Chemotherapy, now and in the future

Mustard gas administered intravenously in the 1940s was the first chemotherapy drug. Though its benefits were temporary, doctors began to pursue other compounds that could kill cancer cells or hold the disease at bay. Today, there are more than 100 drugs used to combat cancers with others being developed in laboratories and tested in clinical trials, according to the American Cancer Society.

Guidance on treatment for gynecologic cancer or genitourinary / prostate cancers is also available.

Researchers are conducting trials to establish the best combinations of drugs and the most effective method of delivery, even pursuing methods which will deliver localized rather than systemic treatments. Particular treatments may not be useful for everyone, however; so researchers are fine-tuning ways to determine which patients will benefit.

Advances in treatment have greatly reduced mortality in some cancers such as breast and prostate, yet much work remains in diseases, such as melanoma, pancreas and bladder cancer. Perhaps the answers lie in newer types of compounds that address cancer on the molecular level. These targeted therapies are potent cancer killers yet less harmful to normal tissues and less toxic to patients.

A brief description of the medical oncology group's current interests includes:

• Anand Jillella, MBBS, a medical oncologist and director of the National Cancer Institute-funded Minority-Based Community Clinical Oncology Program at MCG, has seen many changes in treatment standards over the years.

• Paul Bilodeau, MD

• Teresa Coleman, MD, suspects bladder cancer, already the fourth most common cancer in males and the ninth most common in females, will become more prevalent as baby-boomers — and especially smokers — age.
• Paul M. Dainer, MD
• C. Lawrence Lutcher, MD

• Abdullah Kutlar, MD, director of the Comprehensive Sickle Cell Center at MCG, has broad experience treating sickle cell anemia. He is collaborating with the molecular oncology / genomics/epigenomics program.
• Amanda May, MD, says years of study lie ahead for researchers trying to understand melanoma.

• Russell Moores, MD

• Kavita Natarajan, MBBS, is participating in two clinical trials for rare cancers, cutaneous T cell lymphoma and myelofibrosis.
• Asha Nayak, MBBS, devotes much of her care to patients with colon and rectal cancer, two of the most common cancers in the gastro-intestinal track but works with all her patients to get them into clinical studies whether Phase I, II or III.

• Thomas Samuel, MD, who leads the Multidisciplinary Breast Cancer Team, has seen a dramatic change in treatment options in only the decade since he left medical school.