More Excerpts from My Writing: A Chapter on Cancer

Chapter 3:  Cancer

 As I wrote in the first chapter, one of three goals of the New York trip was to raise awareness for cancer prevention.  On my way up from West Virginia to New York, I had noticed a lump in Petey’s mouth.  I had been periodically reexamining his mouth and, as we left Buffalo, I noticed that the lumps had rapidly begun to spread and were now evident on the other side of the gum.  Doing some research on the internet in Buffalo, I worried that he had mouth cancer.  I became very protective of him, worrying that he was in his last days.  Tears, prayers, more tears, more prayers.  I posted an SOS on the internet.

                                         Photo:  Quick name 3 things you are grateful for

 Cancer is a pretty complicated disease.  It arises when the cell cycle goes awry in a cell, and the cell moves into a mode of unrestrained growth.  Why does this occur?  Like light switches that can turn on a light bulb in a room, there are a few switches in the cell that can activate the transition from noncancerous to uncontrolled growth[1] .  Ras is one[i], IKKalpha[ii] is another, TAK1[iii] still yet another.  Cell growth normally has 4 stages (G1, S, G2, and M), and each stage has its switch.   These switches are for the most part proteins in the cell that turn on or off in response to a signal.  A noncancerous cell will sit in a nondividing state called G0 outside of the cycle, and then reneter at G1 when a switch is activated[iv]

 When cells divide, new material has to be synthesized – mostly protein.  The code to make this new protein is in the cell’s DNA.   Every cell in principle starts out with the same copy of DNA – but there are at least 5 different points were gene expression is controlled to provide the differences that make a liver cell a liver cell and not a nerve or bone cell (http://en.wikipedia.org/wiki/Regulation_of_gene_expression).

 Any given protein can have mistakes that derive from the DNA that encodes it when a mistake is introduced into the DNA.  One inherits a certain propensity for cancer in one’s DNA, and the probability of random mutations developing in DNA that would activate a switch or fail to inactivate a switch also increases with age. Since the human body contains around 50 trillion cells[v] (about 10 times the number of people on the planet in 2010), and an average human body[2]  will experience about 10 000 trillion cell divisions over the course of a lifetime[vi] with each division producing an average of 120 uncorrected mutations, that comes to about 1.2 quadrillion uncorrected mutations in an average lifespan[vii].   98% of our DNA is not really known to do anything[viii].  Of the 2% that code for genes, about 1%[ix] of our 25000[x] genes are implicated in cancer. This is still 240 billion potentially cancer-implicated mutations that will each happen in at least one cell over the course of a lifetime.  If every cell that had a mutated cancer-implicated gene survived in our body, about 0.5% of our body would have mutated cancer genes. For a human being of average weight (150 lb), this would correspond to about ¾ of a pound of potential cancer.  Although it seems like a lot of opportunity for cancer, most of these cells will not survive. Not every mutation in a cancer-implicated gene will cause cancer.  Some mutations and/or genes are more problematic than others.  In addition to this, our body also has some global defenses against cancer largely built into its immune system.  As one can imagine, there are a few “universal switches” that will activate any cell, CDK-cyclin falls into that category.  Normally, however, different kinds of cells need to be activated or inactivated for growth by different switches and at different rates for proportional growth of a multicellular complex body.  Every cancer-implicated gene does not cause cancer in every type of cell[3] .  Inheriting abnormal BRCA tumor suppressor genes that are associated with a 5-fold increase in the incidence of breast cancer in women that have a mother or daughter with breast cancer[xi], can increase the risk of ovarian cancer 25-fold, and also increase the risks[xii] of gastric, renal, hepatobiliary, testis, pancreatic, melanoma, and prostate cancer[xiii], but they are not likely to significantly increase the risk of colon cancer[xiv].  The relative importance of a gene to various cancers is called cancer penetrance. 

 So the point is we are not destined to die with the same DNA that we came into the world with, and not every mutation is likely to cause all kinds of cancer all over the body.  To some extent, this why diseases become more frequent as we age, but it is also why the genetically-derived diseases we get tend to be specific diseases, and not global pathology.

 As seen in Table 1, the lifespan of different cell types varies enormously.

 

Table 1

Cell type

Life span

of cell

(days)

 

Dog cancer

factor[xv] 

Cancer symptoms

bone

between 10-12 days (osteoclasts)and 3-4 months (osteocytes),

Some live for years.  About 10% of one’s skeleton is replaced every year.

