Let's simply learn about drugs that stop the flow of blood to cancer tumors (Angiogenesis Inhibitors)

When your doctor tells you that you have cancer, you have a lot of questions in your mind, right? We've heard about 'chemo' and 'radiation', but your doctor may be talking about a new class of drugs called 'Angiogenesis Inhibitors'. What is this strange drug called? What does it actually do? Don't worry, let's talk about it simply.

First, let's see, what are these angiogenesis inhibitors?

Simply put, this is a type of drug that stops the growth of new blood vessels, which are the blood vessels that supply tumors. Other names for this are anti-angiogenics, anti-angiogenic agents, and anti-angiogenic therapy.

Think about it, for anything to grow, it needs food, nutrition, right? Cancer cells are just like that. They also need a continuous supply of blood filled with nutrients to grow and spread. When a cancer cell is small, it survives by sucking some blood from the healthy tissue around it. But when the cell grows to about 1-2 millimeters, it has to develop its own new blood vessel system. Otherwise, it cannot grow any bigger.

This is where drugs called Angiogenesis Inhibitors come in. These drugs work by blocking the process by which cancer cells grow new blood vessels. It's like cutting off a water supply to a tree. This slows down the growth of the cancer, and sometimes the tumor can even shrink. This treatment may not cure the cancer completely, but it can control the growth of the tumor and allow you to be with your loved ones for a little longer.

How does this medicine work inside the body?

These drugs interfere with a process called angiogenesis . This is actually a normal process in our bodies. Imagine if you cut your hand, new blood vessels need to grow to heal the wound and bring blood to that area. That's called angiogenesis. The injured cells send out a signal, like "Help us!" This signal causes new blood vessels to grow.

But the problem is, cancer cells also use this same process to their advantage. Cancer cells also send out similar signals and grow new blood vessels for themselves. These blood vessels are what provide the tumor with the nutrients it needs, allowing it to grow and spread to other parts of the body.

Angiogenesis Inhibitors work by disrupting this signaling system from the cancer. Most of these drugs work by blocking a protein called vascular endothelial growth factor (VEGF) . Think of VEGF as the main "help" signal released by cancer cells. When this VEGF signal binds to VEGF receptors on cancer cells, new blood vessels begin to form.

Now let's see how this medicine stops this signal.

• Blocking the VEGF signal from binding to the receptor: Some drugs (for example, monoclonal antibodies like Bevacizumab (Avastin®) go directly to the VEGF protein and attach to it. Then it can't go to that receptor and bind to it. It's like intercepting a letter before it reaches the intended recipient.
• Blocking signals from VEGF receptors: Some other drugs (for example, tyrosine kinase inhibitors such as sorafenib (Nexavar®) and sunitinib (Sutent®)) block the receptor from sending the message back, even if it receives the signal.
• Blocking other signaling systems: Some other medications (for example, immunomodulators such as thalidomide and lenalidomide (Revlimid®)) interfere with other signaling systems involved in this process.

What types of cancer is this medicine used for?

Doctors often prescribe these angiogenesis inhibitors for advanced or recurrent cancers. Some of the types of cancer for which this treatment is recommended are:

• Brain cancer
• Breast cancer
• Cervical cancer
• Colon cancer
• Fallopian tube cancer
• Kidney cancer
• Liver cancer
• Lung cancer
• Lymphoma
• Multiple myeloma
• Pancreatic cancer
• Peritoneal cancer
• Stomach cancer
• Thyroid cancer
• Uterine/endometrial cancer

What happens during treatment?

Doctors don't usually give these drugs alone. They are often given in combination with other cancer treatments, such as immunotherapy and chemotherapy .

Think of it like a war. Angiogenesis Inhibitors cut off the food and ammunition (blood) that the enemy (cancer) gets. Other treatments (like chemotherapy) go straight to the enemy (cancer cells) and attack them. When these two methods work together, the results can be more successful.

Depending on the type of medication you are given, you may need to take it as a pill once or twice a day, or you may need to get it as an IV (like saline ) into a vein on a regular schedule.

How long does this treatment take?

The length of your treatment depends on many factors, including the type of medication you are given and the type of cancer you have. Most people continue to take these medications as long as they work. Sometimes, treatment may be stopped if the side effects become too much to bear. Your doctor will discuss the benefits and side effects of treatment with you and make the best decision.

What are the side effects and risks?

Like any medicine, these treatments can have side effects and risks. Most of these are problems with bleeding (bleeding) and blood clotting. In rare cases, these side effects can be life-threatening. So it's important to be aware of these.

Your doctor will regularly monitor your health to reduce these risks.

The most important thing you can do is to understand these side effects and risks before you start treatment. When you know what to expect, you can be more aware of the changes in your body. If you notice anything unusual, let your doctor know right away. He or she can then teach you how to manage the side effects or adjust your medication dosage.

Are there things that can naturally stop this process?

This is a question that many people ask. Some foods contain compounds that block certain signals involved in the process of angiogenesis. Many of these foods are found in the Mediterranean diet. For example:

• Asparagus
• Dandelion root
• Green tea
• Olive oil
• Peanuts
• Red wine
• Red grapes

Medical researchers are trying to use these compounds to create new drugs, but that research is still in its early stages.

When do you need to talk to the doctor?

If you experience any unexpected symptoms during treatment, contact your doctor immediately.

Especially if you see signs of a life-threatening condition, such as a heart attack or stroke, go to the Emergency Department (ETU) immediately.

Angiogenesis inhibitors are a very important treatment that blocks the ability of cancer cells to hijack our body's own healing process. They may not cure the cancer completely, but they can help control its spread and give you more time to live. If your doctor recommends this medication, be sure to talk to your doctor about its role in your overall treatment plan.