FREQUENTLY
ASKED QUESTIONS ON CANCER
FREQUENTLY
ASKED QUESTIONS ON CANCER
When a cell in an individual starts behaving cancerously the individual is said to have cancer, or in other words the cell when starts dividing by its own self-determined rhythm without the body's need and also migrates from its site of origin and colonizes at distant site. On the contrary, a normal cell only divides to replace cell loss and maintain the constancy of cell number.
According to experts there are actually some 200 types of cancer and leukemia (blood cancer). They all agree that there is only one element common to all Cancers; in every case, normal cells have gone wild and lost their normal growth and development control. Why it happens, nobody knows.
No one is in a position to know the what, why, when, how, where and who of tumor formation [which is a la kipling, the aim of clinical cancer research], in a patient with cancer.
The medical finger accuses almost everything as carcinogenic (cancer causing agent) and having accused, move on to accuse still more. From the time Percival Pott suggested the relationship between soot and scrotal cancer in chimney – sweeps, the central theme in cancerology has been the postulated casual relationship between carcinogens and cancer genesis, an endless search for the culprit carcinogens, resulting in a publication explosion that fills innumerable pages in ‘scientific cancer literature’. The list of ‘cancer causing agents’ continues to grow with each passing day ranging from sunshine to sex.
However, where statistics cannot help, logic can. The proposition that a carcinogen causes a cancer is invalidated by the latter occurring without, and refusing to occur despite, the former. This Conundrum of a cancer – causalist could be expressed as follows: X causes Y, but why Y occur without , and not despite, X ?
To take but one example, the authenticated statistics are that on an average, of 740 smokers, only one gets lung cancer [Royal College of Physicians of London: Report on smoking in relation to cancer of the lung and other diseases. Pitman, London, 1962.] Such being the case, the onus of providing / explaining how cancer failed to occur is, for the causalists, 739 times greater than to prove how it did. WHO’s yearly published ‘The World Health Report (1997) said that the rate of women’s lung cancer in china is the highest world-over though Chinese women don’t smoke. Again, Japan has one of the highest per capita cigarette consumption rates, yet it has one of the lowest lung cancer rates in the world. [See, Eat to Beat Cancer - J. Robert. Hatherill, Renaissance Books, Los Angeles] No wonder the causes keep on changing, like ladies’ fashions. For cancer of the cervix, for example, it was smegma yesterday, but is sperm today. Now for lung cancer, smoking is going out, and some unexplained predisposition is coming in. And this parade will continue till we accept the universal intrinsicality of cancer.
Take lessons from Jory Graham. She came to know after surgical removal of both breasts that her cancer had spread to her spine and leg. Faced with so grim a diagnosis, she made a decision to write her cancer experiences in Daily News. ‘Time’ reported: " Each of the ten columns that has appeared so far has brought a heavy volume of mail to the newspaper. Though Graham has not hesitated to scold doctors for their insensitivity and inclination to ‘play God with my body and my life’, physicians are among her most faithful readers. (Time, 14 November 1977).
What were her
suggestions?- She rails against the phony cheerfulness of some visitors to
desperately ill patients: " Distraction isn’t what’s needed, perception
is". She advises the ailing to be candid as well but reminds them of
Hemingway’s definition of courage as " grace under pressure". To
relieve physical discomfort, she encourages friends " to cook a meal, do
the dishes, mend what needs to be mended, water the plants, answer the
phone". What to say to cancer victims? Graham wrote :- " the right
thing is honesty tempered with gentleness and a caring quality which, in the
last analysis, transcends all words".
[Also see 'Treating Cancer' of this website]
No, Cancer is not necessarily a 'Killer Disease'. We know many cancer patients who lived with their cancers (of different types) for decades without any trouble. We have already quoted from the book ‘Seeds of Destruction’ to prove that if not disturbed, cancer generally, causes no such harm to its host for a fairly long period (See 'Home Page' of this website). For your information, we are quoting from obituaries of three aged persons who were diagnosed having very advanced liver cancer hardly few days before their death.
h
fortunate cancer patients whose cancer decided to die with their
hosts.
