Cancer: Diagnosis and Conventional Treatments (Cancer: the Complete Recovery Guide Series Book 2)

None of the studies reported any adverse event associated with reflexology. Due to the lack of medical assessment data before or during implementation of reflexology, it is difficult to determine the safety of reflexology. Moreover, physicians must bear in mind that most patients use CAM to empower themselves in the management of their illness and thus may not be seeking evidence of safety. Yoga is an ancient healing system, inclusive of various asanas or poses with breathing techniques and meditation to assist in the movement and balancing of life force energy or prana.

Though a lot of evidence supports use of yoga as an adjunct treatment for cancer patients and survivors yet studies on Yoga contributing in improvement of pain scores are scant. Individual experiences of patients suffering from cancer have reported that Yoga helped them survive cancer better with strength, hope and vitality. As chemotherapy and radiation therapy pose tremendous stress and emotional burden on the patient complementary therapies like yoga can generate a feeling of well-being for the patient and promote the fighting capabilities. The deep, relaxing breathing often emphasized in yoga in cancer therapy also increases the current of oxygen-rich blood to the cells, delivering vital nutrients to tired cells and further clearing out toxins.

For those recovering from surgery, such as that for breast cancer, yoga can help restore motion and flexibility in a gentle, balanced manner. Out of the records screened, 16 full text research papers on RCTs were included in the review and only four such RCTs evaluated pain as one of the physical outcomes and only one RCT reported a decrease in cancer pain after yoga.

The other three studies reported no significant difference between yoga and control group. However two out of the four studies discussed in this extensive review of Buffart et al. However, several reviews and meta-analysis suggest that yoga contribute to improvement in sleep, mood and QoL, depression, emotional function and anxiety. Recent studies of women cancer survivors of breast cancer, suggest that yoga may help improve several aspects of QoL.

However ACS does not comment about effects of yoga on cancer pain. Another meta-analysis conducted by Lin et al. However interpretation of results on effects of yoga on physical health demonstrates that there was no significant difference between cancer patients in control group or yoga treated group. The author also agrees that because of limited number of studies, effects of yoga on physical health remains unclear. Therefore, at present a lot of studies are providing preliminary support for the feasibility and efficacy of yoga interventions and mindfulness based stress reduction for cancer patients but evidence for contribution of yoga in relieving cancer pain remains scant.

Further studies, systematic reviews and meta-analysis are required to comment on effects of yoga in cancer pain. Tai chi also helps to balance the yin and yang principles, the feminine and masculine life force energies. Eshe reports that regular practice of tai chi promotes wellness of the mind, body and spirit, and can assist in decreasing the severity of side effects of cancer and chemotherapy. Results demonstrated that Tai chi significantly improved the functional capacity including the aerobic capacity, muscle strength and flexibility as well as QoL as compared to psychological support therapy which could only improve flexibility.

A systematic review by Lee et al. Another systematic review evaluating role of Tai chi on breast cancer patients reports that evidence does not support tai chi to be more effective CAM therapy than walking exercise, psychological support therapy or spiritual growth therapy standard control procedures. Three RCTs in this review compared tai chi with the standard control procedures in QoL and psychological health but failed to demonstrate any significant difference between the various procedures adopted.

In contrast to the RCTs the four non-randomized controlled trials included in the extensive review did show some beneficial effects of Tai chi for breast cancer patients but all the studies had high risk of bias as assessed by the Cochrane criteria. Yet another systematic review by Lee et al. On search of various databases we could not find individual studies, systematic reviews or meta-analysis evaluating effects of tai chi specifically on cancer pain, hence at present it is difficult to assess the role of Tai chi on cancer pain though evidence supports its positive role in improving QoL and psychological health of cancer patients.

It is the induction of a trance-like state to facilitate relaxation and enhance suggestibility for treating conditions and introduce behavioural changes. It is not uncommon to see patients fearing a sense of helplessness and a loss of control over his or her own life due to cancer. Hypnosis helps patient cope more effectively with cancer. Research supports that hypnosis can reduce anticipatory nausea and vomiting.

