Cancer: A Preventable Disease Is Creating a Revolution

Cancer is the most dreaded of all diseases, and ever since a "war on cancer" was declared 40 years ago, massive research has made progress, although the battle is far from won. Very little of this research has been directed at prevention. Advanced medicine, like the person on the street, has tended to think of cancer as something we have no control over: It happens to us or it doesn't.

The reason for thinking this way can be seen under a microscope, which reveals that malignant cells are misshapen compared to normal cells. Disastrous mutations at the genetic level lead to abnormal cell division, causing cancer cells to become rogues in the body, multiplying without check, crowding out normal cells, and in general wreaking havoc by losing communication with the body's fine-tuned intelligence.

Yet we may be seeing a revolution in our whole approach to cancer. Some highly-placed researchers now believe that 90-95 percent of cancers are preventable with drastic lifestyle changes. This represents a total reversal from what used to be taught in medical school, which held that only 5 percent of cancers could be traced to environmental factors like diet or chemical toxins. If the new view is correct, then for the first time we may have found an open road to ridding society of its most dreaded scourge.


To begin with, the genetic trail hasn't led to a cure, only to greater and greater complications. A disease like breast cancer, when examined at the genetic level, isn't one disease but hundreds. Yet at the opposite extreme, genetic mutations may be playing a much smaller part than anyone ever thought.
Craig Venter, who led a private effort to successfully map the human genome, neatly summarizes the situation:

"Human biology is actually far more complicated than we imagine. Everybody talks about the genes that they received from their mother and father, for this trait or the other. But in reality, those genes have very little impact on life outcomes. Our biology is far too complicated for that and deals with hundreds of thousands of independent factors. Genes are absolutely not our fate."

In some cancers, inheritance certainly plays a major factor. For example, childhood cancer, of which the most common is a form of leukemia, has a simpler genetic profile than adult cancers. By targeting specific mutations, doctors who treat childhood cancer have raised their success rate from 20 percent to 80 percent in the past 40 years. Children with cancer must undergo severe regimens of chemotherapy and radiation, but it's no longer a case, as it once was, of killing the tumor before the treatment killed the patient.

For a vast majority of oncologists, targeting a malignant cell with chemo and radiation, along with surgery to remove the tumor, remains the mainstream approach. The track of prevention is all but unknown to them. There is no doubt that a cell has to mutate in order to become cancerous. Yet an inherited mutation isn't the same as an acquired mutation, one that develops during the lifetime of the patient. Let's simplify the case and divide acquired mutations into two types: those that result from accident and errors on the part of a person's DNA, and those that are linked to lifestyle. The revolution that is looming in cancer is based on believing that the lifestyle link is so strong that it accounts for 90 percent or more of cancer occurrences.

Let's pursue this line of reasoning with the expectation that doing everything you can to prevent cancer is clearly the best choice.

What medicine refers to as environmental and lifestyle factors include some familiar culprits: overweight, lack of exercise, poor diet, smoking, overuse of alcohol and overexposure to UV and other forms of radiation. Of all cancer-related deaths, it's thought that 25-30 percent are due to tobacco; 30-35 percent are linked to diet; and about 15-20 percent are due to infections, many of them preventable.

What is cancer?

Cells in adults normally have tightly-controlled patterns of growth. They divide in a regulated manner and have definite lifespans. Because of this, the number of cells in a healthy body remains roughly the same over time.

Cancer cells, however, display uncontrolled growth. The rate of division is faster in some cancers than in others, but in all cancers, the cells never stop dividing. In effect, they have infinite lifespans. Malignant tumors invade neighboring tissues and may metastasize, spreading to distant parts of the body. Cancerous tumors have the ability to produce activator molecules, such as vascular endothelial growth factor. Activator molecules induce the formation of new blood vessels to supply the tumor, allowing for cell reproduction and tumor growth.

Cancer is not one but hundreds of different diseases. Breast cancers, for instance, have individual characteristics and display different patterns of growth than lung cancers. That's why a cancer that originates in the breast and metastasizes to the lungs is referred to as metastatic breast cancer, not lung cancer.

How does cancer begin?

Cancer begins when a cell undergoes a mutation: one or more of its genes are damaged or lost. A number of different mutations have to happen before the cell becomes a cancer cell. If a cell carries a mutation, it usually either destroys itself or is recognized as being abnormal by the immune system and killed. This is why cancer usually occurs in older people: There has been more time for mutations to occur and for exposure to cancer-causing agents.

Genes may be damaged by:

• Free radicals produced in the normal process of metabolism 
• Carcinogens, such as radiation, chemicals, tobacco, and infectious agents 
• Random errors in DNA replication 
• Inherited mutated genes

Almost from the time they first arise, cancerous tumors shed cells into the bloodstream. In fact, it's estimated that a 1-cm tumor sheds more than a million cells into the circulatory system in just 24 hours. Most of these cells are killed by cells of the immune system or die due to injury, but some may survive. Traveling cancer cells may become stuck in a capillary and adhere to its lining. From there they penetrate into surrounding tissues or organs, where they may generate secondary tumors. Cancer cells may also penetrate into the lymphatic vessel and travel in the circulating lymph fluid until it becomes lodged in the small channels inside a lymph node.

Cancer prevention

That the vast majority of cancers are not caused by genetic defects means that in most cases we have the power to modify or eliminate most of the factors that lead to it.

Most of the known risk factors for cancer have one thing in common: they create chronic (long-term) inflammation in the body. Inflammation is a normal part of your body's immune system response to injury. Problems arise when that inflammation becomes chronic. When that happens, levels of many potent inflammatory chemicals go up. These substances include cytokines (including TNF, IL-1, and IL-6), enzymes (such as COX-2 and 5-LOX), and adhesion molecules. All of these various chemicals have been linked to the development of cancerous tumors, and chronic inflammation precedes tumor growth in most types of cancer.

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