For a detailed reference see the 'Early Detection' page of this web-site. We will answer this question in this page with some points for pondering:
If we are to bank
upon lab-utopian understanding of cancerology, each of us should undergo at-least 20 different tests for the detection of common cancer, like
lung, prostate, liver, stomach, breast, uterus etc. Rang,M. in his article : The
Ulysses Syndrome (1972) pointed out that if each person has 20 different tests
performed on him or her, then 66 per cent of healthy people will have one or
more abnormal results. This means that 66
per cent of all normal humans will need some - ectomy.
The evolution of
cancer in human body from inception to manifestation, is recognizably a silent
process. And thereafter too, cancer is not synonymous with pain. Nature in its
profound wisdom and generosity has allowed cancer to evolve in the human body
without the punishment of pain. Astonishingly, the WHO has taken upon itself the
task of providing pain relief. One glaring truth it needs to emphasise is that
cancer per se is painless; cancer treatment is painful. Treated cancer and
painful death tend to go together. Ask any cancer victim’s relatives and they
will conform it. The Lancet described oral cancer as an obstinate clinical
problem, and lamented that more than half of all patients in England and Wales
with intra-oral cancer, presented themselves at a late stage of the disease. Why
at all, one may ask, should such a thing happen when a very small aphthous ulcer
in the oral cavity can create hell for a patient through the trigeminal nerve?
Why should the oral cancer not imitate the aphthous ulcer? The truth is that it
is in the very nature of cancer to be painless during the major part of its
existence in the patient’s body. Like Nature, cancer is cruel but cancer is
kind. And cancer is painless, because it is, teleologically speaking, meant to
be so. A Patient who ‘neglects’ a cancer does so because the cancer does
not, for long, dis-ease him or her. Which city dweller ‘neglects’ a foreign
body in the eye or an acute pyogenic abscess in the perianal region? (Editorial:
Oral cancer: A stubborn problem. Lancet, 1:299. 1972.
How can we deny facts and statistics ? What we can do is, 'to seek the truth from facts'. There’s no denial that the death rate of certain cancers have been decreasing . Why? It is because the incidences of such cancers are decreasing since 1950s? We hope, viewers will bee able to understand the truth from the following revelation:
"Nevertheless, cancer of the stomach accounts for only 4 percent of all cancer deaths today, compared to 20 percent in the 1950s, nobody knows why." [The New Complete Medical and Health Encyclopedia, (volume 4, Page 1267)- by J. G. Furguson Publishing Company, Chicago]
When nothing really works, everything can be supposed or shown as working against cancer. In Genes, Dreams and Realities the politics and funding of the non-science of cancer have been most candidly and most pertinently stated by Nobel Laureate, Burnet. He points out that scientists now-a-days have got used to telling "white lies – making announcements to justify public support for their own work, knowing fully well that their claims that their work will help toward discovering the cause and cure of cancer have no scientific validity." [See, Burnet, M. : Genes, Dreams and Realities. MTP, Bucks, 1971.]
The whole concept of oncogenes rests on circular reasoning. "How far is your home from mine?" – "Simple, It is as far as my home is from yours." "What is the difference between capitalism and communism?" – " In capitalism, man exploits the man. In communism, it is just the reverse."
The above questions and answers illustrate circular reasoning: apparently convincing, but basically senseless. Koestler found that Darwinian dogma of "survival of the fittest" was pregnant with circular reasoning: "Who are fittest?" – "Those who survive." " Who survives?" – "Those who are fittest."
A cancer (onco = cancer) must be dependent on genes that can thus be called oncogenes. Oncongenes work by secreting oncoproteins. Oncogenes can be countered by anti - cancer – genes or anti – oncogenes, thus providing you with the concept of gene – therapy of cancer . It is significant to note that science as of now can define neither cancer nor genes, and yet can talk of and work upon cancer – genes or oncogenes.
