Cancer, Anticancer Drugs and the Historical Development of Anticancer Drugs

Cancer is the name given to malignant tumours that appear as a result of DNA damage in cells in various parts of our body, leading to uncontrolled cell proliferation; it does not describe a single disease but is a general disease designation encompassing more than 100 disease groups. Despite the wide variety of cancer types, all of them begin with uncontrolled proliferation of cells that have suffered DNA damage. The oldest known document on cancer and its treatment is the Edwin Smith papyrus, discovered in Egypt and believed to have been written around 1600 BCE. Since the use of the Latin word for cancer as the name of the disease began centuries later, this word is not used in the papyrus. However, it mentions the treatment of eight cases of tumours or ulcers using the cauterization method, whose descriptions suggest that at least some of them could have been cancer. Similarly, the Ebers papyrus, written in Egypt around 1550 BCE as a compilation of medical texts of the period, includes treatment of similar cases. The word cancer was first created by Greek physician Hippocrates. Hippocrates used the terms carcinos and carcinoma for ulcer-forming and non-ulcer-forming tumours. Healthy cells in our tissues have the ability to divide. They possess this property for the renewal of dead cells and the repair of damaged tissues. However, the ability of cells to do this is limited; they cannot divide infinitely. Each cell has a certain number of divisions possible. Cells die after a certain time, which is called apoptosis, or programmed cell death. Normally, for the body to function healthily and properly, cells need to grow, divide and produce more cells. Sometimes the natural process goes awry, and cells continue to divide even when new cells are not needed. Cancer cells that have lost control begin to divide uncontrollably and multiply. The masses of excess cells form a lump or tumours. Tumours can compress, penetrate into, or destroy normal tissues. If cancer cells separate from the tumour where they originated, they can progress to other parts of the body through blood or lymph circulation, forming tumour colonies in the places they reach and continuing to grow. The spread of cancer in this way to other parts of the body is called metastasis.

Cancer is classified according to the organ where it begins to form and its appearance under the microscope. Different types of cancer cells grow at different rates and spread through the body in different ways. For this reason, different treatments are applied depending on the type of cancer in the treatment of cancer disease.

For this reason, anti-cancer drugs used in cancer therapies vary. Chemotherapy occupies an important place in the treatment of cancer disease. Chemotherapy is the treatment of cancer with drugs. Chemotherapy attempts to kill cancer cells or slow the growth of tumours. The drugs used are chemotherapeutics known as anti-cancer drugs or antineoplastic drugs. The objectives of chemotherapy can be listed as: treating cancer disease, preventing its transmission and spread to other organs, slowing tumour growth, eliminating these cells if they have spread elsewhere, and eliminating the discomfort caused by cancer disease. Drugs are distributed through the blood throughout the body to prevent the proliferation of uncontrollably growing tumour cells. Different classifications exist for anti-cancer drugs used from the first half of the 20th century to the present day according to their different properties; for example, they can be categorized according to their chemical structure, their sources of origin, their mechanisms of action, or their damage potential. Among anti-cancer drugs, cytotoxic chemotherapeutics are chemical substances that damage cells through mechanisms such as inhibition of certain cellular functions and thus cell division at a certain or any stage of the cell cycle, or induction of apoptotic or necrotic cell death. Natural origin chemical substances have been used in the treatment of diseases for centuries; today, one of the most well-known examples of these chemical substances is penicillins isolated from fungi of the Penicillium genus. As of 2009, drugs derived from natural sources constituted more than half of the drugs on the market. Drugs isolated from natural sources such as plants or microorganisms or developed through synthesis following isolation constitute an important percentage of cytotoxic anti-cancer agents in cancer treatment in the same way. Until the 2000s, 47% of 155 anti-cancer drugs approved and used in the world were composed of chemical substances derived from nature and their synthetic derivatives. Current cancer therapies do not provide entirely satisfactory treatments even in the 21st century, and new advances are being made every day in the field of drug development.

Prof. Dr. Zehra Nüket Öcal Sunguroğlu

In Respect, Affection and Longing…

Unfortunately, in 2018, we lost our esteemed professor Prof. Dr. Nüket Öcal, who was serving in the Department of Organic Chemistry at Yıldız Technical University. During the years she served, our professor trained many master's and doctoral students, wrote numerous articles and made significant contributions to science by serving as director in many TUBITAK projects. Before her passing, she wrote the TUBITAK project related to 'Synthesis and Activity Studies of New Heterocyclic Molecules that Could be Anti-Cancer Agents or GSK-3β Inhibitors' on which we worked together. As a scientist, she set an example to all her students through her diligence, determination and creativity. I remember my dear professor with respect, affection and longing, she who made us feel every day we spent together that we were a family. Dr. Ömer Tahir Günkara Yıldız Technical University Department of Chemistry Department of Organic Chemistry 7th Drug Chemistry Congress Congress Secretary