8X less in dogs

pain[xvi],sometimes a lump

testes

72

 

lump with or without pain[xvii],swelling,

pain in back or groin

leukocyte

13-20

2X less in dogs

fatigue, weakness, poor exercise tolerance, abdominal pain, swelling,

enlarged lymph nodes[xviii]

Blood red

120

  symptoms[4] 

skin

50-100

35X more in dogs

new growth, change in growth, or sore that won’t heal[xix]

brain

life

 

headache, weakness, clumsiness, seizures[xx]

prostate

 stromal 30 years

epithelial

>2 years

http://onlinelibrary.wiley.com/doi/10.1002/pros.2990150307/abstract

 

Frequent (night) urination, weak or interrupted stream, blood[xxi]

stomach

 2 days

http://vitanetonline.com/forums/1/Thread/1001

13X more in dogs

Abdominal pain, nausea, blood in stool[xxii]

thyroid

   

problems swallowing or breathing, hoarseness, enlarged neck lymph nodes, pain[xxiii]

bladder

   

blood clots in urine, urinating small amounts frequently, pain[xxiv]

esophageal

 

13X more in dogs

Heartburn, difficulty swallowing, vomiting, blood in stool or vomit[xxv]

mouth

   

sores that don’t heal, pain, lumps[xxvi]

pancreas

 1 year or more

http://vitanetonline.com/forums/1/Thread/1001

 

weight loss, jaundice, pain, fat in stool[xxvii]

kidney

   

red urine, pain, lump, weight loss, fever, tiredness[xxviii]

lung

17 months[5] [xxix]

7X less in dogs

cough, coughing blood, shortness of breath, chest pain[xxx]

liver

   

progressive weakness, appetite loss, often nausea and vomiting, constant pain in the right abdomen.[xxxi]

muscle

    symptoms

colon

 3-4 days

http://vitanetonline.com/forums/1/Thread/1001

 

blood in stool, diarrhea, constipation

abdominal discomfort

breast

 

4X less in dogs

lump, discharge from nipple

ovary

   

Abdominal bloating or pain, urinary urgency[xxxii]

cervical

   

discharge, bleeding after menopause[xxxiii]

uterine

   

Unusual bleeding or discharge,

painful urination; pain in pelvic area[xxxiv]

fat

 entire life of organism   symptoms

eye

    symptoms

 

Main Symptoms of Cancer in Dogs[xxxv]

Abnormal swellings that persist or continue to grow

Sores that do not heal

Weight loss

Loss of appetite

Bleeding or discharge from any body opening

Offensive odor

Difficulty eating or swallowing

Hesitation to exercise or loss of stamina

Persistent lameness or stiffness

Difficulty breathing, urinating, or defecating

 Cells need to grow at different rates when the body needs a response.  A broken bone needs to be rapidly repaired. Blood cells need to be able to respond to infection and redirect if necessary to another infection.  Sometimes it is what turns a switch for growth off that goes wrong. Apart from genetics and age, there is one other very big factor that influences the robustness of a switch – the environment.  Eighty to ninety percent of cancers appear to be caused by environmental agents[6] .  Of these, 30-40% can be influenced by diet.  The other significant causative factors are cigarette smoking, car exhaust, sunlight, and occupation.  The 7-fold increase in lung cancer in humans with respect to dogs is not accidental.

 

Graph 1:  Incidence of Cancer world-wide as a function of type of cancer[xxxvi],[xxxvii].

Graph 2:  Types of Cancer in Women (a) and Men (b)

Graph 3.  a) Breast cancer as a function of region  b)  Lung cancer as a function of region and gender in 2008.

 Over a million people were studied in 3 independent different studies to demonstrate a relationship between cigarette smoking and lung cancer.

 Graph 4:  Risk of lung cancer as a function of the number of cigs smoked daily

 Relative risk of Lung Cancer as a function of number of cigarettes smoked daily[xxxviii]

 Graph 5:  Effect of cigarette smoking, chewing tobacco, diet, and sunlight on cancer rates.

Time Lag between Cigarette Consumption and Cancer Incidence[xxxix]

 

The same foods that protect cells from the mutations that occur with age also protect cells from mutations that might occur through the environment.  Free radicals can be produced with toxins or age, and the radicals act on our DNA to change it.  Antioxidants are the main dietary weapons against free radicals.  Polyphenol phytochemicals (berries, apples), vitamin A or beta-carotene (greens, squash, carrots), lycopene (tomatoes), flavonoids and catechins (green and black teas, chocolate, grapes and wine, onions, garlic, leeks), vitamins C and E (found in citrus fruit, juices, and green vegetables) all contain a healthy dose of antioxidants.  Probiotics (yoghurt) seemingly reduce the risk of colon cancer, by populating the gut with bacteria lower in beta-glucuronidase activity[xl].  Diets rich in fruits, vegetables, and grain products have been demonstrated to have a beneficial effect in reducing the risk of cancer.  Watercress helps against breast cancer.  Tumeric fights cancer.  Fiber may help to reduce colon cancer (proposed mechanism[7] ).  Lowering the amount of fat we carry on our body, for example by fasting, as well as lowering our consumption of meat may also improve cancer risk, perhaps because many carcinogens (pesticides and steroids) dissolve in fat.  Fat cells apparently don’t ever die.  Microwaving food and pouring off the melted grease to remove the fat prior to consumption can seemingly also reduce cancer risk[xli]

 Graph 6: Consumption of fruit and vegetables and cancer incidence.