The polar opposite of oncogenes is the concept of oncosuppressor – genes which supposedly prevent cells turning cancerous. When the suppressor – genes get mutated (read changed), they lose their control and cancer results. The suppressor – gene concept is another variant of circular reasoning : if there are genes that cause cancer, there must be those that suppress / prevent its occurrence. In 1979, at the 66th Ciba Foundation Symposium between 26 world – class scientists and clinicians, some of them Nobel – laureates, they discussed the Possibilities and Realities of Human Genetics. The chairman’s final lines, with which the whole symposium ends, are very telling : "We have had a very exciting meeting and our symposium will be a landmark even if it only records our confused perception of the future of genetics and human biology." [Brener, S.; chairman’s closing remarks. In, Human Genetics: Possibilities and Realities. Ciba Foundation Symposium 66. Excerpta Medica, Amsterdam, 1979, pp. 413-414.]
Let us move from 1979 to 1997. The epilogue to a 1000-page tome Genes VI (sixth edition) talks only of " romantic pessimism." [Luria, S. : Quoted in, Epilogue. Genes VI by B. Levin, OUP, Oxford, 1997, P.1211.]
A great paradox of "Human Genes Mapping and Cancer Therapy" is that it uses viruses to carry into cancer cells the right message that they better turn wise. [Siniscalco, M. : Human Gene Mapping and Cancer Biology. Loc. Cit, in 19, pp.283-307].
This is a classic example of set a thief to catch a thief. That has been the history of cancer therapy : What causes cancer ; hormones, rays, chemicals, viruses: is mooted as curative.
Cancer cannot be inherited i.e. cannot it be passed from one generation to another. Willis the famous bio-pathologist had generalized that most of the ‘cancer families’ exemplify only the laws of chance (Pathology of Tumors, Butterworths, London, 1967). Scheinfeld commented way back in 1939 on the problem - ‘Thus, in grandmother, mother and daughter, where all have breast cancers, each of their cancers may be entirely unrelated to the others ... The breast cancers in the three generations of women might be no more related than three cases of stomach trouble, one resulting from over-eating, another from drinking bad liquor, and the third due to stomach ulcers.’ Researchers from the Karolinska Institute in Sweden studied more than 44,000 pairs of identical twins from Denmark, Finland and Sweden. Generally, if one of the pair developed cancer, the odds of the other twin developing the same cancer were less than 15 per cent. Let us move on to some facts: American Cancer Society also observed that "Only about 5% to 10% of all cancers are the inherited type". The breast cancer issue of EHP (Environment Health and Perspective, April 1997) found that only in 2% cases of breast cancer the predecessor of the patient had breast cancer.
Cancer is remarkably constant as
a herd feature. ‘Anybody who spends a little time brooding over the statistics
of cancer must be struck by their unexpected constancy. From year to year the
figures for each form of cancer show remarkably little variation.’ Having so
generalized, Glemser cites exact figures: ‘ Here there are 5,355 cases of
cancer of the pancreas one year, 5,427 cases of cancer of the pancreas two years
later - almost the same number. Or in another country, there are 218 cases of
cancer of the pancreas one year, 221 cases of the pancreas the following
year.’
Sir Thomas Browne, the author of
Religio Medici, compassionately opined that ‘the mercy of God has
scattered the great heap of diseases, and not loaded any one country with
all.’ Cancer occurs everywhere, but in excess nowhere. A high incidence of
cancer in one organ in a given country gets balanced by a low incidence of
cancer in another organ. Segi and co-workers in their report on mortality due to
cancer at selected sites in 24 countries for the year 1962-63, placed
Chile first (among all countries) for carcinoma of the uterus and of the stomach
in females, second for carcinoma of stomach in males, twenty-fourth for leukemia
in males and twenty- third for the same in females. They placed Israel
first for leukemia in males and females, and twenty-fourth for carcinoma uterus.
