Interestingly, this basic structural etiology of cancer has been known only for the last sixty years when Watson of the United States and Crick of England worked out the helical structure of the DNA molecule and won the Nobel Prize in Medicine. Progress slowly evolved in understanding cancer from this point on.
Cancer then, basic to our very being, involves life at its origin; cell growth gone awry. And as it takes this turn, mankind struggles to understand a disease involving the very basic physiological underpinning of life itself; God’s secret. Is it any wonder why the task has been so difficult? Cancer remains the number two cause of death, second only to heart disease. Our task, in the future, remains to tame these twin killers; a daunting task as cancer kills 1,500 people per day, or about one-half million per year.
Although cancer can occur at any age from infancy on, it is basically a disease of the elderly; over 77 percent of cancers occurring from age 55 on. One out of every four deaths in the United States occurs from cancer. In a lifetime, 50 percent of men and 33 percent of women will develop cancer. In men, the three leading causes of cancer are prostate, lung and colorectal cancer; in Caucasian women, the leading causes of cancer are breast, lung and colorectal cancer. The most common cancer in children ages 14 and younger are the leukemias, and only five percent of cancers are hereditary.
Statistics for cancer survival have improved over the years and the five-year survival rate for all cancers is 86 percent.
CHAPTER 2
Classifications
Science is built up with facts, as a house is with stones. But a collection of facts is no more a science than a heap of stones is a house.
Jules Henri Poincare
1854-1912
When physicians discuss a cancer diagnosis with patients, they will describe the cancer in reference to its location: stomach cancer, breast cancer, lung cancer, pancreatic cancer etc. This is simple to understand and clarifies the issue as to diagnosis and location.
Another method of describing cancer is by microscopic evaluation of the cancer itself. Histology is the section of biology that deals with the microscopic structure of organic tissues. On this basis, microscopically, cancer can be divided into five divisions based upon the histological picture and the portion of the microscopic structure that the cancer has originated from.
There are five divisions with this method:
1.A carcinoma is a cancer that arises in skin or in tissues lining internal organs such as the stomach, intestines, lungs, urinary bladder. Under this heading, there are various histological types based upon the microscopic picture including:
•Adenocarcinoma (adeno means gland) refers to a cancer arising in the glandular elements of the lining
•Squamous cell carcinoma refers to cancers arising from squamous cells, the main cell type of skin and the lining of the gastrointestinal track, lungs, urinary bladder, prostate, and uterine cervix
•Adenosquamous carcinoma refers to a combination of both types of cellular elements
•Carcinomas with either small or large cells
•Anaplastic carcinoma histologically represents the greatest disturbance of cell growth, making it difficult to distinguish squamous or glandular features
Carcinomas are most frequently found in the lung, breast, colon, rectum, prostate, and pancreas. They represent about 80 to 90 percent of all cancers.
2.A sarcoma is a type of cancer growing from connective tissue such as found in bone, cartilage, muscle, fat, and blood vessels. Connective tissue, as the name implies, “connects.” It serves a connecting function by binding other tissues. Connective tissue comes in a number of types:
•Loose connective tissue holds organs in place. There are three types:
1.Collagenous fibers made of collagen, a protein found throughout our bodies that binds and supports other tissues.
2.Elastic fibers. As the name implies they are stretchable: they can stretch and recoil.
3.Reticular fibers join connective tissue to other tissues.
•Fibrous connective tissue: found in ligaments and tendons.
•Specialized connective tissue
1.Adipose tissue stores fat
2.Cartilage: found in our joints, nose, ears, and trachea
3.Bone contains calcium giving bone its firm hardness
4.Fortunately, sarcomas are quite rare representing one percent of the 1.5 million new cancer cases each year. They are very difficult to treat.
3.Leukemia is cancer arising in the blood forming tissue (bone marrow), which prevents the bone marrow from producing normal red blood cells, normal white blood cells and normal platelets. Instead, the bone marrow produces cancerous blood cells that leave the bone marrow and circulate in the blood vessels throughout the body.
4.Brain and spinal cord cancers are made up of neurological tissue.
5.Lymphoma and Multiple Myeloma are cancers that arise in the cells of or the lymph glands of the immune system. Lymphomas occur in two varieties: Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Myelomas grow in the plasma cells of the bone marrow, sometimes collecting in one bone where it is known as a plasmacytoma, or collecting in multiple bones known as multiple myeloma.
CHAPTER 3
Big-Data
Given for one instant an intelligence which could comprehend all the forces by which nature is animated and the respective positions of the beings which compose it, if moreover this intelligence were vast enough to submit these data to analysis. It would embrace in the same formula both the movements of the largest bodies in the universe and those of the lightest atom; to it nothing would be uncertain, and the future as the past would be present to its eyes.
Pierre Simon de Laplace
1749-1827
You don’t have to be a physician, to grasp the idea that prevention of any disease is a lot simpler and safer than treating a disease once developed. Because once a disease has developed, the horse is out of the barn and it may gallop away before it can be reined in. This concept applies to a disease of any type, but is especially relevant with cancer where the earlier a group of cancerous cells is identified, the better it is for the patient. Examples include regular mammographic screening for breast cancers, skin screenings for skin cancers, Pap smears for gynecological cancers, prostate-specific antigen (PSA) for prostatic cancer.
For many years the physician population lived with the idea that the earlier the better when it comes to cancer discovery; and screening continued unabated. Although the percentage of individuals who availed themselves of this important preventive approach remained depressingly lower than preventive medical experts hoped for. Once the statistics rolled in, things slowly changed; and that complicated things for physicians always enamored with simplistic concepts such as “the earlier the better.” The monkey wrench was lobbed into the physician population by the United States Preventive Services Task Force (USPSTF).
Before