Treatment strategies in cancer from past to present

For many centuries surgery is the most commonly used cancer management. However curing knew that cancer would come back, with such an invasive method. For this reason, the use of therapeutics were engaged with this need. In the 19th century, regressive effects of hormone therapy on breast and prostate cancers were assessed. The invention of X-rays led to the use of radiation in cancer treatment. After a while, the cancer-causing effect of radiation was recognized and a need for new methodologies arose. For this reason, proton beams were used instead of X-ray radiation and chemical modifiers were developed, both to sensitize tumor cells to radiation and to protect normal cells. Chemical agents have been used since it was noticed during World War II, that they could kill cancer cells by damaging their DNA. Over time, novel chemotherapeutics were designed with minimum side effects and to maximum activity. Synchronous with the improvement of knowledge on cell biology, immunotherapeutic agents were engaged that could mimic normal cell growth process. However, because all these therapeutics have a mortal effect both on healthy and cancer cells, targeted therapies should be preferred. Targeted therapies act by affecting the pathways responsible in cell growth, division, and spread of cancer cells. Following scientific and technological developments, new approaches have arisen, such as gene-therapy, stem cell therapy, immunotherapy, and nanotechnology derived therapies. Combination of chemotherapeutic with nanoparticles is a novel approach that is being used in the treatment of cancer. With the development of imaging technologies and diagnostic methods, many cancer types may be detected in much earlier stages. The more cancer signaling pathways are determined, the better the diagnostics and therapies will be achieved. Topics in this chapter can be summarized as surgical resection, radiation therapy, chemotherapy, ımmunotherapy, novel and target-specific therapies, and future perspectives. The main aim of this chapter is not to give exact information about survey of the current studies in this area since it is not possible to reach whole information of preclinical or clinical research.