Anticipatory nausea and vomiting occur prior to chemotherapy when previous exposure to chemotherapy has already caused nausea and vomiting but hypnosis had less effects on nausea and vomiting that happened after the chemotherapy dose is given. A prospective, randomized study of 39 advanced-stage Stage III or IV cancer patients with malignant bone disease who received weekly sessions of supportive attention or a hypnosis intervention. A systematic review of 27 papers comprising of RCTs, observational studies, retrospective questionnaires and 24 case studies for use of hypnotherapy to treat symptoms of terminally ill adult cancer patients concludes that quality of research done is not adequate and further research is required to understand the role of hypnotherapy in terminal cancer patients.

A review concluded that four of five RCTs found hypnosis plus cognitive behavioural techniques reduced pain intensity and severity compared with the control in patients with acute procedure related pain and oral mucositis pain related to bone marrow transplant.

Various studies and reviews have reported that hypnotherapy may be helpful to reduce procedure related pain viz. The review also cautions use of hypnosis by an expert only as this form of CAM may be associate with short term fatigue, anxiety, confusion, fainting or rarely serious reactions also stupor, chronic psychological problems, seizures and therefore screening of vulnerable individuals is recommended for this therapy.

A systematic review for effectiveness of hypnosis and procedure related pain and distress in pediatric cancer patients reveals that though hypnosis has potential as a clinically valuable intervention in such patients yet further research is required as various studies had lot of methodological limitations.

Therefore at present evidence supports use of hypnotherapy for various procedure related pain in pediatric and adult cancer patients but evidence for use of hypnotherapy for chronic cancer pain is inconclusive. This is the controlled use of plant essences, applied either to the skin through massage, added to baths or inhaled with steaming water. It has been shown that the aromatic oils reached the lymph system by means of blood circulation and provided recovery by means of intercellular fluids. A Cochrane systematic review concluded that aromatherapy have beneficial short-term effects on well-being in cancer patients.

Many people fear that massage may spread the tumour to various other areas as it shall increase the blood supply to which Horrigan opines that surface massage will not make the cancer grow due an increased blood supply,[ 48 ] nor make the cancer spread, nor interfere with chemotherapy or radiotherapy, nor cure cancer by natural means. However aroma therapists advise not to use unresearched oils or unfamiliar oils. There is no evidence that either essential oils or aromatherapy has caused cancer in humans.

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Lavender and citrus oils of a good quality are also useful for relieving stress. Essential oils have been helpful when used during radiotherapy to help reduce or prevent deep burning and scarring. There is no evidence of any interaction of any essential oils with cytotoxic chemotherapeutic agents therefore cancer patients may be given a trial of aromatherapy for nausea and vomiting due to chemotherapy.

A systematic review of 18 clinical trials reveal that aromatherapy has short term benefits on depression, anxiety and overall well-being, improved sleep and better pain control. The neurotransmitters suggest inhibition of glutamate binding and GABA augmentation. Linalool is the main component of lavender oil and it inhibits glutamate binding in rats and augments gamma-aminobutyric acid GABA action.

Surveys carried out in the UK showed that Repeated exposure to lavender and tea tree oils by topical administration was shown in one study to be associated with reversible prepubertal gynecomastia, therefore patients with estrogen-dependant tumors should exercise caution. Research reports that music therapy can help decrease the nausea and vomiting in patients undergoing radiotherapy and chemotherapy. Music therapy can affect stress hormone levels and improve brain waves and brain circulation.

Another review on quantitative literature on music based interventions in palliative cancer care reports that available evidence supports that music-based interventions may have a positive impact on cancer pain, anxiety, mood disturbance, and QoL in cancer patients. The review also reports that no evidence was found on the effect of music for pain or anxiety. Therefore at present mixed results of use of music therapy for cancer pain exists and high quality evidence for its use is awaited.

The TENS unit delivers low-voltage electrical stimulation to leads which are placed over the skin on or near the painful sites. The efficacy of TENS in chronic cancer patients has shown mixed results. Certain limitations of TENS therapy are that electrodes should not be placed on certain parts of the body, such as near eyes, on front of neck, open wounds or infections, near tumors, in pregnant women, or on genitals.

TENS is also contraindicated for people with pacemakers, implantable cardiac defibrillators, or other implanted devices, epilepsy and undiagnosed pain. Though specific guidelines for cancer pain do not exist, TENS has been tried in cancer patients for pain relief. This is currently the most widely used psychological treatment for persistent pain. This involves three steps. The first step is Pain education. Pain is described as a complex sensory and emotional experience that is influenced by the patient's thoughts, feelings, and behavior.

