Advancements and limitations in traditional anti-cancer therapies: a comprehensive review of surgery, chemotherapy, radiation therapy, and hormonal therapy

Abstract

Cancer remains a major global health challenge, consistently ranking as the second leading cause of mortality worldwide. Despite significant advancements in research and technology, the need to deepen our understanding of tumor biology and improve therapeutic strategies persists. This review focuses on the progress and challenges of four traditional cancer treatment modalities: surgery, chemotherapy, radiation therapy, and hormonal therapy. Surgery, the primary method for tumor removal, has evolved with the integration of fluorescence-based technology and robotic systems, enhancing precision and minimizing collateral damage. Radiation therapy has progressed with improved focus, intensity control, and 3D technology, refining both diagnosis and treatment. Chemotherapy has advanced from natural extracts to synthesized derivatives with amplified cytotoxicity against cancer cells. Hormonal therapy has emerged as a crucial strategy for hormone-dependent cancers, restraining growth or inducing regression. Despite these advancements, each approach faces ongoing challenges. Surgery struggles with complete tumor removal due to heterogeneity. Chemotherapy contends with drug resistance and side effects. Radiation therapy grapples with precision issues and limited access in some regions. Hormonal therapy faces resistance development and quality of life impacts. This study provides a comprehensive analysis of the evolution of these traditional anti-cancer therapies, offering insights into their progress and highlighting areas for future research. By examining these modalities, we aim to underscore their relevance in the current oncology landscape and identify opportunities for improvement in cancer treatment strategies.

Keywords: Anticancer therapies; Antimetabolites; Cancer; Hormonal therapy; Surgery.

Fig. 1

Evolution and milestones of traditional anticancer therapies across centuries: A comprehensive overview of development and progress

Fig. 2

Mechanisms of action of different chemotherapeutic drugs. A Alkylating agents form inter-strand and/or intra-strand adducts making DNA unable to open for replication and transcription. B Antimetabolites utilize nucleotide analogs. Misincorporation of these nucleotide analogues initiates DNA repair on hundreds of sites simultaneously causing DNA stress and ultimate cell death. C Antitumor antibiotics cause DNA fragmentation and disruption of transcription and translation. D Topoisomerase inhibitor obstructs DNA replication, transcription, chromosomal segregation and recombination. E Antimitotic drugs target microtubule assembly and disassembly thereby disrupting mitosis and causing cell cycle arrest

Fig. 3

Evolution of traditional therapies: past, present, and future directions, illustrated through different font colors. The black font categorizes the techniques for each anti-cancer treatment. The red font highlights the challenges associated with these therapies. Green font represents the innovations made to overcome these challenges, while the blue font emphasizes the future directions aimed at enhancing the efficiency of specific therapies