THE OTHER FACE OF CANCER

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IMMUNOLOGICAL ILLUSION

Before justifying the heresy that cancer indeed is unresearchbable, it would be helpful to define research in order to understand,

science in general, and cancerology in particular.

The dictionary 1 definition of research has full comprehensiveness, clarity and, in the current context, rich applicability. It defines research as a 'critical and exhaustive investigation or experimentation having for its aim the discovery of new facts and their correct interpretation, the revision of accepted conclusion, theories, or laws in the light of newly discovered facts, or the practical application of such new or revised conclusions, theories or laws.'

Cancerology has searched what it could - funds, power, statistics, but not researched , as evidenced from its chronic failure to revise its cher- ished conclusions, much less to put them into practice. The story is singularly one of the denial of seeing the writing on the wall. On sci- ence, we might consider what Bobynin says, in Solzhenitsyn's The First Circle : 153 'What d'you think science is - a magic wand that you just have to wave to get what you want? Supposing the problem's been put in the wrong terms or new factors crop up?' The problem- put-wrong is cancerology's assumption that 'cancer is conquerable'. 14 The new factors that have cropped up are (a) the discovery of the compelling biological features of cancer, and (b) the tell-tale reversals of all therapeutic strategies because of a single unquestonable fact viz ., cancer is a part and parcel of ourselves.

Cancerology has been a professed art of enormous beneficence but with no profound thought or insight. The whole public image of can- cerology, Burnet 5 sums up, is one of humanitarianism, but not of bio- logical scholarship. Burnet 15 wonders why so much work for so long by so many top scientists at such a colossal cost has had so insignifi- cant an effect on the prevention or treatment of cancer.

The insurmountable reality about cancer is that it is not amenable to science, being, what Weinberg 154 calls, trans-science. All the acces- sible and analyzable facets of cancer - cell, tumour, treatment, cause and prevention, genetics, its very raison d' etre - for one reason or another, do not lend themselves to prediction by what we know or can do. Set below are the various points / counterpoints vis-a-vis each of the above facets.

Cancer Cell

1. Put in Shakespearean style, a cancer cell is, for a person, 'an ill- favoured thing, sir (Mr. Researcher), but mine own.'

2. Not one known structural, biochemical or immunological feature helps in distinguishing a cancer cell from a normal cell. 98,155,156,315

3. A cancer cell suffers from an incurable selfsameness. It, therefore, emerges and multiplies like any other cell, and it falls prey to cytotoxic agents - drugs, X-rays - with no greater willing- ness than other normal cells of the body. By this one feature of selfsameness, the cancer cell has as it were cured itself, once and for ever, of any selective action by radiotherapy or chemotherapy.

4. A cancer cell carries in itself an indelible stamp of its own unique- ness - rendering itself neither susceptible to a specific drug nor preventable by a vaccine.

5. Cancer cells are, in the human or animal body, in an inexhaust- ible supply. The reason is simple: recruitment into the cancerous army of many a normal cell that neocancerates 6 to form a cancer cell.

It is little wonder that patient with acute leukemia, even when bombarded with heavy doses of cell poisons over protracted pe- riods, are never free of leukemia cells. This is a classic example of the cancerrealistic fact that whilst some cancer cells can be destroyed, a cancer itself cannot.

6. A cancer cell's faculty of leaving its site of origin and migrating elsewhere is predetermined, individualistic, and unpredictable.

7. The uncertainty and individuality surrounding a cancer cell rule out the creation of a cancer-cell-model.

8. Like matter, 157 a cancer cell defies being defined. The best we can do is to paraphrase an academic circumlocution on matter. 158

Cancer cell is, what it is,
For it does, what it does.
And it does, what it does;
For it is, what it is.

The above lines amplify Smithers' 71 generalization that a cancer cell is no distinct structural entity, but an organ of behaviour. The same could be said of the overall phenomenon of cancer.

Tumour

The aim of tumour research (clinical cancer research) is, a la Kipling, to know the what, why, when, how, where and who of tumour forma- tion, in a patient with cancer.

1. A clinician, with all his gadgets, is only wiser after the event. For him to know the when of a tumour is impossible whether the patient presents himself for the first time, or after having been treated.

2. The what belongs to the realm of individuality of tumours: No two tumours, even in the same person, are exactly alike. 3 All experienced pathologists know that every tumour exhibits its own individuality of microscopic structure. 15,239

3. The why and how belongs to acausalism, canceration and tumour-formation being integral parts of life. Much as a 'normal' cell and all its manifestations are a mystery to us, so are a cancer cell and its manifestations.

4. The what, where and who are predictable certainties at the herd level, but only probabilities at the individual level. The epidemio- logic concept of probability can be best amplified by acute lym- phoblastic leukemia, a form of blood cancer. Globally, it occurs at the rate of two or three cases per 100,000 population per year with little variation from country to country. 98 Here, the certainty is two to three cases per 100,000 people; who will get it is the quan- tified uncertainty or probability viz ., 1 in 50,000 or 1 in 33,333.