By discussing this topic, patients understand how their own responses to pain influence their pain experience and start to recognize the role that their own coping efforts can play a role in pain control. The second step is training in one or more coping skills for managing pain e. For each skill, a therapist provides an educational rationale, basic instruction, and guided practice and feedback.

The third step in training is home practice with learned skills. Patients are initially encouraged to practice in non-demanding situations e. The final step in training involves helping patients develop a program for maintaining their skills practice after training is completed and for overcoming setbacks and relapses in their coping efforts. Spiritual beliefs and beliefs about the meaning of life are often overlooked in CBT, but can be critical when cancer pain is persistent. Thus we can make no recommendations about the effectiveness of CBT in cancer pain management. We suggest that future trials employ adequate sample size to detect feasible and statistically significant improvements in cancer pain management.

This has been the most promising psychosocial intervention in the treatment of cancer pain. In this the patient is taught self guided imagery. The patient is made to focus on a pleasant or distracting scene to attend to the sensation in the scene like sights, sounds, smell etc. Once the patient develops this skill, it will enable them to divert their attention from pain. In hypnosis based CBT, the therapist teach skills which helps the patient relax. This intervention showed significant decrease in pain among children with lumbar puncture and bone marrow biopsy. The guidelines for treatment of cancer pain involve educating the patient and their family about cancer throughout the treatment process.

These guidelines advocate providing the patient and caregivers with written information about pain management, the types of pain medications prescribed, and the type, cost, and efficacy of pain treatment options. The studies that included more intensive skills training showed the best results. A systematic review and metanalysis which aimed to quantify the benefit of patient based education intervention in management of cancer pain reported equivocal evidence for the effect of education in self efficacy, but no significant benefit on medication adherence or on reducing interference with daily activities.

There is no evidence showing that educational intervention can reduce cancer pain. The most promising avenue for improving cancer pain control in ambulatory settings may be brief nursing interventions targeting patients in combination with a daily pain diary. This therapy emphasizes the importance of learning different coping skills like relaxation, imagery, self calming statements, problem solving. The patients systematically learn and master the skills of coping cancer pain.

The patients are encouraged to combine various coping skills to deal with daily challenges. In a study carried out in advanced cancer patients, comprehensive cognitive therapy showed an improvement in pain control. The Society also warns patients and families to avoid CAM therapies which make false claims for cancer.

Signs of treatments to avoid enlisted by ACS website. ACS also provides details of some of the websites that can provide reliable information on CAM therapies:. This extensive review is an attempt by authors to help medical, surgical and radiation oncologists who wish to suggest CAM therapies to their patients and to help them evaluate the role of various CAM therapies and understand the existing evidence to guide the treatment. However this is not a systematic review and results must be interpreted with caution.

When battling cancer the worst part is not just the symptoms of the disease itself, but often the discomfort and debilitating fatigue brought on from cancer treatments. To summarize, QoL of a cancer patient can be effectively improved with the combination of pharmacological and non pharmacological therapies. There has been a rapid growth in CAM therapies for cancer patients in the recent past.

However it needs to be steered by scientific enquiry, medical judgement, regulatory authority and collective decision making The modern medicine needs to accept its limitations and recognize the calling of cancer patients for inadequate symptom control and needs to stretch out its hand to accept the holistic approaches for cancer treatment to actually provide health benefit to its consumers by improving both the quality and quantity of life lived by the patient as together every one achieves more.

National Center for Biotechnology Information , U. Indian J Palliat Care. Priyanka Singh and Aditi Chaturvedi 1. In addition there is a lengthy list of suggestions of ways in which people with cancer can help avoid or overcome the pain and damage of conventional treatments. The Complete Recovery Guides in 8 books collectively tell you what cancer is; what the diagnostic tools are; what the pros and cons are of surgery, radiation and chemotherapy; how to protect yourself from damage; what the other new mainstream treatments are; why cancer research is failing to come up with cures; what the alternative therapies are that many people are doing - often with great success: The books also contain stories of over two dozen people who recovered from their cancers mainly using alternative approaches.

