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Saturday, November 27, 2010

Why We Haven't Cured Cancer

I’m going to try to give everyone a brief overview as to why researchers have been unable to cure cancer for the last twenty years and I would love anyone who has additional feedback to comment. Let's get right into it. DNA is our genetic material found in every single human being. DNA consists of 4 nucleotides(A,T,C,G). Many nucleotides can form a gene and this gene can make a protein. These proteins are critical for our survival and play many important functions. In DNA the A nucleotides pair up with the T’s and the C’s pair up with the G’s. It should be stated that many of our nucleotides don’t form proteins and we still don't have a good grasp on what these nucleotides actually do. Most researchers believe these nucleotides play a role in structure. Cancer results when random mutations form in our DNA everytime we replicate our cells. For example, a T nucleotide will mistakenly base pair with a C instead of an A. One big potential problem with this inaccurate basepairing is that we no longer form the proteins that need to be made from that specific gene. Also, we could potentially form abnormal proteins that can lead to cancer forming. Clever scientists decided that it was time to sequence all the genes in cancer cells they isolated from the tumors of cancer patients and compare these with normal cells in the same area. These scientists eventually noticed similar patterns of mutations occurring in various types of cancer in different patients. As a result, these doctors attempted to inhibit these genes that were accumulating mutations shown in many patients with similar forms of cancer by using drugs. Unfortunately, our bodies are constantly changing and new mutations are always forming so eventually resistance forms against the drugs given to block these genes. Now, the next question most of you probably are asking is “why don’t we find the form of resistance and target a drug to stop this”? The overwhelming problem is that it is very hard to specifically find what mutations are causing the resistance and there are many mechanisms of resistance possible to the drugs used to treat cancer. Furthermore, while one drug might block a long sequence of one gene, all it may take is a single nucleotide mutation to cause the cells to become resistant to the drug given. By the way, these drugs(herceptin, gleevec) are pretty expensive(averaging around 60000 dollars a year). Most of the time these drugs are combined with chemotherapy to give an enhanced affect to try to kill the malignant cells and they tend to add about an extra two months to lifespan on average for some individuals. Bottom line, even a small tumor contains tens of billions of cancer cells which are constantly evolving. It is impossible for us to try to target one specific gene or try to identify one protein that could be the sole cause of cancer occurring. We can not predict the evolution that is constantly taking place in our bodies. Instead we need to focus on the simpler models of cancer and try to solve the problem on a larger scale. All cancerous cells require normal cell machinery to function. Also, all cancerous cells need to be able to proliferate and be invasive(cross the basement membrane and enter new sites of the body) in order to cause damage. Researcher needs to focus more on the mechanisms that are found in the normal machinery that are allowing all cancerous cells to do their job. If we can inhibit proteins needed for invasiveness and stop replication of cancerous cells we will be able to solve the problems of cancer. On that note, I have come to the realization that being healthy both on a physical, dietary, and mental level is of key importance. It has been shown in many studies that microtumors are unable to develop into large scale tumors unless our environment triggers this effect. Also, it has been shown that eating right and being less stressed(practicing breathing exercises, meditating) can actually change expression of genes in a positive manner and can help fight cancer. If you need evidence for this, just look at the fact that most Japanese men do not develop cancer in their own countries; however, when they migrate to America and start eating a western diet cancer rates skyrocket. Also, although i’m very new to this field of research, after reading many books I feel every cancer patient should realize that they have a choice. Cancer patients should always get a second opinion and not resort to the first form of treatment justified by their doctors. Many times surgery is not the answer and active surveillance can be used instead. Also, a cancer patients outlook on life and belief that they will win this fight is of utmost importance. With that said I will continue to find information about many questions people might have(Can biopsies spread cancer? Which foods are good for fighting certain types of cancer?). I will also continue to highlight relevant research and find out any new forms of conventional treatment proven to be helpful. For more information on why cancer is so difficult to cure, check out this excellent talk by Carlo Maley in which he gives an in depth look at all the mechanisms involved in causing cancerous lesions to form and what we want to do in the future to look at tumor evolution.

Thursday, November 18, 2010

Sugar's impact on Cancer

Cancer cells are rich in insulin receptors on their surfaces. As a result, it is key for people to maintain a diet low in simple sugars if cancer is present. It's good for all of us to cut down on the amount of sugar we consume; however, it is of utmost importance for all cancer patients. It has been shown that cancer cells are unable to metabolize carbohydrates, fats, or proteins. Sugar is the fuel source of cancer cells. If you are diagnosed with cancer, going to the doctor and thinking he will cure you is not enough. The more I look into current research, the more I learn about the importance of certain factors you, the patient, can control. Also, cancer cells have been shown to thrive in acidic conditions. Drinking alkaline water while eating different vegetables to make your body more basic can help in the fight against cancer. I recently have read about a doctor(Nick Gonzalez) treating multiple types of cancer using nutrition as the main source for fighting. He gives his patients supplements and enzymes as well as detoxifies the patients bodies with many different methods. All of this is without the toxic effects of chemotherapy. Furthermore, he prescribes a diet to each patient after blood testing and taking hair samples. Afterwards, he tells his cancer patients to eat certain foods based on overactivity of their sympathetic or parasympathetic nervous systems. I hope to share more about him soon.

