Integration of phytochemicals and phytotherapy into cancer precision medicine.

Concepts of individualized therapy in the 1970s and 1980s attempted to develop predictive in vitro tests for individual drug responsiveness without reaching clinical routine. Precision medicine attempts to device novel individual cancer therapy strategies. Using bioinformatics, relevant knowledge is extracted from huge data amounts. However, tumor heterogeneity challenges chemotherapy due to genetically and phenotypically different cell subpopulations, which may lead to refractory tumors. Natural products always served as vital resources for cancer therapy (e.g., Vinca alkaloids, camptothecin, paclitaxel, etc.) and are also sources for novel drugs. Targeted drugs developed to specifically address tumor-related proteins represent the basis of precision medicine. Natural products from plants represent excellent resource for targeted therapies. Phytochemicals and herbal mixtures act multi-specifically, i.e. they attack multiple targets at the same time. Network pharmacology facilitates the identification of the complexity of pharmacogenomic networks and new signaling networks that are distorted in tumors. In the present review, we give a conceptual overview, how the problem of drug resistance may be approached by integrating phytochemicals and phytotherapy into academic western medicine. Modern technology platforms (e.g. "-omics" technologies, DNA/RNA sequencing, and network pharmacology) can be applied for diverse treatment modalities such as cytotoxic and targeted chemotherapy as well as phytochemicals and phytotherapy. Thereby, these technologies represent an integrative momentum to merge the best of two worlds: clinical oncology and traditional medicine. In conclusion, the integration of phytochemicals and phytotherapy into cancer precision medicine represents a valuable asset to chemically synthesized chemicals and therapeutic antibodies.

A Five-year Survey of Cancer Prevalence in Sudan.

BACKGROUND: While cancer epidemiology is well-investigated in developed countries, the cancer burden in Africa is less well documented. We provide cancer statistics of 33,201 patients from all Sudan diagnosed at the Radiation and Isotope Centre in Khartoum (RICK). This hospital covers approximately 80% of patients with cancer in Sudan and is, therefore, considered representative for the situation in this country. MATERIALS AND METHODS: Data from 2009-2013 were collected at RICK. Cancer diagnoses were made by standard pathological and radiological methods. Epidemiological data were categorized by age, gender, resident state, marital status etc. and subjected to statistical analyses by SPSS 21v. RESULTS: The cancer prevalence rate per year was 5,000-7,000 among adults and 300-400 among children, with increasing tendency for adults. Male:female ratios were 1:1.18 for adults and 1.46:1 for children. The five most frequent tumour types were breast cancer, leukaemia, prostatic carcinoma, lymphoma and colorectal carcinoma in adults and leukaemia, lymphoma, eye tumours, sarcoma and brain tumours in children. Remarkably, the median age of cancer diagnosis was 10-20 years higher in men than in women, mainly due to earlier onset of gender-related tumours in females (cancer of breast, cervix, or ovary) than in men (prostatic carcinoma). Chronic myeloid leukaemia was the most frequent haematopoietic malignancy in adults and acute lymphoblastic leukaemia in children. Comparing cancer cases with population numbers of Sudanese states, Northern Sudan, River Nile and Khartoum revealed up to 8-fold higher cancer incidence rates than Al Gedarif, Southern Dafur and Blue Nile. The other states had intermediate incidence rates. Interestingly, oesophageal carcinoma occurred proportionally more frequently in Kassala (rank 3) than in the entire Sudan (rank 7) or other states. CONCLUSION: This is the largest survey on cancer burden in Sudan. It may serve as basis for governmental programmes for assessing risk factors, improving cancer prevention (e.g. by educational and vaccination programmes) and cancer therapy in the future.