This series of eight short books is also available in a single volume with index under the title: The Cancer Survivor's Bible. Detox and Diet Jonathan Chamberlain. Cancer Recovery Guide Jonathan Chamberlain. Energy, Mind and Emotions Jonathan Chamberlain. The Complete Recovery Guide Serie The heterogeneity of the EPR effect may reduce the tumor delivery of macromolecular drugs.

Cancer treatment - Mayo Clinic

Nanomedicines primarily aim to improve the circulation time of the conjugated or entrapped chemo- therapeutic drugs. Nanomedicines use the pathophysiological cancer tissues exploit, where solid tumors tend to present with a tortuous and poorly differentiated vasculature in contrast to the vasculature in healthy tissues. Such exploit enables nanomedicines to extravasate into the cancer tissues selectively in a passive manner with sizes of up to several hundreds of nanometers. Using nanocarriers that respond only to cancer tissue conditions and release the drug at the cancer site only is an example on passive targeting.

Active targeting was proposed for improved targeting efficacy. The autophagosome, derived from a tumor cell, includes defective ribosomal products of the target antigen. The advancement in molecular pharmacology of cancer, phytochemistry, medicinal chemistry, computer-aided drug design, and docking-based drug synthesis contributed to the generation of new active pharmaceutical entities and the tailored designing of active targeting moieties for breast cancer management.

Limited, tetrahydrocannabinol and phytocannabinoid cannabidiol were proposed for the treatment of breast cancer. In a US patent owned by Martin Slade and Raoul Charles described a gamma secretase inhibitor 1 GSI1 for effective killing of breast cancer cell lines by inhibiting the production of the substrate binding component nicastrin, Nct, a single span membrane protein with a large, heavily glycosylated extracellular domain , which was particularly effective in selectively targeting breast cancer cell lines.

A patent by University of Maryland, Baltimore, proposed another novel combination of anticancer agents, retinamides retinoic acid metabolism blocking agents , which inhibited the growth of established breast and prostate tumor xenografts via apoptosis and cell cycle arrest. In a US patent owned by Steven P. Bremer, and Cornelius A. Diamond, diagnostic markers CDKN1B and others for breast cancer treatment and diagnosis were described. NPs provide many favorable properties to the drug including longer elimination time; increase drug-site contact time, and reducing drug resistance.

NPs represent versatile tools to encapsulate various types of drugs, either hydrophilic or hydrophobic altering their physicochemical parameters and pharmacokinetics profile. Furthermore, NPs represent a platform for custom-tailored novel therapy design, through ease of conjugation of various helping moieties via a linker such as stimuli-responsive peptide or polymers, protective PEGylation layer, cell-penetrating peptide, targeting moiety, or antibodies. They also enable the creation of a multifunctional platform incorporating multiple-therapeutic agents for efficient treatment.

Thus, they bypass the recognition of P-glycoprotein that is responsible for drug resistance and therapy failure. Delivery system diagram illustrating different types of linkers to achieve different properties. However, NPs can show some serious adverse effects. NPs can be synthesized by different materials including polymers, lipids, organometallic compounds, and viruses. Polymers used in the formulation of NPs can be either synthetic or natural. The nature of the chosen polymer and the NP formulation technique can create diverse types of polymeric NPs.

The drug loaded to the polymeric NPs is either physically entrapped or covalently bounded to the polymer matrix depending on the method of formulation. Natural polymers are obtained from plant or animal origin or any other living organism such as albumin, chitosan, and heparin. The polymer matrix is from a synthetic polymer that is chemically designed and engineered. Usually, researchers use the words biocompatible and biodegradable interchangeably. Unfortunately, biocompatible does not guarantee biodegradability or safety. Usually, most inventors and researchers tend to design new polymers and describe them as biocompatible or biodegradable without proof, especially there is no standard protocol for testing the biocompatibility or biodegradability of newly synthesized and designed moieties.

In aqueous media, the hydrophilic heads are arranged to outside and the hydrophobic tails to inside to stabilize the structure, which is suitable for IV injections. Dendrimers Tree in Latin are multiple highly branched synthetic polymer macromolecules. Dendrimers are flexible modifiable systems with monodisperse size distribution.

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They are easy to manipulate and to conjugate with different therapeutic agents. A patent in suggested a novel antibreast-cancer Her2 vaccine with dendrimers of lysine and cysteine backbone structure as a carrier system. This could be due to the ensured safety of the phospholipid bilayer structure of the liposomal lipids.

