THE OTHER FACE OF CANCER

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CAUSELESS AND UNPREVENTABLE

The medical finger accuses almost everything as cancerogenic and having accused, moves 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 causal relationship between cancerogens and cancerogenesis, an endless search for the culprit cancerogens, 48,49 resulting in a publication explosion that fills innumerable pages in sci- entific cancer literature. Very few thinkers have raised any objection against the search for cancerogens which is really like asking a blind man to go into a dark room to find a black hat which is not there. A certain note of disdain may be seen in Kaplan's 50 words: 'I would like to question just why it is desirable to find more cancerogens when we already seem to be plagued with them?' The cancerogens that we know about, from experimental and clinical data, are by now legion. Boyd 51 poses a simple question, as to how, with cancerogens all around us most of us escape?

The latest accused is the human sperm, with the charge that, apart from occasionally fertilizing human ova, it fertilizes the cells of the cervix in the female to induce the much-feared cancer of the cervix. 52 Thus arises the sweeping conclusion that 'untold numbers of hus- bands bear some measure of responsibility for initiating malignancies (cancers) in untold numbers of wives.' 22 Should a woman with cancer of the cervix sue her present/former husband/ lover for having given the wrong sperm? Hypothetical as this may seem, it has become a reality today. 53

The gains of this rabid cancerogenism have been nil; the harm done is a global cancerophobia; should people eat, drink, breathe, or make love. 'Unfortunately, when it comes to cancer, American society (and the many societies which follow, as a matter of faith) is far from rational.' 10 For this state of panic, fear, irrationality, and paranoia - 'CANCER! ALARM! CANCER!' - gripping us all, Ingelfinger 10 blames doctors, cancer societies, and of course, the media who specialize in converting all the trivia on cancer into sensational matters.

How do we cure ourselves of this? The voluminous and evergrowing statistics on cancerogens cannot be matched by counter-statistics. Inundated by the floodtide of cancerogens, no one has been bold enough to perceive and proclaim the very absurdity of anything and everything maliciously cancerizing mankind. The burden of the dis- proof is on the disbeliever. If a claim is made that drinking tea or run- ning at the Olympics causes cancer, the possibilities are only two - right, or wrong. The 'rightness' of the proposition depends on the claimer's conviction and some statistical data. The 'wrongness' has to be proved beyond doubt, without taking recourse to statistics. For, till such time that some statistics favourable to the proposition exist, the counter-statistics are connived at by scientists and people biased in favour of the causation of cancer.

However, where statistics cannot help, logic can. The proposition that a cancerogen 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 does Y occur without, and not occur despite, X?

No cancerogen has yet proved the causa sine qua non of any particu- lar cancer, in humans or in animals, in vivo or in vitro . Citing Hume, Fuller 54 puts down, as the earmark of causality, an invariant relation- ship of events in which the cause must precede its effect and the effect must follow its cause, in time. 'It is this sense of must which distinguishes causal connection from coincidence.' 54 Further, Fuller 54 emphasizes, the effect must immediately follow the cause: 'Causality can no more jump gaps in time than it can gaps in space.' The con- cept of 'latency' 55 that allows as many as thirty-six years between the exposure to the postulated cause and the occurrence of cancer is, because of the irreconcilable temporal gap, clearly against the causalism of cancerogenism.

This brings us to the Bombay razor (cf. the one proposed by William of Occam): Any causalistic proposition that A causes B must in the same breath explain how A fails to cause B, and how B manages to occur without A. To take but one example, the authenticated statistics are that on an average, of 740 smokers, one gets lung cancer. 56 Such being the case, the onus of proving/explaining how cancer failed to occur is, for the causalists, 739 times greater than to prove how it did. No causalistic proposition, be it heart disease, hypertension, or cancer, has been able to meet the logical sharpness of the Bombay ra- zor. 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. For lung cancer, too, smoking is going out, and some unexplained predisposition is coming in. And this parade will continue till we accept the universal intrinsicality of cancer.

Way back in 1918, Bertrand Russell 57 delivered a devastating judge- ment against causalism: 'All philosophers, of every school, imagine that causation is one of the fundamental axioms of science, yet oddly enough, in advanced sciences such as gravitational astronomy, the word cause never occurs.' Causalism survives, nay thrives in medi- cine probably because either it is not science, or it is not advanced or it isn't both. Russell 57 gives some other reason for its survival: 'The law of causality, I believe, like much that passes muster among phi- losophers, is a relic of a bygone age, surviving, like the monarchy, only because it is erroneously supposed to do no harm.' Cancerological causalism, having presented mankind with hysterical cancerophobia, marches on regardless. This is despite the fact that even the much- vaunted virus and smoking have lost their cancerogenic value. Vi- ruses have been held as lab artifacts that have nothing to do with human cancer 5, and smoking has aptly been declared as the leading cause of statistics. 58

Koestler 59 has alluded to the perversity of scientists. Such perversity reaches its climax when patients are purportedly 'cured' by the very agents known as causing cancer - irradiation, chemicals, and hor- mones. Viruses and immunity had hitherto escaped this cancerological disbolism of what causes, cures cancer. However,viruses have been mooted as curative 60 while immunity, our last hope against cancer, has been incriminated 61 as not only cancerogenic, but also cancerotrophic. Diagnostic procedures (mammography 62 right now) are not exempt from the cancerogenic scare. All that is done to cure cancer, appears to cause cancer.

The noble aim behind the hunt for the cause is the promise of the prevention. 'Since so little is known about the origin and development of neoplasia, it is not surprising that many cancers can be neither prevented nor cured. 63 What if much is known? Reviewing a book ambitiously titled The Prevention of Cancer, Jelliffe 64 concluded that, although the various authors provide an excellent analysis of the large amount of data related to the causation of different cancers, no rea- sonable means are provided anywhere for prevention. 'For example,' Jelliffee 64 remarked, 'after twelve erudite pages on breast cancer, the reader can discover no practical alternative to prophylactic bilateral mastectomy at an early age.' Harvey Cushing 65 exclaimed that, like many other catchwords, prevention can be overworked: 'There is only one ultimate and effectual preventive for the maladies to which flesh is heir, and that is death.' Life's close link with cancer means the only way to prevent cancer is to prevent life. And, in a way, the only truly effective remedy for cancer is death.

The realization that cancer is not caused , and therefore, is not ' pre- ventable ' is a mixed blessing. The happy part is that the all-pervasive cancerophobia will disappear and we shall be able to sip coffee and enjoy a smoke without the subconscious feeling of committing slow suicide, by inviting cancer. The bitter part is that some of us - one in five - would always be doomed to cancer, no matter what. Sad? But that is how Nature operates.

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