Graph 7:  Weight and cancer incidence

 Poor people very often don’t have much choice in the kind of food they eat.  Food recalls, like the cranberry or peanut butter scare, have been known to pack the church food pantries[8] .  A lot of it was thrown away, but some of us ate it.  Even when there was a recall and it was the 5th jar of peanut butter in the pantry (or outdoor box).  Here, at least during the summer and fall in New York State, nature provided.  We had apples – an excellent source of phytochemicals and vitamins. Hopefully they were pesticide-free.

 

Cartoon of Biological mechanisms [9] responsible for cancer.

 

There are many things we can do, simply and naturally, to help to prevent cancer.  Controlling what goes in our bodies is an obvious way of limiting exposure, and stacking the cards in our favor.  Cleaning up our environment, and demonstrating care for the chemicals that we release into the environment is a social imperative that is also friendly to animals who are forced to unknowingly consume these chemicals sometimes through insects, air, or the water supply for example.  Plants [10] can also get cancer. 

Picture of toxic waste

Graph 8;   Incidence rates of all cancer by state

 Ref. U.S. government[xlii]

 Approximately 1.3 million people were diagnosed with cancer in the United States in 2005 with a total treatment expenditure of about 48 billion dollars[xliii].  This puts the average treatment cost in the U.S. at $37000 in 2005.  With a projected worldwide incidence of 23 million in 2030[xliv], the global cost assuming a 2005 U.S. price tag and no inflation will be 851 billion dollars. The current world GNP is 30 trillion dollars[xlv].  About 3 cents of every dollar earned worldwide will go for cancer treatment if everyone is treated. It technically could work.  But let’s be realistic here.  With 4 cents of every dollar going for food alone[xlvi], and 15 million children dying yearly of starvation[xlvii], there is a distribution and priority problem to be considered.  With a world population of 6.7 billion[xlviii] today, (179 dollars/person need 2.7 billion dollars to feed children/ 1.2 trillion currently spent on food/) we would have to increase the food budget by about 2.7 billion dollars or 0.009 % just to address the issue of starvation in children.  That’s about 1 penny for about every $100 earned worldwide, or about a 1 cent donation every day by every person in your average U.S. household[xlix] assuming everyone worldwide is taxed equally.  If the U.S. were to assume this burden alone with its GNP of 14.2 trillion and population of 307 million, it would be about 2-3 cents/day for every person. 

 These are children looking for the most basic need, and still the penny doesn’t trickle down.  Three cents of every dollar does not seem like a lot at first, but when you consider the lives of these children, you start to realize that 1 cent/day/person = 15 million child deaths in our average global value system.  The economics are mind boggling.  There are many simplifications that were used in the calculations and perhaps a most basic assumption that feeding these children who currently die of starvation would cost as much as feeding the average child. 

As these words were written, the holy season of Ramadan began.  I had bought an alarm clock to set it for the 6 daily prayers, reciting those suras of the Quran that I felt comfortable with at these times.  The alarm was set to go off before the prayers begin so that I could wake up and feed myself.  Daylight is fasting.  No food or drink.  As it turns out, the Great Spirit sent a coyote this morning around 3 am, so the alarm clock really wasn’t necessary.  At least the first day – there were 29 more to go.  I have a few extra minutes, so I pick up the text that I have been writing and begin to reread and edit it.  The alarm to prepare for the 5:37 prayer sounds as I reread the third sentence 2 paragraphs above changing the position of the number 2005 in the sentence.

 “With a projected worldwide incidence of 23 million in 2030[l], the global cost assuming a 2005 U.S. price tag and no inflation will be 851 billion dollars.”

 The alarm for the 6:47 prayer sounds as I reread the 1st sentence[11]  of the following paragraph:.

 “These are children looking for the most basic need, and still the penny doesn’t trickle down.”

 It’s a lot to pray about, I realize, as I prepare two of my dogs for the sunrise prayer walk.  We pass a penny on the floor near the food on my way out.

