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Korean Journal of Epidemiology 1988;10(1): 64-74.
암관리를 위한 연구현황과 과제
이원영, 김정순
Current status of cancer research and future goals
Won Young Lee, Joung Soon Kim
Abstract
The current status of cancer research have been briefly summarized to clarify the problems remained to be solved for the cancer control. Cancer control program can be divided into three steps which are the general principle of disease control; the primary, the secondary, and the tertiary prevention. For the primary prevention, it is neccessary to iden¬tify the etiologic agent for the desease to be controlled. It has been reported that the agents associated with human cancers cannot be singled out. Furthermore, the genes which act a critical role(s) in pathways of tumorigenesis are our own in every normal cells. Thus, the primary prevention for the cancer can not be applicable at present except for the public health education especially when a certain risk factors are avoidable by changing human behaviors and working environments(eg; smoking and lung cancer). The tertiary prevention provides measures to help the persons recovered from the cancer to adapt to the society. However, this is applicable only when the secondary prevention measures are satisfactory and successful. Therefore, the only step we have to put our major efforts for the cancer control today may be the field of research for the secondary prevention. Since the secondary prevention depend upon the measures for the diagnosis and therapy for the patients suffering from the cancer, this is the urgently needed field not only for the patients but also the medical workers in this fields. Chemotherarpy and radiotherapy except surgery are the methods of cell killing by use of cytotoxic effect of the chemotherapeutics and radiation. The others are hyperthermia and photodynamic therapy which are not widely used at present. All of these methods have the limitation in use mainely due to the lack of the specificty. One of the methods to increase the specificity of these method were the introduction of the immunologic tools including monoclonal antibodies which can be used independently or in combinatory ways. However, practical value of the methods were not so much appreciated due to the heterogeneic nature of the tumor cells in various aspects. Also the use of the various types of the biological response modifiers have been extensively studied for the clinical applications. Those have been proved to be strong immune-adjuvants in vitro. Their role(s) in vivo especially for the tumor control remained to be analized. Emergence of the resistant cells, especially the fraction of the stem cell population following tumor therapy regardless the types of the therapy, chemotherapy or radiotherapy is the major problem to be solved. Thus, it is necessary to develope highly sensitive and specific chemotherapeutic method which may kill only the tumor cells leaving the normal cells alive. Efforts must be focused on the search and development of new agents. This may be the primary task in cancer control today. Because the development of new agents includes not only the new source of chemeotherapeutics but also the agents which can provide a certain complementary fuctions to the defects found in chemotherapy, radiotherapy, immunotherapy, and hyperthermia to maximize the efficiency of the therapy.


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