Saturday, November 13, 2010

Sunlight vs. Vitamin D

[Reposted from my blog entry on Emergent Fool]

You may have heard there is an epidemic of low vitamin D levels in the U.S.  An estimated 60% of Americans are at a level that has been correlated with increased risk of nearly all chronic diseases, including cancer, heart disease, diabetes, autoimmune diseases, and depression.  My personal belief is that the epidemiology is horribly flawed.  But perhaps not in the way you might think….

As most people know by now, we humans photosynthesize vitamin D in our skin when it is exposed to direct sunlight.  How fast depends on our ethnicity and amount of exposure.  Since I’m light skinned and get a lot of sun in my normal life, it came as a huge surprise when some routine bloodwork I had done about 9 months ago indicated I was “dangerously low.”

My doctor immediately prescribed large doses of vitamin D supplement, but I was convinced that the result was spurious.  Perhaps it was due to an abnormal period of low sun exposure.  After all, I’d been traveling quite a bit and thus not outside much.  Plus, maybe the jet lag was disrupting my metabolism in some way that impacted vitamin D levels?

I vowed to get my 20 minutes of sunscreen-free, noontime exposure per day.  (Morning and late afternoon sun is useless for vitamin D production, and sunscreen blocks the UVB rays which initiate it).  In addition I intended to eat more oily fish (like sardines) as they contain vitamin D.   Though most experts agree it’s almost impossible to get what we need from food alone, I know that such foods are good for me in other ways.   My plan was to get checked in three months and I was confident that I could raise my vitamin D levels back into health range without supplements.

After three months my test came back… unchanged!  This was very alarming.  The medically acceptable range is between 30 and 74, but I was coming in at 15.  These numbers refer to the freely available levels of 25-hydroxy D in your bloodstream.

A brief aside about vitamin D: it’s not really one substance.  There are many different biomolecules that are involved in a complex cycle that initiates when the sunlight hits your skin.  It’s just a few of the many byproducts of this cycle that we call “vitamin D”.  25-hydroxy D is the one we typically measure, but to focus on this one substance seems unwise given how complex the cycle is.  Personally, I’ve come to think of vitamin D not as a noun but as a verb, as in the “vitamin D process” (with kudos to Danny Hillis for coining this metaphor with the verb “cancering”).

Before I resigned to taking the supplements, I did some googling and stumbled across this video which alerted me to a possibly key factor I was ignorant about: soap.  Turns out that if you wash with soap within 48 hours of sun exposure, you are not getting the full benefit.  That’s because you are washing off the D3 that the sun photosynthesizes when it hits your skin.  And it takes 48 hours to fully absorb into your bloodstream, where it is a critical element in the vitamin D process.  So I switched to the recommended “soap only where the sun don’t shine” strategy.  Three weeks later I got a home testing kit and my count almost doubled to 28.  A month after that, I was within range at 34.

Now, it should be noted that these 25-hydroxy tests (whether performed at home or by your doctor) are notoriously poor indicators of pathology.  Even still, I was advised that with a count of 15 it was very unlikely that I was maximally healthy, even though I hadn’t shown any symptoms yet.  Had my low D state continued, the prognosis is that it was a matter of time before symptoms started appearing.  There is another test which measures functional vitamin D efficiency at the cellular level, and which is supposedly a better indicator.  But that I didn’t know about this test until I consulted with Dr. Myles Spar who is an MD with an integrative/holistic practice.  On that test I scored “above 50th percentile” in vitamin D health.  This was around the time of my second home test, where I scored barely within range at 34.  Thus, according to the more accurate test, I am currently fine, but according to the test that is universally used, I am still in danger and almost all MDs would recommend supplements for me.

For the most part, I’m against supplements, but when presented with possibly serious consequences, it’s seductively easy to justify popping the pills “just in case” they help.  After all, the epidemiology shows very strong correlation between absence of the chemical and presence of disease.  There are two problems with this logic, though.  Almost all bioactive substances become toxic at some dosage.  In the case of vitamin D supplements, they can become toxic even at normally prescribed dosages.

But ignoring the toxicity, there is a bigger problem: taking vitamin D supplements has NOT been shown to reduce mortality.  While supplements reduce melanoma incidence, so does sun exposure.  According to the data, the sunlight effect is so powerful that even sunburns may reduce your chances of dying of skin cancer.  Also, vitamin D supplements don’t appear to prevent autoimmune disease, whereas sunlight does.  Finally, obesity is doubly-linked with depression, which is correlated with lack of sunlight.