 Still, there is a lot that can be done.  The buck isn’t the only way out.  We should never forget that there is a lot that can be accomplished without money.  Using one’s legs to visit someone or hunt for food in nature, one’s voice to talk to someone, one’s arms to hold someone, none of this requires money. A lot of prevention is in our hands with education.  When I think of the child who needed a liver transplant who was held hostage by a system until she died the day after it was finally approved, I have to ask:  What part of this problem really needed an insurance company’s signature to perform the transplant?  Were there not enough scalpels?  Were there not enough surgeons – one that would have had to work a sleepless 2nd shift perhaps?  Was the anesthesia not available for the surgery? Were the rejection drugs not there?  Would a scientist have had to spend a few more hours in the lab running tests?  It was a 17 year old child – and what happened was tragic[li].  We have to learn how to think outside the box.

 Immune systems play a pretty important factor in fighting some cancers.  Cancers of the lymphoid system, skin, and gastrointestinal tract are cancers commonly present in persons who lack an antibody component to their immune system (CVID disorder)[lii].  Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer are seen in AIDS, a CD4+ T cell disorder.  Each of these cancers can be caused by a specific virus in an immunocompromised person[liii].  In fact, as I find out later, Petey’s symptoms may have been benign tumors called papillomas surfacing in the absence of an immune response[liv]

Chemotherapy very often depletes the immune system since many therapies target rapidly dividing cells, so there is an interest among people with cancer in immune stimulants.  From a dietary point of view, these are found with echinacea[12] … There is a certain natural immunity that can also be a factor in protection against cancers. Someday, we may find vaccines for cancer[13] .  There is already one for human papilloma virus, the virus that causes cervical cancer. 

 Interestingly, from the U.S. data, in contrast to the world data, poverty does not seem to be an influence on the diagnostic incidence.  Two of the poorest states, Oklahoma and Kentucky, are also highest in incidence.  Perhaps education and lifestyle associated with poverty also has a negative impact on cancer incidence in these states.  Maybe it’s also the toxic waste dumpsites.  Toxic waste rarely gets dumped in a state where the cost of real estate is high.

 Obviously, in many countries, there isn’t enough money to even be able to ask the question: do I have cancer?  Why bother with a diagnosis for a disease that you can’t afford to cure?  Do you really want to know that you have this problem that you can’t do anything about?  The huge rally that can come from someone who has a lot to lose is simply not there in someone who, with more or less rapidity, is giving more and more of themselves simply to survive on a daily basis.  There were times on this trip through New York when people would leave spare change on the side of the road.  In the beginning, I would always pick it up.  Later, as I became more tired, I would weigh it out mentally.  Was a penny really going to solve my problem?  Was I going to be able to stand back up if I bent over to pick it up with my 70 pound pack?  It depended.  One mile into the day, I would go for it.  Several miles into the day, I probably wouldn’t.  Sometimes you just accept the cards you are dealt, and do the best you can with what you are given.  Earthly life is finite and each of us must meet its end more or less bravely with the resources we have.  There are many who have gone before us.   We should aspire to die with dignity.  It’s hard for the ones left behind, but time does heal the pain.

 We finally get enough money ($40) together for a vet visit in Alden, NY.  The vet said the tumors were caused by a virus, and that they would clear when his immune system kicked in.  It was a relief.  I guess what I really wanted to know was, how much time did he have?  If it had been a very rapid downfall, I might have simply just waited it out someplace without putting him through a trip.

 I hoped that the vet was right, and began prayers as we walked, thankful for the ability that allowed us to mobilize, in an act repeated humbly, desperately, and silently in all corners of the world by sick people who seek the closest help for their disease.  In other countries, the barrier that has to be breached may be distance, education, technology, and/or infrastructure (a road that might need to be built, for example, or more simply, a computer system that might need to be set up, and people trained).  In this country, the barrier might be an economic one.


[v]Asimov, Isaac. The Human Body, New rev. ed., p. 79; New Encyclopaedia Britannica, vol. 6, p. 134; Van Amerogen, C. The Way Things Work Book of the Body, p. 13.

[xxxvi]Ferlay J, Shin HR, Bray F, Forman D, Mathers C and Parkin DM.
GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010. Available from: http://globocan.iarc.fr


 [1]Look up cell cycle and switches that cause cancer.

 [2]How is a dog different?

 [3]True?

 [4]Look up symptoms of blood, fat, eye, muscle cancers.

 [5]Find accurate cell lifespans

 [6]reference

 [7]Need mechanism for fiber reduction of colon cancer.

 [8]Reference here

 [9]Biological mechanisms cartoon

 [10]Research and reference on plant cancer

 [11]Check with editing

 [12]Dietary immune stimulants.

 [13]Priorities for cancer research

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