[YOUR HEALTH] Why there seems to be cancer everywhere

There are few diseases that can evoke fear in us than cancer. Perhaps, not just because of its creeping nature, but because it connotes doom.

In the developed world, the number one killer disease is still ischaemic heart disease. In the developing world, it is lower respiratory infections (mainly in children). Though in the developing world, they are now eating what the developed world eat, and living a more sedentary lifestyle, heart-related diseases and such other non-communicable diseases mainly found in the developed world are now finding their way into the developing world. Nonetheless, in many parts of the world, cancer wants to be second to none.

Continue reading after the cut....

Though the fact that cancer wants to be number one sounds disturbing, perhaps, it is not proper to start comparing cancer to other diseases. As George Johnson, editor and author of “The Cancer Chronicles,” argued, “Cancer is, by far, the harder problem—a condition deeply ingrained in the nature of evolution and multi-cellular life. Given that obstacle, cancer researchers are fighting and even winning smaller battles: reducing the death toll from childhood cancers and preventing—and sometimes curing—cancers that strike people in their prime. But when it comes to diseases of the elderly, there can be no decisive victory. This is, in the end, a zero-sum game.”

It is believed that with enough money and the will, science might reduce cancer mortality to a significant minimum. “But what, then, would we die from?” asks Johnson. Heart disease and cancer are mainly diseases associated with old age. If we have less people dying from one of them, it means more people will live long enough to die of the other.

There is a general increase in life expectancy in most parts of the world. If you get to age 67, you are very much likely to get past 80. The median age for people to die of cancer is 72. But we now live long enough for cancer to get us.

What used to be major killer diseases, like tuberculosis, smallpox, influenza, bubonic plague were easier to handle. For each of these diseases, there was a single infectious agent, an identified cause that could be faced.

Nevertheless, death from heart disease is being reduced, or perhaps delayed with diet, exercise and drugs which help control blood pressure and cholesterol. Even major heart problems seen as mechanical, like worn-out valves, clogged piping, may have temporary solutions.

With these interventions, people between 55 and 84 are now more likely to die from cancer than from heart disease. But for those who live beyond those ages, heart disease overtakes cancer. And as Johnson puts it, “Year by year, as more failing hearts can be repaired or replaced, cancer has been slowly closing the gap.”

Cancer remains the most intractable. This is because it is more of a phenomenon, than a disease, the result of a basic evolutionary arrangement. As our body lives and grows, its cells are constantly dividing, and copying their DNA, and giving it to the daughter cells. It is a large genetic library. The daughter cells then pass it to their own progeny: copies after copies after copies. Somehow, along the way, inevitably errors occur. Some of these errors are caused by carcinogens, but most of them are due to random misprints.

However, cells have complex mechanisms which recognise and correct many of the errors. But sadly, this mechanism is not foolproof, and it can’t ever be. Mutations are what bring about evolution. Without mutations, humans would not have evolved. A certain combination will give a cell too much power. It starts to evolve on its own apart from the rest of the body. Just like new species trying to live in an ecosystem, it grows to become a cancerous tumour. And that cannot be easily repaired.

As Johnson elucidates further, “These microscopic rebellions have been happening for at least half a billion years, since the advent of complex multi-cellular life—collectives of cells that must work together, holding back, as best each can, the natural tendency to proliferate. Those that do not—the cancer cells—are doing, in a Darwinian sense, what they are supposed to do: mutating, evolving and increasing in fitness compared with their neighbours, the better behaved cells of the body. And these are left at a competitive disadvantage, shackled by a compulsion to obey the rules.”

As people become old, their cells gather more potentially cancerous mutations. If given a long enough life, you will eventually succumb to cancer, unless something else kills you. That would still happen even with the best medical technology and even if the world is free of carcinogens.

Still, the best we can do is to prevent cancer. And places where you hear better news about cancer is where they have better preventive measures. Worldwide, about 15 to 20 per cent of cancers are thought to be caused by infectious agents. Improved refrigeration and public sanitation, have significantly reduced stomach cancer, which is linked to Helicobacter pylori bacteria. Vaccines against human papilloma virus can potentially eliminate cervical cancer. Where you have successful anti-smoking campaigns, lung cancer, which accounts for almost 30 per cent of cancer deaths in the United States, is reducing gradually. We can make more progress with improvements in screening and by reducing the incidence of obesity (A 2012 study in the Lancet linked cancer to high body-mass index), which along with diabetes, gives cancer a strong foothold.

Amazingly, only a small percentage of cancers have been traced to the many synthetic chemicals that industries have added to the environment. As regulations become stricter, cancer rates are being reduced a little more.

Again, most of the progress made on cancer has been in advanced countries. With enough political will, the same effort can be taken to less developed countries.

More progress will be made in the sciences. New immune system therapies that bolster the body’s own defences have shown promise for certain cancers. There are nano robots which repair and reverse cellular damage. There are also genomic scans that can tell a cancer’s precise genetic signature.

As of today, with genetic information, colon, ovarian and breast cancer can be prevented in many patients. Perhaps, as a consolation for those who live in less developed countries like Nigeria, Theodora Ross, an oncologist, advises, “Most people should focus less on the high-tech future of genetic testing and more on the low-tech history of their family trees. Those who don’t know their own family histories, because of adoption, secrecy, loss or estrangement, should take comfort in the fact that we are one big family.”

Perhaps, in time to come some of us will give Methuselah a good run for his money. But except for medicine for immortality, a body will get to a point where it has outfoxed every danger life has thrown at it. And for each added period of life, there will be more mutations, which also means more accumulations. “If the heart holds out, then waiting at the end will be cancer,” Johnson forewarns.

- Dr Odomena/terafema.blogspot

Share your thoughts......thanks