In the global scatter of cancer incidence, India shows the highest
incidence of cancer of the mouth, pharynx and larynx, but is down below the
other countries in the incidence of other cancers.
There are other implications of
cancer’s constancy as a herd feature. Geographically adjacent countries
present startlingly different statistics. Ireland, barely 60 miles away from
England, has 10 times more cancer of the lip than England, with reversal of the
rates for cancers of lung, breast and uterus. On the other hand, countries poles
apart present comparable cancer incidence - lethal prostatic carcinoma shows
nearly equal incidence in Canada and New Zealand; women in Scotland and the USA
have similar death rates from carcinoma of the colon and the rectum.
A large part of the so-called
geographic variations in cancer of different organs is more racial than
geographic. For example, as Khanolkar stated: ‘Now, what is remarkable
from a cancer point of view is that the most common cancer in Hindu women is a
uterine cancer. But with the Parsi women the most common cancer is of the breast
... Environmentally, their conditions appear to be the same. What is so
interesting is that we find some cancers more common in certain groups of people
than in other groups living in almost identical circumstances.’ While Parsis
have a high incidence of breast cancer, they have ‘an exceptionally low
incidence’ of other cancers.
The impartiality with which
cancer affects mankind the world over, the constancy of its occurrence at
particular sites in a country year after year, its ‘startlingly different
statistics’ for geographically adjacent countries,. and equally startlingly
similar statistics for countries and people poles apart are all
indicators of cancer as an integral human/herd feature that has nothing to do
with all the postulated cancerogens. The International Agency for Research on
Cancer (IARC) Lyon, France, works on and publishes continental data on
cancer to get clues to the causation of cancer on the basis of ‘risk
differentials,’ which insimple terms means an explanation for the high
incidence of oral cancer in India but not in Japan. The IARC fails to mention
that reliable-year-after-year data on cancer in a country or in a population,
and never refers to the fact that if there are ‘high differentials,’ there
are compensating low or very low differentials, as well.
Summarizing, one could say that cancer is, even at the
human level, a discernible universal feature that is independent of the presumed
cancerogens, and is impartial in its global sway. Cancer is a part and parcel of
mankind.
The environmentalistic claim that migrants readily develop a cancer profile typical of the host community made regardless of the ‘manifestly inadequate’ data and the many difficulties associated with the study of migrants, fails to find support epidemiologically. Japanese migrants in the USA maintain the high rates of stomach cancer typical of Japan, as also the characteristics low rates of breast and cervical cancers, and of leukemias
Should I be tested for Cancer ?
We had answered this question in negative in the page "Treating Cancer" of this website. To make things further more clear to our viewers we reproduce here in verbatim a book review published in JAMA (The Journal of the American Medical Association, December 8 2004 - Vol. 292). Hanna E Bloomfield of Center for Chronic Disease Outcomes Research Minneapolis Veterans Affairs Medical Center University of Minnesota have made an excellent review of the book "Should I Be Tested for Cancer? May be Not and Here's Why by H. Gilbert Welch":
IN THIS ENGAGING, CLEARLY WRITTEN book, H. Gilbert Welch, MD, MPH, attempts to make the case that, when it comes to screening for cancer, an ounce of prevention may, in fact, not be worth a pound of cure.
Written primarily for a lay audience, the book is divided into two parts. ln the first, "Problems You Should Know About," the author outlines the various potential downsides of cancer screening, including adverse effects of the invasive testing that. often follows positive screening results: the detection of pseudo-disease or early disease that may lead to unnecessary treatment: and the anxiety engendered by false-positive results, repeated cycles of testing, or the detection of disease for which the benefits of treatment are not known.