5. The sequence of events from inception of a cancer to tumour formation to disease to death is governed by unpredictability at each step. An earlier event in this sequence is not necessarily followed by the next one. The scare-mongering statistics by cancer societies are generally based on the assumed invariable progression along the above sequence of events. The lack of such inevitable progression, in fact, invalidates the so-called animal-tumour-model used in the laboratory so far.

Treatment

1. The cardinal error of the cancer-must-be-treated dogma is the assumption that a patient survives or feels better because of and not despite the treatment. A surgeon 284 who paid a heavy price for such a dogma depicted his experiences in 'A personal ac- count of the after-effects of the modern treatment of carcinoma.' This 1938 article has undiminished relevance in 2009.

2. No mode of cancer therapy can cure cancer, all attack its detect- able manifestation.

3. All therapies come on the scene when the silent spread of cancer is a fait accompli.

4. Surgery can promote the spread of cancer, 246,247 most other therapies promote the occurrence of cancer. 6,8,15,101,102,248-250

5. Cancer therapies may ease life, but do not prolong survival, no matter given when and how. To cite some examples: 'In the case of chronic lymphatic leukemia and breast cancer, the mortality rate is independent of the duration of disease. Thus it is reason- able to expect that even a very effective chemotherapeutic agent would not improve the survival of patients with either of these diseases; indeed, it has so far not been possible to demonstrate any effect of chemotherapy on survival. This point was recently reemphasized for acute myeloblastic leukemia of adults.' 113

6. The standard 'tumour/test systems'- e.g. Lymphoid leukemia L1210, Sarcoma 180, Adenocarcinoma 755, L5178 leukemia - are each a borrowed mass of dividing cells, conveniently 6 called transplanted cancer . They have nothing to do with human or animal cancers. This dissociation may be realized from the fact that natural or authochthonous cancer is 100% resistant to the drugs that are 100% effective against the so-called transplanted cancer.

7. Cancerology has no cancer-therapy-model bearing relevance to the human or animal situation. Successes gained in test tubes have remained restricted to the test tubes only.

Cause and Prevention

Chapter Four makes it clear that cancerology has been searching for a cause that never was. What has no cause can have no prevention either.

Genetics

Cancer is an eminent vertebrate feature that functions at the herd level, mediated by multifactorial inheritance. The unreasoning dictates of heredity have been epitomized in the Gaiusian dictum - Damnosa hereditas . Since cancer has nothing to do with heredity, being basically a herd function that must find expression at some indi- vidual level, shall we say, of cancer, that it's an example of Damnosa herditas ?

It is the corporate gene pool of a herd that determines which type of cancer - nasopharyngeal carcinoma in Chinese populations and leukemia in Jews, around the world - would occur, in which individu- als of the herd, and at what different ages. The occurrence of cancer in an individual person is governed not just by his genes but by their corporate interaction with the herd gene pool, a realization that makes cancer not a matter of heredity but herdity (herd-ity), and a phenom- enon most certainly beyond the ken of genetics - to be candid, trans- genetics.

Modern genetics has given up its one-gene-one-character concept, accepting that a single character is controlled by many genes, and vice versa . Which of a human cell's 100,000 genes controls the con- version of such a cell into a cancerous one is unknown, more so since the precise definition of gene itself is unknown. 159 Any attempts at locating cancer gene/s is fraught with problems that are beyond the science of genetics. Burnet 15 has alluded to the current illusion, that what can happen in E. coli can also be made to happen in an elephant . Cure of cancer through gene-manipulation is as tall an order as that.

Raison d'Ítre of Cancer

The late Leslie Foulds emphasized the need for contemplative research on cancer - to understand it more, than to conquer it. 'Some investigators,' Foulds 3 remarked, 'are fond of saying, "what we need is more facts." The truth is that we already have more "facts" than anybody knows what to do with.' And the incontrovertible facts that we do have, are enough to carry us all towards an understanding of cancer.

The approaches that the so-called experimental cancer research has employed lack three essential features - comparability, predictability, and reproducibility. The result, therefore of all this research has been essentially unhelpful towards the elucidation either of the cause or the cure of cancer. Contemplative cancer research requires three quali- ties - the humility to consider man on par with other animals, the comprehensive approach of a generalist and from these two, the acceptance of cancer as a part of living, and dying. Cancer is researchable, but only at the level of understanding.

Having understood cancer, what next? Acceptance. To the frontiers- men of science, Ardrey 160 points out, the discovery of natural laws meant no more than that we had come to know certain forces govern- ing the dispositions of man. But for many a 'popular' scientist who came later, such discoveries meant something very different: 'Man could master nature.'

The 'hoi-polloiness' of cancer scientists has been charitably described by Burnet 5 as a beneficent trait, devoid of biological scholarship. The latter quality ought to be evident from the current unwritten law in science-writing and reporting: Anything that happens to science, happens against cancer . If a recombinant E. coli can be made, can- cer can be understood: 161 and when a slime mould shifts from 'amoe- bae-like feeding to plant-like reproduction,' we are all very near 'a cancer cure.' 162

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