After emptying the virus from its genetic material, drugs can be loaded into the empty virus capsid. They are composed of benzene rings forming carbon cylinders. They have very low solubility that is overcome by linking water soluble ligands such as proteins and peptides as well as therapeutic agents. Drug delivery, magnetic resonance and fluorescence imaging, magnetic influence, and cell targeting are concurrently feasible using multifunctional inorganic NPs such as mesoporous silica NP, superparamagnetic iron oxide NPs, calcium phosphosilicate NPs, gold NPs, and others.

Inorganic particles often exhibit novel physical properties as their size approaches nanometer scale. For example, the unique electronic and optical properties of nanocrystalline quantum dots may lead to future applications in electro-optic devices and biomedical imaging. Treating and imaging the primary and metastatic tumors using inorganic NPs were the main target of several patents in the last few years.

In another patent, owned by Johns Hopkins University and Nanomaterials Technology PTE Ltd, surfactant-coated iron oxide NPs for breast cancer diagnosis and treatment prepared via high gravity controlled precipitation were described. The main aim of bioconjugation is to form a stable biologically cleavable covalent link between two molecules, at least one of which is a biomolecule. Thus, one could choose a suitable molecule and suitable cross-linker to form the bioconjugate.

As described earlier in NP design, bioconjugates are usually tailored designed to provide the function of interest. The active drug entity can be linked to a diagnostic agent, targeting moiety, pharmacokinetics-modifying agent such as PEG, bioresponsive or stimuli-sensitive agent, an aptamer or antibody Fig. Furthermore, the choice of the proper linker can impart new functions and smart characteristics to the bioconjugate system. In the recent literature and patents, numerous examples of bioconjugates have been described for the treatment and diagnosis of cancer, including breast cancer.

In a patent owned by Phigenix, Inc. In a Johns Hopkins University owned patent, novel bioconjugate systems synthesized via in situ complexation of two or more delivery components by the bioorthogonal click reactions were described. The first bioconjugate system constituted of multiple azido-functionalized or tetrazine-functionalized monoclonal antibody and multiple cyclooctyne-functionalized nanocarrier bioconjugate. The second bioconjugate system components were trans-cyclooctene functionalization and bovine serum albumin BSA substituted with chemotherapeutics, such as paclitaxel.

A patent, owned by Dartmouth College, described a targeted bioconjugate that consists of a metal NP such as a gold, silver, copper, nickel, aluminum, zinc, calcium, platinum, palladium, or iron NPs bound to at least one peptide that is modified at its N-terminal with a myristoyl group. The approach of using stimuli-responsive drug-delivery system had been applied in by studying stimuli-responsive hydrogels in drug release and in by thermosensitive liposomes in drug release.

Several recent patents described stimulus-responsive systems for breast cancer treatment and diagnosis. Chilkoti et al designed a drug-delivery system with stimulus-responsive biopolymers in a patent owned by Duke University. In another patent owned by Magnamedics Gmbh, a thermosensitive biocompatible polymer for breast cancer management was described.

The polymer has variable features for therapy, diagnostics, and analytics. A US patent owned by the Industry Academic Cooperation Foundation Younsei University proposed a stimulus-sensitive magnetic nanocomposite using pyrene polymer and different contrast agents. The siRNA was the target of recent papers and patents lately. The University of Utah Research Foundation owned patent that proposed an RNAi agent covalently coupled to the alpha or omega end of a pH-dependent membrane-destabilizing polymer.

Liu et al used doxorubicin and siRNA-loaded heptapeptide-conjugated NPs to enhance chemosensitization against epidermal growth factor receptor, which is overexpressed on breast cancer cells. Aptamers are nonbiological oligonucleotides that can bind to protein targets. A series of aptamers currently in development may change how nucleic acid therapeutics are perceived. In a patent owned by Ecosynthetix Ltd. In a recent publication, Wang et al described specific stimuli sensitive pH sensitive and NIR-triggered release photothermal aptamer-conjugated mesoporous silica—carbon NPs for HER2-targeted chemo-photothermal combined therapy.

Tumor targeting appears to be controlled by tumor-specific and circulating cell-specific factors. Consequently, targeted cancer therapy using cancer cells could be a promising field of investigation. University of Florida Research Foundation, Inc.

