UPSC Aspirant 2025-26

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destroy it. Now what cancer does- it expresses some markers which lead the immune system to get suppressed. So the immune system doesn't see the cancer causing cells and doesn't destroy it. The molecules of immunotherapy have been development of long time. Now, in this molecular specific, check point inhibitors remove suppression and the immune system removes the cancer. When we talk about immunotherapy checkpoint drugs, these drugs are not doing anything against cancer. What they do is remove inhibition which has been put by the cancer on the immune system, and the immune system destroys the tumor. So, basically, it is your own body's immune system that is destroying the tumor and therefore the chances of getting side effects are minimal. In such cases, we need to understand that two-three things are important. -First, the tumor should have been such that it puts an immune suppressive mechanism in the immune system. -Second, the immune system should be good-enough to destroy the tumor. Now, the question arises here is, how do you know that a tumor is experiencing this immune suppression? So there are multiple markers that will tell you the tumor is experiencing this immune suppressive mechanism. One common marker is PD-L 1. The others are microsatellite instability and tumor mutation burden. Now, let's talk about the study. First of all, we must understand it is a very small study. We must understand, if i say 100 patients of Rectal Cancer, only 10-12% will have those kinds of microsatellite instability which were the patients taken in the study. In these patients, they have been given immunotherapy and cancer disappears. But the follow up of this study is short as compared to normal treatment procedures. In future, the study might be a promising treatment for this 10-12% of patients but this needs to get confirmed when the cases are followed up for years.

All about Cancer ♋ Hearing that your loved one is suffering from cancer can be stressful and frightening. However, knowing what to expect — from diagnosis to recovery — can help one in taking appropriate care of their health during these tough times. To understand more about the disease, PBNS had an in-depth conversation with Dr Vijay Patil from Tata Memorial Centre. Dr. Patil is a specialist Head & Neck Cancer Medical Oncologist. Understanding the disease Dr Patil: Cancer is a very 'unique' disease. What happens is, every cell in our body divides and then has to die, for normal organs to function. But, in the case of cancer patients, cells have a unique ability to, what you can say, escape from death i.e. it doesn't die off. As we know, all cells in the body are dividing, so the affected cell also starts dividing and when it divides it passes that unique ability of not dying off to others. So to simplify, if one cell like this occurs, it will divide into two, two will then become four and further continues to increase. And now this conglomeration of cells is what is known as cancer. What it does is when it starts becoming huge, cell mass, it destroys the functions from where it originates. For example, let's say that if the origin was in the lungs, because it will keep dividing, it would occupy more space and so the normal functioning of lungs will start getting affected. Not only that, the affected cells after some time will also get the ability to start moving in other parts of the body and can affect the normal functioning of that organ or part. So this is the way the cancer can start spreading and destroy the vital functions of the body. Subsequently, leading to the death of the patient. Understanding Cancer Risk Dr Patil: Causes of Cancer are Hereditary and Non- Hereditary. Hereditary means in some cancer cases, it has been witnessed that the patient has some genetic mutations which are there in the family. We must understand that Hereditary Cancer exists but is not a very common cause of Cancer. Other common causes of cancer are dependent upon what kind of exposure to environmental factors the patient gets into. It is pertinent to note that tobacco use is one of the most common cause of Cancer. Certain infections like Hepatitis B - could get Hepatocellular carcinoma. HPV infection is a cause of cervical cancer. So, what we need to understand here is hereditary, infection, environmental causes, certain work-related occupational hazards are few of the factors leading to cancer. One can also have cancer because of their current lifestyle which they have, like a sedentary lifestyle, obesity, alcohol consumption, smoking habits, etc. Up till now, science has not been able to pin-point the cause of cancer. What we have seen is that, if we have 100 patients with smoking habits, the chances they will get lung cancer is much more than a person with no smoking habit. The cause and effect relationship is there, but it is not very perfect in cancer. What we say is that it is a multi-facto disease. But it is important to always remember if there is a family history of cancer or people are getting cancer at a young age, then we need to screen the patient if he/she had mutations, which are seen in case of hereditary cancer. All you need to know about the miracle drug ‘Dostarlimab’ Dr Patil: The drug was administered to patients of Rectal Cancer. Now the standard treatment for rectal cancer is that you give chemo and radiation first, followed by the surgery of the patients. But, the problem is, what was done in the trial was they had super-selected patients. So, first we will talk about drugs and then why super selection was important. Dostarlimab, the drug, is a type of immunotherapy. Now what is immunotherapy? Sometimes, we don't need to take antibiotics to treat any infection. Our own immune system, the WBC, destroys the bacteria. The same thing goes with cancer also. If the cancer develops in the body, our own immune system, the WBCs, are supposed to