Is your body resisting cancer treatment? Doctors list potential reasons for drug resistance

Health experts reveal why do cancer treatments fail and the shocking truth about drug resistance!

One of the most significant challenges in cancer treatment is the development of drug resistance by cancer cells, which often leads to treatment failure. When we say the body "resists" cancer treatment, it typically refers to the cancer cells' ability to evade or withstand the effects of the treatment.

Is Your Cancer Treatment Working? The Hidden Threat of Drug Resistance(File Photo)

Why do cancer treatments stop working?

In an interview with HT Lifestyle, Dr Anjali Kulkarni, Vice President - RWE Strategy and Analytics and Oncologist at 4baseCare, expalined, “Drug resistance means the cancer cells do not respond to the treatment as expected. There may be partial response or in some cases there may be relapse of the disease despite the best treatment protocol. Sometimes drug resistance develops quickly, within a matter of weeks of starting treatment. In other cases, it develops months, or even years, later.”

“Radiotherapy is an essential treatment modality in cancer care. It employs high-energy X-ray beams to target and destroy cancer cells," said Dr Prashant Nayak.(Unsplash)

Bringing his expertise to the same, Dr Sandeep Nayak, Director - Department of Surgical Oncology at Fortis Hospital in Bengaluru's Bannerghatta Road, elaborated upon what does it mean when the body resists cancer treatment and said, “Cancer treatments, such as chemotherapy, are designed to target rapidly dividing cells, which include cancer cells. However, normal cells in the body, such as those in the bone marrow, digestive tract, and hair follicles, can also be affected, leading to side effects.”

He added, "The term "resistance" in cancer treatment usually refers to the cancer itself, not the body. Resistance occurs when cancer cells adapt or develop mechanisms to survive despite the treatment. This can result in the treatment becoming less effective or completely ineffective over time. For example, cancer cells may mutate or activate survival pathways that allow them to evade destruction by the drug."

What are the potential reasons for treatment/drug resistance in cancer patients?

According to Dr Anjali Kulkarni, there can be multiple reasons and it is very difficult to predict any particular reason for drug resistance. She revealed, “Cancer cells, surrounding environment, immune system and metabolic changes play an important role in drug resistance. The cancer cells within a tumour may have different molecular markers and some of them cause drug resistance. Sometimes tumour burden, specific genetic changes can alter drug response.”

In a quest to optimize cancer care, researchers are asking: “Do we need all that treatment that we have used in the past?” (Pexels)

As per Dr Sandeep Nayak, cancer treatment resistance can arise due to several mechanisms, including:

1. Genetic Mutations in Cancer Cells: Cancer cells can acquire mutations that make them less susceptible to the drug. For example, mutations in the EGFR gene can lead to resistance to targeted therapies like tyrosine kinase inhibitors.
2. Drug Efflux Mechanisms: Cancer cells may develop the ability to pump out the drug using proteins like P-glycoprotein, reducing the drug's effectiveness.
3. Tumour Microenvironment: The environment around the tumor, including immune cells, blood vessels, and extracellular matrix, can protect cancer cells from treatment. For instance, hypoxia (low oxygen levels) in the tumor microenvironment can reduce the effectiveness of radiation therapy.
4. Cancer Stem Cells: Some cancers contain a small population of cancer stem cells that are inherently resistant to treatment and can regenerate the tumor after therapy.
5. Epigenetic Changes: Changes in gene expression without altering the DNA sequence can also contribute to resistance. For example, cancer cells may silence genes that make them sensitive to treatment.
6. Immune Evasion: In immunotherapy, cancer cells may evade detection by the immune system by downregulating molecules like PD-L1 or mutating antigens that immune cells target.

Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.