Since their emergence in , liposomes have been investigated as important targeted drug carriers for cancer CT. However, a major limitation for the use of systemic liposomal preparations for drug delivery was soon perceived; the clearance of the liposomes following intravenous administration was very rapid usually within minutes. This was accompanied by the rapid release of a large fraction of encapsulated content into circulation resulting in reduced bioavailability and impairment of targeting. The rapid clearance was likely attributed to the uptake of the liposomes by the Kupffer cells of the reticuloendothelial system RES following opsonization of liposomes by plasma proteins.

Several interventions were previously employed to prolong the circulation time of liposomes and thus improve targeting. For example, the use of high phase-transition temperature lipids and cholesterol. Conjugation of PEG moiety through a lipid anchor to the liposomes successfully reduced their RES uptake, which could be attributed, at least in part, to the reduced opsonization by plasma proteins.

PEGylation has been shown to alter the pharmacokinetics of doxorubicin considerably; the total clearance CL was significantly reduced. On the other hand, the leaky nature of cancerous vasculature would allow the selective diffusion of PLD into cancerous tissue. Modifying the pharmacokinetics profile of existing anticancer drugs has been the main focus of some pharmaceutical companies, such as Nektar Therapeutics. Nektar develops new drug candidates by applying its proprietary three-dimensional 3D four-armed branched PEGylation and advanced polymer conjugate technologies to modify chemical structure of various APIs.

Nektar therapeutics has several patents on PEGylation bioconjugation aiming to modifying the pharmacokinetic profile. Targeting cancer cells while avoiding noncancerous cells is the Holy Grail of cancer therapy. Many different systems and strategies have been designed for drug targeting to tumors over the years. Improved insights into the genetic and patho- physiological processes contributing to malignant transformation and tumorigenesis have resulted in the development of several novel chemotherapeutic drugs and strategies.

For these reasons, emerging pharmaceutical and nanotechnology companies try to increase their patent portfolio to increase their commercial value for possible buyouts by big pharmaceutical firms.

Cancer: The Complete Recovery Guide Series: Bk. 2 Cancer: Diagnosis and Conventional Treatments

Such acquisitions show the importance of this area of research and, most importantly, highlight the global need for effective and safe pharmaceutical chemotherapeutic agents that have the potential to target tumors like breast cancer with minimal toxicity and side effects. Unfortunately, these factors affected the quality and value of patents registered currently for the management of breast cancer. Most of the reviewed patents were extremely broad within their scope, unclear, and unorganized to avoid any specifications of the invention. This prevents researchers and scientists from reproducing the patents results and conclusions.

This could also be attributed to the companies urge to gain maximum intellectual properties rights. Furthermore, multiple patents were found to be describing the same product exactly. Such flaws in the patents system need more strict regulations during patents filing to protect consumers as well as inventors. Surveying the published research papers and patents also revealed other major drawbacks in the methodology design, which is the lack of standardization.

Most studies only depended on MTT assay depends on MTT dyes 3- 4,5-dimethylthiazolyl -2,5-diphenyltetrazolium bromide XTT assay depend on XTT dye 2,3-bis- 2-methoxynitrosulfophenyl -2H-tetrazoliumcarboxanilide cell viability studies as an efficacy evaluation tool for the antineoplastic property. The use of a single test could never describe the true efficacy pattern, especially that MTT only depends on mitochondrial activity as a marker for cell death. Multiple evaluation techniques should be adopted for safety and efficacy evaluation of antineoplastic agents.

This could provide misleading conclusions for the efficacy of the proposed treatment strategies. Another major flaw is the lack of proper in vivo models in the majority studies. Only few studies deployed a truly breast cancer model in animals. The establishment of an in vivo animal model with recent breast cancer cell lines from patients is an invaluable tool in the true assessment of the efficacy and safety of novel strategies in breast cancer management.

Another major debate still ongoing, as revealed by the recent patents and papers portfolio, is the preferential advantage of active targeting over passive targeting. Several important pitfalls in active tumor-targeted drug delivery were identified by Lammers et al. This could be attributed to the fact that irregular particles are easily trapped in cancerous leaky angiogenic blood vessels compared to spherical traditional particles. Finally, a major limitation impeding the entry of novel nanomedicines for breast cancer into the market is that new concepts and innovative research ideas within academia are not being developed and exploited in collaboration with the pharmaceutical industry.

