During World War I, one of the horrors of trench warfare was a poisonous yellow cloud called mustard gas. For those unlucky enough to be exposed, it made the air impossible to breathe, burned their eyes, and caused huge blisters on exposed skin.
一戰期間,壕溝戰的慘狀之一 是瀰漫著黃色雲狀 名叫芥子毒氣的有毒氣體。 那些暴露於氣體的倒霉人, 氣體讓他們難以呼吸, 灼傷他們的雙眼, 且在裸露的皮膚上燙出水泡。
Scientists tried desperately to develop an antidote to this vicious weapon of war. In the process they discovered the gas was irrevocably damaging the bone marrow of affected soldiers— halting its ability to make blood cells. Despite these awful effects, it gave scientists an idea. Cancer cells share a characteristic with bone marrow: both replicate rapidly. So could one of the atrocities of war become a champion in the fight against cancer? Researchers in the 1930s investigated this idea by injecting compounds derived from mustard gas into the veins of cancer patients. It took time and trial and error to find treatments that did more good than harm, but by the end of World War II, they discovered what became known as the first chemotherapy drugs.
科學家們拚命地研發 這惡性戰爭武器的解藥。 他們於過程中發現 氣體侵害的士兵的骨髓, 那些傷害無可挽回, 會阻撓紅血球的生成。 撇除這些可怕的影響, 它提供科學家一個點子。 癌細胞與骨髓有相同的特點: 兩者都迅速複製。 有人能夠於殘暴的戰爭中 成為抗癌的勝利者嗎? 研究人員在 1930 年代 把從芥子毒氣萃取出的化合物 注入癌症病人的靜脈, 深入研究這個想法。 尋找利大於弊的療法 需要時間和嘗試錯誤, 在二戰結束之際, 他們發現了第一種化學療法藥物。
Today, there are more than 100. Chemotherapy drugs are delivered through pills and injections and use "cytotoxic agents," which means compounds that are toxic to living cells. Essentially, these medicines cause some level of harm to all cells in the body— even healthy ones. But they reserve their most powerful effects for rapidly-dividing cells, which is precisely the hallmark of cancer.
現今有多於一百種的藥物。 化療藥物藉藥丸和注射劑傳遞, 並使用「細胞毒劑」, 也就是對活細胞有毒的化合物。 這些藥物的本質會對所有的 體內細胞造成一定程度的傷害, 健康的細胞包括在內, 但保留最強效的作用 給快速分裂的細胞, (快速分裂)正是癌症的標誌。
Take, for example, those first chemotherapy drugs, which are still used today and are called alkylating agents. They’re injected into the bloodstream, which delivers them to cells all over the body. Once inside, when the cell exposes its DNA in order to copy it, they damage the building blocks of DNA’s double helix structure, which can lead to cell death unless the damage is repaired. Because cancer cells multiply rapidly, they take in a high concentration of alkylating agents, and their DNA is frequently exposed and rarely repaired. So they die off more often than most other cells, which have time to fix damaged DNA and don’t accumulate the same concentrations of alkylating agents.
舉例來說,那些至今 仍被使用的第一批化療藥物, 叫做烷化劑。 它們被注入血管, 好讓它們傳遞至全身的細胞。 一旦抵達,當細胞為了複製 而暴露 DNA 時, 它們會損害 DNA 雙股螺旋狀組件, 除非細胞的損害已修復, 否則會導致細胞的死亡。 因為癌細胞可以迅速地複製, 它們攝入高濃度的烷化劑, 其 DNA 經常暴露但極少復原。 所以比其他多數細胞更常相繼死去, 後者有時間修復受損的 DNA, 不會累積相同的烷化劑濃度。
Another form of chemotherapy involves compounds called microtubule stabilizers. Cells have small tubes that assemble to help with cell division and DNA replication, then break back down. When microtubule stabilizers get inside a cell, they keep those tiny tubes from disassembling. That prevents the cell from completing its replication, leading to its death.
另一種形式的化療涵蓋了 名為「微管穩定劑」的化合物。 細胞小管的聚集可以幫助有絲分裂, 以及 DNA 的複製,然後分解。 當微管穩定劑進入一個細胞, 它們保護微小的管狀器官免於分解。 這阻止細胞完成複製, 從而導致死亡。
These are just two examples of the six classes of chemotherapy drugs we use to treat cancer today. But despite its huge benefits, chemotherapy has one big disadvantage: it affects other healthy cells in the body that naturally have to renew rapidly. Hair follicles, the cells of the mouth, the gastrointestinal lining, the reproductive system, and bone marrow are hit nearly as hard as cancer.
這只是今日我們用來治療癌症 六類化療藥物中的兩個例子。 儘管有龐大的好處, 化療有個大缺點: 它會波及體內自然 快速更新的其他健康細胞。 毛囊、口腔細胞、胃黏膜、 生殖系統和骨髓
Similar to cancer cells, the rapid production of these normal cells means that they’re reaching for resources more frequently— and are therefore more exposed to the effects of chemo drugs. That leads to several common side effects of chemotherapy, including hair loss, fatigue, infertility, nausea, and vomiting. Doctors commonly prescribe options to help manage these side-effects, such as strong anti-nausea medications. For hair loss, devices called cold caps can help lower the temperature around the head and constrict blood vessels, limiting the amount of chemotherapy drugs that reach hair follicles. And once a course of chemo treatment is over, the healthy tissues that’ve been badly affected by the drug will recover and begin to renew as usual.
所遭受的傷害和癌症一樣大。 這些快速複製的正常細胞 和癌細胞很像, 意味著它們更頻繁地取用資源, 因此更容易暴露於 化學藥物的作用中, 造成一些常見的化療副作用, 包括掉髮、疲勞、不孕、噁心和嘔吐。 醫生普遍開處方來解決這些副作用, 例如強效的抗噁心藥物。 感冒膠囊則有助於 降低頭周圍的溫度和控制血壓, 以解決掉髮問題, 限制化療藥物送至毛囊的總量。 一旦化學療程結束, 受藥物嚴重影響的健康組織會康復 並且照常開始更新。
In 2018 alone, over 17 million people world-wide received a cancer diagnosis. But chemotherapy and other treatments have changed the outlook for so many. Just take the fact that up to 95% of individuals with testicular cancer survive it, thanks to advances in treatment. Even in people with acute myeloid leukemia— an aggressive blood cancer— chemotherapy puts an estimated 60% of patients under 60 into remission following their first phase of treatment.
單在 2018 年, 世界上有超過 1700 萬人 得知自己罹患癌症。 但化療和其他療法 改變了許多人的前景。 現在請思考一件事:多虧先進的療法, 高達 95% 的睪丸癌患者倖存。 即使在患有急性髓性白血病 (一種激進性血液癌)的人中, 化學治療也使估計 60% 的 60 歲以下患者 在其第一階段治療後緩解。
Researchers are still developing more precise interventions that only target the intended cancer cells. That’ll help improve survival rates while leaving healthy tissues with reduced harm, making one of the best tools we have in the fight against cancer even better.
研究員仍在開發更精確的介入方法 只瞄準目標的癌症細胞。 這將有助於提高存活率, 同時減低留下的 健康組織所受的傷害, 使我們擁有的抗癌工具之一