What does all this mean?

Here is a partial list of lessons I’ve learned about how complex systems theory applies to me as an individual:
  • It’s appropriate to use blood level indicators to diagnose potential disorders, but it’s rarely beneficial — and quite often harmful — to treat such indicators directly with drugs.  I would rather understand the etiology and treat the pathology, not the symptoms.
  • For every manufactured drug there are natural remedies which have been used for thousands of years without the high level of toxicity.  Many of these are at least as good as the drugs even when focusing narrowly on changing blood level indicators.
  • I don’t want to take any substance chronically, whether it’s manufactured or natural.  The only exception would be if an organ stopped functioning properly and its biochemical output could not be manufactured naturally, e.g. if my thyroid was damaged beyond repair.
  • Most of my body’s systems are homeostatic, meaning when they are pushed “out of whack” temporarily by outside influences, they move back to their previous state once the influence is taken away.
  • In homeostatic systems there emerge one or more “set points” (aka chaotic attractors).  If pushed far enough away from one set point, the body naturally gravitates to a different one.
  • The result being that it is often harder to achieve systemic changes than it is to maintain them.  This may be why it is harder for an obese person to lose weight than to maintain a healthy weight.
  • A valid use of drug therapy is for acute conditions, to bring the body back into a healthy homeostatic set point (or stabilize the body while other interventions do so).
Combining these lessons with my own experience and the epidemiology, the vitamin D story is not so mystifying (to me at least):
  • Why did my vitamin D levels drop suddenly and not bounce back once I resumed my normal lifestyle?
  • Why did my vitamin D level double in a short period of time without taking supplements?
  • Is there really an epidemic of low vitamin D?
  • To what extent is this related to sunshine?
  • How does the epidemiology relate to changes in lifestyle trends?
I’ll leave you with a final thought, and I’d be curious what you think.  Could there be an epidemiological tipping point?  One that either already happened, or that may be seen in the future?  How would we look for such an effect in the data?   How would we tell if it’s a true effect, or just something that we sought to discover and then used faulty statistical reasoning to “prove”?

Thursday, November 11, 2010

Diet and Cancer Risk- Importance of Realizing the Impact of Food put into our Bodies

Diets high in fat have been linked to increased risk of various cancers, particularly breast, colon, prostate, and possibly pancreas, ovary, and endometrium (USDHHS, 1988; National Research Council, 1989). Although it is hard to put a numerical value on diet contributing to cancer risk, it has been estimated that 35 percent of cancer deaths may be related to dietary factors (Doll and Peto, 1981) while at the same time most cancers are considered entirely preventable by most leading experts.  We need to realize that the food we eat on a daily basis has an important affect on our survival and well being in the future. We don’t need to stop eating the fatty foods we love completely, but we do need to stop this mindset in America that the only option is eating foods high in fat and sugar content. Unfortunately, eating plant foods is much more expensive than eating meat and foods high in sugar. At McDonald's, I can get a McDouble for one dollar but getting a small salad costs up to 4. However, it’s absolutely necessary for us to change our mentality regarding diet. In this excellent video by Michael Pollen which you can find on the bottom of this blog, he highlights the importance of maintainging a green diet and consuming less calories. In the next paragraph I discuss some of the interesting parts of the video but I highly recommend everyone to watch it.
First off, 1/3 of all fossil fuels come from producing the food we eat and the highest source of production of these fossil fuels comes from the meat industry. Not only that, according to Pollen and most leading researchers, with the rate of obesity in the American diet, children born in the year 2000 will be amongst the first generation that lives less than their parents due to the amount of people developing preventable diseases such as type 2 diabetes and cancer. So, after all this bad news, what can we do to bring about a change. Pollen gives his input which I think is absolutely valid. We need to start shopping local farmers market, eating less food, taking in more plants in our diet, and focusing on quality versus the quantity of food. Also, an excellent way to make cheaper food is to plant a garden. This can provide people with an inexpensive way to produce vegetables right from their house or apartment while helping the ecosystem at the same time. High fat diets have been shown to damage the systems of our body necessary to fight off the hundreds of mutations that form on a daily basis. If these mutations aren't fixed they eventually lead to the formation of cancerous tumors.  As a result, eating high fat diets full of sugar from an early age have been correlated to much higher risks of developing cancer in the future. 
I hope you have learned something substantial and will make a change on your diet to allow for a better chance of avoiding disease in the future.  For some, this may involve baby steps at first, but eventually, with hard work, you will get to the point of feeling healthy and being happier with your conscious eating habits. In America, by fighting the system, you can bring about change. Let's start a new revolution in the way we eat and allow ourselves to reach our full potential.

PopTech 2009: Michael Pollan from PopTech on Vimeo.