To explain why pain occurs due to artemisinin therapy, I must explain to you in detail the complete mechanism of pain in cancerous diseases and all the characteristics of cancer associated with pain. We must also focus on classical anticancer protocols such as chemotherapy and radiation and analyze their impact on the development of pain due to their constant use and greater use than the alternative method of artemisinin.
How cancer develops
Cancer occurs when cells in our body accumulate enough mutations and disrupt regulatory factors in the cellular environment. These cells will continue to divide, regardless of the level of cell density in the environment in which they are located. Cancer cells have managed to overcome the status of extinction, and in that way, malignant cells achieve the status of immortality. These cells will continue their local proliferation, depriving healthy cells of their blood supply, taking blood as a non-functional organ in the body, and consuming huge amounts of energy.
Cancer cells will at some point acquire the ability to penetrate the basement membrane and thus allow themselves to invade other distant parts of the body, a process called metastasis. These cells will repeat the same pattern in a distant area of the body, multiplying by stimulating angiogenesis to provide enough blood in nutrients and fuel for their unbridled metabolic activity. Healthy cells deprived of these ingredients will also have reduced functions and endangered survival. All these events of carcinogenic activity can be observed through the following physical results: increase in the external mass of the tumor due to its spread and increase in the mass of tumor cells, increase in the internal mass due to compression and cell development, and as a result of severe pain due to neurological deficit.
Cancerous cells, whether benign or malignant, resulting in abnormal growth and development. If the tumor cells are located on the skin or near the body’s outer parts, they can also spread externally. If the mass of tumor cells is located in the internal part and since it does not have an expandable nature due to our internal barriers in the body, the mass of tumor cells will manifest as a compression syndrome. This space occupied by the lesion will result in a compression syndrome. For example, in brain tumors, the mass will be compressed in a certain brain area by pressing on blood vessels, neurons, and long surrounding tissue. The result of this process will be a local neurological deficit and pain. Healthy cells will be prevented from sufficient blood flow and eventually begin to die, creating space for further cancer. If compression occurs in the lungs, it will cause difficulty breathing. As in bone cancer, compression in the bones causes deformity in the bones, unbearable pain due to stretching or compression of the bone cells.
Construction of cancer cells and their metabolism
Healthy cells are fighting a constant battle to supply blood and nutrients to cancer cells. Cancer cells have a higher degree of metabolic activity due to continuous division. These cells will induce blood vessels’ growth through a process called angiogenesis. Through this dilation of blood vessels, normal cells are deprived of the supply of nutrients, manifested through the dysfunction of certain organs, and leads to certain clinical abnormalities in the body. Relevant markers of organ function will also show abnormal values.
Since cancer cells use a huge part of cellular resources, the patient’s body will begin to lose weight in a short time with the accelerated loss of energy. The immune system of cancer patients is very endangered, leaving the organism very susceptible to diseases. It will also not be able to fight against neoplastic cells, leaving a huge space for further development and cancer progression.
Pain when using artemisinin
75% of the pain caused by cancer is attributed to its disease. The pain is related primarily and is caused by compression of the surrounding tissue and pressure nerve endings and further by transmitting painful signals to the brain. Also, the death of certain cells can cause pain. If the cancer is located near the surface of the body or on the surface itself, the pain will be localized due to the nature of the nerves’ spread. On the other hand, if the tumor spreads within one of the internal organs, the pain is usually not exactly localized. It spreads to other parts of the body far from the original location. Since pain is mainly related to tumor cells’ activity and size, its presence may be directly related to increased tumor activity, but this may not be the rule with every onset of pain.
Patients undergoing treatments such as radiation or chemotherapy may experience post-procedural pain caused by the effects of radiation and chemotherapy on healthy cells. In that case, normal cells are damaged due to the therapeutic process, which results in pain due to damage to the neurons themselves.
When cancerous or healthy cells are injured in the therapeutic process, they release cytokines that act as nociceptive stimulants on nerve endings, stimulating pain signals. This is why some people may experience pain after post chemo or radiotherapy. With quality analgesics, pain can be well controlled in about 90% of cases. It is important to note that pain can also be modulated in different perceptions and tolerances in patients, explaining why different people respond differently to the same level of pain. Most of them are under the influence of the stigma of whether they will fail or fall into deep helplessness in cancer patients. In these cases, deep depression occurs in patients with cancer, which greatly affects the modulation of pain perception.
Increased level of tumor markers
In addition to very high pain, some patients experienced increased levels of tumor markers due to chemotherapy treatment. This phenomenon is not uncommon. Tumor markers grow mainly in correlation with increased tumor activity, but this should not be equated with chemotherapy’s ineffectiveness. In many cases, these phenomena were directly related to chemotherapy’s effectiveness. Due to some scientific research on colon cancer that has metastasized to other organs due to chemotherapy, there was an increased level of tumor markers. Still, after some time, there was a reduction of tumor markers and a reduction in tumor volume and metastasis.
Researchers are currently working on an explanation of this phenomenon described above. Before starting chemotherapy, cancer cells function in a balanced way. Their growth limits the blood supply. As cancer cells’ growth accelerates, the blood supply becomes a limiting factor, which goes beyond angiogenesis to provide nutrients and meet the metabolic requirements of cancer. The mass of the cells will continue to grow, and the cells in the center of the mass will slowly be deprived of the blood supply, resulting in the death of the cells in the tumor nucleus. The tumor mass will decrease over time, which will provide space for the development of new cells and their growth. The cycle will continue, and in the process, the body will be deprived of all nutrients and energy.
The same is the case with the successful action of some anticancer therapy. When using the anticancer drug artemisinin, some cancer cells die, releasing cytokines that, as mentioned above, stimulate nerves and produce pain signals, and by reducing the population of cancer cells, its activity increases. This action automatically leads to increased levels of tumor markers in the body. . Also, this activity of dying gives more space for increased development of new cells. This action can compress the surrounding areas by pressing the nerve endings, stimulating additional pain. When this therapy reaches the optimal level, when more cancer cells are destroyed than cancer manages to produce, there is a sudden drop in tumor markers and a decrease in tumor development due to artemisinin’s action. Also, in some initial results before reaching this level, we have a case where the volume of cancer did not decrease, but there is a decrease in the tumor’s compression or density. Over time, the action of artemisinin on the tumor due to reduced compression increased death of cancer cells about their re-production leads to a decrease in volume and reduced pressure on nerve endings and reduced cytokine release resulting in reduced pain.