Revisiting the standards of cancer detection and therapy alongside their comparison to modern methods

Abstract

In accordance with the World Health Organization data, cancer remains at the forefront of fatal diseases. An upward trend in cancer incidence and mortality has been observed globally, emphasizing that efforts in developing detection and treatment methods should continue. The diagnostic path typically begins with learning the medical history of a patient; this is followed by basic blood tests and imaging tests to indicate where cancer may be located to schedule a needle biopsy. Prompt initiation of diagnosis is crucial since delayed cancer detection entails higher costs of treatment and hospitalization. Thus, there is a need for novel cancer detection methods such as liquid biopsy, elastography, synthetic biosensors, fluorescence imaging, and reflectance confocal microscopy. Conventional therapeutic methods, although still common in clinical practice, pose many limitations and are unsatisfactory. Nowadays, there is a dynamic advancement of clinical research and the development of more precise and effective methods such as oncolytic virotherapy, exosome-based therapy, nanotechnology, dendritic cells, chimeric antigen receptors, immune checkpoint inhibitors, natural product-based therapy, tumor-treating fields, and photodynamic therapy. The present paper compares available data on conventional and modern methods of cancer detection and therapy to facilitate an understanding of this rapidly advancing field and its future directions. As evidenced, modern methods are not without drawbacks; there is still a need to develop new detection strategies and therapeutic approaches to improve sensitivity, specificity, safety, and efficacy. Nevertheless, an appropriate route has been taken, as confirmed by the approval of some modern methods by the Food and Drug Administration.

Keywords: Cancer detection; Cancer therapy; Elastography; Fluorescence imaging; Liquid biopsy; Synthetic biosensors; Nanotechnology; Oncolytic virotherapy; Reflectance confocal microscopy; Tumor-treating fields.

Figure 1

Conventional and modern methods of cancer detection. The diagnostic path begins with learning the medical history of a patient, followed by performing basic blood tests (e.g., complete blood count, creatinine level, liver function test) and imaging tests (e.g., X-ray scan, ultrasound, magnetic resonance spectroscopy) to indicate where cancer may be located. Afterwards, the patient is scheduled for a needle biopsy. Prompt initiation of diagnosis is crucial since delayed cancer detection entails higher costs of treatment and hospitalization. Novel cancer detection methods include liquid biopsy, elastography, synthetic biosensors, fluorescence imaging, and reflectance confocal microscopy. Standards of cancer detection are located in a light pink area, whereas novel methods are placed on a light blue background. Figure created with BioRender. CTCs: Circulating tumor cells; CAFs: Cancer-related fibroblasts; TEPs: Tumor-educated platelets; cfDNA: Cell-free DNA; cfRNA: Cell-free RNA; EVs: Extracellular vesicles; US: Ultrasound (sonogram); MRI: Magnetic resonance imaging.

Figure 2

Conventional and modern methods of cancer therapy. Chemotherapy, radiotherapy, and surgery are standard approaches that can be used in combination. Chemotherapeutics are harmful to both cancer cells and normal cells, negatively affecting the quality of life. Radiotherapy counteracts cancer via ionizing radiation that deposits high-energy beams in cells. Surgery does not guarantee improvement in the patient’s health and carries several risks such as bleeding and damage to surrounding organs and tissues. The current standard of care is unsatisfactory in most cancer types, necessitating the use of novel methods such as oncolytic virotherapy, exosome-based therapy, nanotechnology, dendritic cells, CAR-based therapies, immune checkpoint inhibitors, natural product-based therapy, tumor treating fields, and photodynamic therapy. Figure created with BioRender. CAR: Chimeric antigen receptor; UCAR: Universal CAR; NK: Natural killer; PTX: Paclitaxel.