email sent May 12, 2016

Subject: Delete If Cancer Bores You…

… or, Finally, a Brief Email and It’s Only About Cancer?!

Yesterday, a wonderful friend from forever ago asked, “What causes that first cell to change?” It’s a tough question and a great question. Obviously, I’m no expert, not at all. But, as I am wont to do, I have formed opinions. After 5 years I should have some thoughts, right? I answered her mostly by digging up passages from what I have read.

  •  All of our bodies possess oncogenes that have the potential to induce a normal cell to become cancerous.
  • A cancer cell must acquire six characteristics as it develops: “It must acquire the ability to stimulate its own growth and to ignore signals admonishing it to slow down. That is where the oncogenes and tumor suppressors come in. It must learn to circumvent the safeguard of programmed cell death and to defeat the internal encounters – the telomeres – that normally limit the number of times a cell is allowed to divide. It must learn to initiate angiogenesis – the sprouting of its own blood vessels – and finally to eat into surrounding tissue and to metastasize.” [per Douglas Hanahan & Robert Weinberg, The Hallmarks of Cancer, 2000, excerpted from George Johnson’s The Cancer Chronicles Unlocking Medicine’s Deepest Mystery]

Along with smoking and obesity, the greatest risk factors are old age and entropy. Environment, genetics, and diet play a role, but a very small role in comparison. Every day, our cells are wildly mutating as they divide. As we live longer, the mutant cells have a greater chance of meeting the six requirements and forming tumors. And once formed, they are very adept at adapting to challenges to their survival. Sheesh, even dinosaurs had cancer!

“The infectious diseases we have defeated were each caused by a single agent – an identifiable enemy that could be killed or vaccinated against. With cancer we would have to seize control of a whole slew of factors, including the mishmash of symptoms arising from imbalances in energy metabolism. And the biggest risks will always lie beyond our grip: old age and entropy. Cancer is not a disease. It is a phenomenon.”

The author also made the case for how different cancer is from other maladies. Unlike the diseases that have been conquered in the past, there won’t be a single vaccine or a single antibiotic to vanquish cancer. Cancers vary greatly; it’s highly unlikely there will ever be a single panacea.

[George Johnson, The Cancer Chronicles: Unlocking Medicine’s Deepest Mystery]

  • ŸA Johns Hopkins news release from January 1, 2015 stated, “Scientists from the Johns Hopkins Kimmel Cancer Center have created a statistical model that measures the proportion of cancer incidence, across many tissue types, caused mainly by random mutations that occur when stem cells divide. By their measure, two-thirds of adult cancer incidence across tissues can be explained primarily by ‘bad luck,’ when these random mutations occur in genes that can drive cancer growth, while the remaining third are due to environmental factors and inherited genes.” And, of course, the random mutations accumulate as we age, which isn’t bad luck, but we are taking our chances.
  • 1 in 2 American males develop cancer, 1 in 4 die from it (mostly lung/bronchus and prostate). 1 in 3 American women develop cancer, 1 in 5 die from it (mostly breast, lung/bronchus, and colon/rectal). [as of 10/1/14]

[http://www.cancer.org/cancer/cancerbasics/lifetime-probability-of-developing-or-dying-from-cancer]

My conclusions… Cancer is prevalent, far more so than you may think. There are three major risk factors. We can increase our risk by smoking and becoming obese. The third major factor is living longer. For this reason, we are almost predisposed to develop cancer. The mutations accumulate with time; the longer we live, the higher the risk. The randomness of mutations, combined with the ingenuity and resiliency of cancer cells, make this disease so exceptionally difficult to conquer.

With love and gratitude,

Jim

p.s. Bonus quotation for those of you who read this to the end:

“The best remedy for those who are afraid, lonely or unhappy is to go outside, somewhere where they can be quiet, alone with the heavens, nature and God. Because only then does one feel that all is as it should be.” Anne Frank

p.p.s. The alleged 2.5 inch suture line turned out to be 5 inches long. Owie!

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