Medical Management of Malignancies

Cancer is a genetic disease resulting from the mutations, either inherited or acquired, altering the normal genes to abnormal ‘oncogenes’. These in turn lead through a complicated cascade of biochemical signals to uncontrolled proliferation of the affected cells, which have the properties of autonomy (independent growth), metastasis (spread to other organs), dysplasia (altered structure of the cell) and clonality (same origin of cells). These malignant cells lead to death of the patient by uncontrolled growth, widespread metastasis, malnutrition, and other systemic effects. For earliest clinically detectable tumor, 10 cells are required and 10 cells for death of the patient. To achieve cure, all these cells must be eliminated and presence of a single cell, at the end of treatment, can lead to recurrence and death (Skipper’s postulates).