The new year began with comforting reports assuring us that cancer is due to bad luck. Johns Hopkins researchers concluded that up to two out of every three cancers could be tied chiefly to how many stem cells divide within an organ. They advise expanding screening programs since most of the disease cannot be prevented.
The backlash to the story continues to mount. In an unusual rebuke, the International Agency for Research on Cancer of the World Health Organization lambasted this well-publicized study. Christopher Wild, Ph.D., director of the agency, declared:
We already knew that for an individual to develop a certain cancer there is an element of chance, yet this has little to say about the level of cancer risk in a population. Concluding that "bad luck" is the major cause of cancer would be misleading and may detract from efforts to identify the causes of the disease and effectively prevent it.
The WHO notes that cancer rates are growing fastest in the developing world where access to treatment and diagnosis remains poor. Screening programs are paltry and ineffective in much of the world and result in over-diagnosis and over-treatment in the U.S. Chief Medical Advisor of the American Cancer Society, Otis Brawley, M.D., told Medscape recently that as many as 20 percent to 30 percent of those diagnosed with lung, breast, and prostate cancers had disease that would never have killed them and probably should not have been treated.
"The remaining knowledge gaps on cancer etiology should not be simply ascribed to 'bad luck,'" says Dr Wild. "The search for causes must continue while also investing in prevention measures for those cancers where risk factors are known. This is particularly important in the most deprived areas of the world, which face a growing burden of cancer with limited health service resources."
In fact, the Hopkins analysis does not give smoking or other reckless habits a free pass, nor mean we should stop supporting efforts to identify and control cancer causes. Bert Vogelstein, the distinguished cancer biologist and senior researcher on the paper, noted that, "All cancers are caused by a combination of bad luck, the environment and heredity..."
Bad luck does not explain why five members of Raven Thundersky's Northwestern Native Canadian family died from a crippling lung cancer. Their deaths are believed to have come from living in a home tightly insulated with asbestos. Bad luck does not tell us why young men and women died of the same suffocating disease. Their deaths came from bystander exposure to their fathers' work clothes. Bad luck does not explain why an 8-year-old girl from Jiangsu Province developed lung cancer. Her doctor and the Chinese government fingered chronic air pollution as the cause of her disease. This past year the World Health Organization estimated that up to 7 million avoidable deaths occur each year because of polluted air.
The Hopkins analysis showed that the more common cancers they studied occur in those organs that grow the fastest. But, this new analysis does not mean that we should abandon efforts to clean up the environment and workplace. If anything their work only strengthens the case for protecting our environment and following tips such as those by Prevent Cancer Now.
There is no debate that whether speaking, driving or growing our cells, the chance a mistake can be made increases over time. Each instance a cell divides it copies its genetic code of DNA from one cell to another. The faster the growth and the more divisions that occur the greater the odds are that a mistake will be made and passed on to the next set of copied cells. Still, the Hopkins analysis explains the variation between some types of cancer but cannot account for why some workers, some residents of certain regions, or those that migrate die from developing to developed countries more often succumb to certain types of cancer. That's where the important new book by integrative oncologist Mitchell Gaynor can and should make a huge impact.
Gaynor's book, The Gene Therapy Plan shows that most cancer is not born but comes about as a result of things that happen to us after our birth. Even identical twins do not develop the same cancer. Basically, genes give us the guns, and the environment pulls the trigger. Tapping into a growing literature on the science of epigenetics, Gaynor outlines a host of nutritional and other factors that can fundamentally alter the risk of disease and even serious learning disabilities.
What if an environmental exposure increased the speed with which cells grow or hampers the capacity of the immune system to weed out bad apples? That's what Martin Blank explains can occur after exposing cells to mobile phone or other microwave wireless radiation. Similar impacts occur from volatile organic compounds such as those found in some engine exhausts, paints and plastics. What if an exposure mimics a hormone like estrogen and alters the rate at which breast, prostate, testes grow and repair damage? That's what studies with endocrine disrupting chemicals make clear.
In point of fact, the Hopkins researchers did not include two of the most common cancers in the world -- breast and prostate cancers -- because they could not find reliable information on stem cells. As Prevent Cancer Now research leader Meg Sears has suggested, "Perhaps that lack of reliable data is related to environmental exposures, or to exposures to chemicals from plastics used in laboratories." The work of Mark Hyman and colleagues as well as Breast Cancer Fund and Breast Cancer Action confirm the importance of many different environmental factors for that disease.
Studies of workers do find that rates of the Hopkins-excluded breast and prostate cancer are higher in those who work with solvents, ionizing radiation, heavy metals and a host of other environmental toxicants.
The ingenious mathematical modeling of the Hopkins report fails to take into account the growing recognition of the importance of fetal and early life exposures for adult diseases. It also cannot take into account the capacity of nutritional epigenetics to alter the chances we will develop cancer and other diseases and how well we may fare with them. We really are in some sense what we eat.
The Johns Hopkins analysis suggest there is a relationship between risk of cancer and number of cell divisions. But it does not address the proportion of cancers due to avoidable factors that can alter the rate of cell division. Want more proof about how the environment affects cancers?
Studies of adopted children show that the chance of getting cancer depends on the family in which you grow up in not the one to which you were born -- cancer risks of their adoptive families not that of their biological parents. Those who wish to prevent cancer would do well to focus on avoidable and controllable causes of cancer and other chronic diseases outlined in Gaynor's important new work and highlighted at next week's Integrative Healthcare Symposium in New York City February 19-21.