In the second part, "Becoming a Better Educated Consumer," Dr Welch explores the multiple and complex forces that have propelled cancer screening to its exalted position in the US health care culture, including fear of malpractice, infatuation with technology', and financial incentives. He also devotes a chapter to explaining why certain-widely quoted statistics, such as 5-years survival and cancer incidence rates can be extraordinarily misleading. In my view one of the most important messages of this book that most patients and health care providers don't understand, but need to, is that "new diagnostic tests and aggressive screening rates will always lead to increased five-year survival rates, even if early diagnosis doesn't help people live one day longer" (p 149). Another chapter explains the inherent difficulties of doing research in this area, using the mammography screening studies as an example. This is a difficult chapter to follow, and a hurried reader who chose to skip it would not be missing much.
In the final chapter, the author tries to tie it all together to answer the question on every patient's mind: when all is said and done, should I, be screened for cancer or not? And if so, for which cancers? While there are clearly no definitive answers to these questions, this chapter does include some practical suggestions. Perhaps the most important contribution Welch makes here is to empower people who are inclined not to be screened for cancer by showing how this decision is not only not an irresponsible choice but can, in fact, be an expression of very positive personal values. "People who feel this way prefer to work to stay well, reserving medical care for problems as they present themselves" (p 181). Also useful in this chapter are four "prudent policies": "Tell your doctor you understand there are reasons not to be tested"; "Don't overreact to abnormal test results"; "Have another pathologist evaluate small cancers"; and "Consider a menu of treatment options" (pp 185-186).
This is an exceptionally well-written book with excellent use of anecdote and dear and direct explanations of complex concepts. The author assumes a friendly persona; it felt like a trusted doctor who had just stepped out of a Norman Rockwell painting was talking to me. (This may sound cloying but was actually surprisingly effective). Although it is clear that Welch has a strong point of view, his case is made in an even-handed way, and he acknowledges areas of uncertainty clearly. The text is accompanied by useful figures, graphs, and tables and, for the lay reader, a good glossary of scientific terms.
Although the book is written primarily for a lay audience, the concepts in it are challenging and complex and will be readily understood only by the most educated and diligent lay readers. I can imagine recommending this book to only a very few patients or friends who are really interested in the topic. Even some health care professionals will find this material difficult, although I believe primary care providers owe it to themselves and their patients to become familiar with the rationale for exercising caution when it comes to cancer screening. Readers generally familiar with basic statistical and epidemiological principles and the potential pitfalls of cancer screening will probably find the book unnecessarily long. Overall, though, I strongly recommend Should I Be Tested for Cancer? as a welcome antidote to the hype and simplistic slogans that characterize the current widespread and indiscriminate promotion of cancer screening.
“In several forms of cancer, survival of five years after a therapeutic procedure means little by itself, since a considerable proportion of untreated patients are known to survive five years or longer.” (Homeburger, F. “ The Biologic Basis of Cancer Management, Hoeber Harper N.Y.1957.)
Yes the evidences are galore. We have sited some facts in the page "Treating Cancer" of this website and present some more below, though oncologists continue to believe in aggressive theraupetic treatments:
"On the contrary (to the fact of treatment), if one bothers to scan the literature, there are ample articles on just this subject"- wrote K G Swan in his article "Surgeon and Operations" [New England Journal of Medicine, 282:1105, 1970]
HJG Bloom wrote on "Untreated Breast Cancer" in Annual N.Y. Academy of Science, 114:747,1964
We can know about untreated cancers of esophagus, stomach, colon, rectum, liver, gall bladder and pancreas from H.S Eisenbreg's article "Trend in Survival of digestive system cancer patients in Connecticut, 1935 to 1962", which was published in "Gastroenterology" 53: 528, 1967.
Durrant and Co-workers reported, in 1971 a "Comparison of Treatment Policies in Inoperable Bronchial (lung) Carcinoma". They randomly allocated 249 patients to four different groups, each treated differently. One such groups was – the wait and see group. The other three groups were given radiotherapy, chemotherapy, or combination of both. The authors of the report felt that their results offered no evidence that immediate radiotherapy and / or chemotherapy leads to prolongation of survival or to prevention of incapacitating system in-patients with inoperable lung cancer.[Lancet 1:715,1971]
We also furnish here some cases of well known personalities who preferred non-treatment or at best symptomatic treatment:
In 1948, William Boyd, the great guru of pathology and author of "A Textbook of Pathology", was diagnosed having mucus-cell carcinoma of the parotid, at the age of 63. He lived with his cancer for more than 25 years and superbly updated his book’s eighth edition, having 1464 pages with 908 illustrations in 1970.