An integrated bench-to-clinic approach, realized through a structural collaboration between industry and academia, would strongly stimulate the progression of tumor-targeted nanomedicines toward clinical application. Developing novel complexes and sophisticated systems that could never reach the market due to high cost, inability of scaling up the system, or instability of the final formulation is a major hurdle. Major process and formulation development concerns exist with respect to scale up process of complex nanoparticluate carriers. Most of the reagents and inactive moieties in the formulation of such novel therapeutic systems are not included in the FDA approved inactive ingredient database.

Use of click chemistry, NP formulations, ligand postinsertion, and labeling techniques need to be extensively researched for ease of scale up and proper bench to bedside transformation. Consequently, many patents currently focus heavily on simple bioconjugate structures, which are easily synthesized with high yield, reduced cost, and high stability profile of the final formulation.

This could provide a practical direction for the development of novel management tools and therapeutics for breast cancer for researchers worldwide, paving the road to affordable, scalable, stable, efficient, and safe management strategies. Acronyms and abbreviations used in the manuscript.

Dimri, Editor in Chief. Four peer reviewers contributed to the peer review report. Authors disclose no potential conflicts of interest. Wrote the first draft of the manuscript: Contributed to the writing of the manuscript: Agree with manuscript results and conclusions: Jointly developed the structure and arguments for the paper: Made critical revisions and approved final version: All authors reviewed and approved of the final manuscript. Authors disclose no funding sources. Paper subject to independent expert blind peer review. All editorial decisions made by independent academic editor. Upon submission manuscript was subject to anti-plagiarism scanning.

Prior to publication all authors have given signed confirmation of agreement to article publication and compliance with all applicable ethical and legal requirements, including the accuracy of author and contributor information, disclosure of competing interests and funding sources, compliance with ethical requirements relating to human and animal study participants, and compliance with any copyright requirements of third parties.

National Center for Biotechnology Information , U. Journal List Breast Cancer Auckl v. Published online Sep Find articles by Mohamed I. Find articles by Fatema ElAmrawy. Find articles by Nada Ahmed. Find articles by Kamilia Abdelraouf. Satyanarayana Goda 2 Formurex, Inc. Find articles by Satyanarayana Goda. Find articles by Hussaini Syed-Sha-Qhattal. Author information Article notes Copyright and License information Disclaimer.

This article has been cited by other articles in PMC. Associated Data Supplementary Materials Supplementary table 1. Abstract Breast cancer is the most prevalent cancer among women worldwide. However, survival rates vary widely, optimistically heading toward a positive trend. Increased survival is due to the drastic shift in the screening methods, early diagnosis, and breakthroughs in treatments. Different strategies of breast cancer classification and staging have evolved over the years. Intrinsic molecular subtyping is essential in clinical trials and well understanding of the disease.

Many novel technologies are being developed to detect distant metastases and recurrent disease as well as to assess response to breast cancer management. Intensive research efforts are actively ongoing to take novel breast cancer therapeutics to potential clinical application. Most of the recent research papers and patents discuss one of the following strategies: Medical Background Breast cancer history dates back to around 1, years B.

Prevalence of breast cancer among females Breast cancer is the most common cancer in women worldwide, with nearly 1. Breast cancer in men Breast cancer is similar in men and women; however, breast cancer in men is more frequently hormone receptor positive and may be more sensitive to hormonal therapy. Classification of breast cancer Early diagnosis and intervention can make a transformational shift in the statistics. Papillary and micropapillary DCIS: Molecular subtype Breast cancer complexity has long been known and investigated.

Triple-negative breast cancer TNBC: Triple negative also includes some special histological types such as typical medullary and adenoid cystic carcinoma with low risks of distant recurrence. This cancer is particularly aggressive and more likely to spread rapidly than other types of breast cancer. Infiltration with lymphocytes is common. Magnetic resonance imaging MRI MRI is a powerful imaging tool that produces high-resolution images without requiring the application of harmful radiation.

Molecular breast imaging MBI MBI uses a radioactive tracer that lights up cancer tissues of the breast, visualized by a nuclear medicine scanner. Breast biopsy The only definitive method for diagnosing breast cancer is with a breast biopsy. Markers under research Proteins Mammaglobin is a protein found in mammary tissue and can be detected in serum.