's cancer cells. that the abnormal cells that cause cancer arise from what mechanism And what drugs can block the mechanisms that cause cancer? We will be able to choose the right drug. It's more personalized and more efficient. We will call this treatment Precision Cancer Medicine because cancer of the same organ. May be caused by cancer cells that have different disease mechanisms

"Precision Cancer Medicine" is the analysis of cancer cells to obtain more information than the type, stage or appearance of the cancer. Rather, it will be a specific test down to the cancer genetic code level. which the doctor will use to draw blood or patient tissue Take it for diagnostic testing in the laboratory. and analyzed on a central database What we call Big DATA, which can indicate the mechanism of disease. that are different for each individual This allows doctors to choose the right cancer drug. Reduce or avoid unnecessary medications. This makes it possible to reduce and avoid side effects that are likely to occur in the first place.

In Precision Cancer Medicine, the genetic code of each patient's cancer cell is obtained from a biopsy. to be analyzed through a gene analyzer To see the abnormality and mutation of the genes in detail, and then compare the data on a central database called Big DATA, which will let us know what kind of cancer patients have abnormalities and how we can Which method of treatment will be the best and the most effective?

The treatment must be analyzed, including the underlying disease, concerns, and the patient's requirements. For example, some people may be afraid of hair loss. We will have a method of treatment that meets the needs and works for this patient. Therefore, Precision Cancer Medicine is designed to be truly personalized.

Once physicians have identified the underlying causes of cancer through Precision Cancer Medicine, their cancer drug planning can be more specific and effective. The treatment methods range from

1. Anti-hormonal therapy (Hormonal Therapy) is a drug that inhibits the work and or the creation of sex hormones. This can inhibit the growth of cancer cells that are stimulated by sex hormones, such as prostate cancer in men and breast cancer in women, etc.

2. The use of targeted therapy (Targeted Therapy) from the results of the analysis of the mechanism of cancer of each patient. Let us know which mechanism or changes in the cancer genetic code. that makes normal cells turn into cancer cells We will choose drugs that directly inhibit specific mechanisms. making it possible to treat cancer on the spot

3. Treatment with immunotherapy drugs Immunotherapy is a switch that allows the immune system to kill cancer cells more effectively. It is suitable for cancer cells that have been shown to respond well to immunotherapy.

4. Treatment with cell therapy (Cell therapy). We can strengthen cells in the immune system. related to the mechanism of elimination of cancer cells, supplementing the patient by choosing a supplement to suit the physical condition of each patient and specific to the disease or cancer cells of each patient

5. Cancer vaccine treatment (Cancer Vaccine) is a treatment for cancer that has already occurred. The vaccine is specific to each patient's cancer cells. It helps to slow or stop the growth of cancer cells. reduce the size of the tumor Prevent cancer recurrence or eliminate cancer cells that are not killed by other treatments such as surgery, radiation, or chemotherapy.

Therefore, Precision Cancer Medicine is a new alternative for cancer patients. in order to receive treatment that is more targeted and personalized This results in good results and reduces the occurrence of side effects.

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