Alexander Solzhenitsyn had stomach cancer which was far too advanced to be operable in mid-1950s. But it could not dried up his pen nor has it deprived him of a marriage thereafter to Natalya from whom he has two sons. He got the Nobel prize, too, for literature despite a ‘Killer’ disease over decades ago. He is alive today.
Sigmond Freud had two ‘Killer’ diseases: ‘a coronary thrombosis’ in his 30s and an oral carcinoma in his 60s. He lived with his cancer for 16 years and had 33 operations performed on him for this. Repeated recurrences of cancer could not kill him but had to be helped to death by a friend, his physician, Max Schur, who injected morphine to put him into ‘a peaceful sleep’.
“In 1960, I was diagnosed cancer melanoma, and doctor gave me two months to live. But I did not let that deter me, and here I am today.” That was from Fr. Joachin Fuster, the authority of Counseling Psychology, to a roomful of people, who are among the India’s foremost doctors and psychologists today. (See, The Times of India [Mumbai] 28/10/2004).
Mr. Komal Kothari, an authority of Rajasthan folklore, was diagnosed having advanced cancer in 1996 by Tata Memorial (Mumbai) specialists. The prognosis of the doctors was three years and was prescribed chemo theraupic drugs. Mr. Kothari refused to take that medicine and lived with his cancer for approximately nine years and died at the age of 76.
Mrs. Mina Ganguly a well known resident of Dum-Dum Motijheel of Calcutta was diagnosed having a very advanced stomach cancer in 1980, when she was 53. Cancer specialists told her relatives that “She will have to go within 15 days.” But, that was not to be. She lived up to 1997, practically without any trouble, except feeling of pain which she managed by taking painkillers and thus gaining comfort.
The real enemy of cancer cure is not the cancer itself, but the adjacent normal cell, waiting for its turn to grow cancerous.
In cancerologic parlance, this process of normal cell joining the cancerous troop is called recruitment or neo-canceration of normal cell. The cancerous army thus can potentially become as big as that of the normal cells in the body. This simple fact rules out the cancerologist’s dream of ‘The Last Surviving Cancer Cell - The Chances of Killing it'. The neo-canceration cannot be prevented as the process of canceration is causeless.
Why do we term cancer as a "Biological Phenomenon" and not a medical problem?
Cancer is a "Biological Phenomenon" due to the following reasons:
Cancer occurs in all living beings including Plants and insects.
It has been suggested that life, as we understand it today, emerged from the purposeless, incessantly proliferating cancerous mass called pre-life (Dawe, C.J.: Phylogeny and oncogeny. )
Differentiation of cell is a normal process, hence all cell has the potential of turning cancerous.
The formation of a cancer cell, from a normal cell of the body at any age, is once again the creation of a distinct, new cell type - one that looks and behaves differently despite having the same genetic content as all the other normal cells of the body.
There is no consistent single, structural, immunological, or biochemical dividing line between a normal cell and its cancerous counterpart. Thus a cancer cell does not have any feature which is not observed in some normal body cell. e.g. Cytokinetically, both leukemic and normal cells demonstrate ‘equivalent cell renewal activity' (Henderson, E.S.: Acute lymphoblastic leukemia. In, Cancer Medicine)
Cancer does not dis-ease an individual for a long-long time, a mole in the tooth in many occasions much more painful than a cancer in its fourth stage. Every individual has the potential of developing cancer but world-over 1 in five will get it that is a certainty, but who that one is a probability (Kark, W.: A symposis of Cancer. John Wright, Bristol, 1966, p.101 )