CANCER IS FAR and away medicine’s deepest mystery. Medical science has long unraveled the causes of many of the other diseases that afflict us. Infections are caused by bacteria, viruses, and fungi. Blockages in arteries cause heart disease, strokes, and peripheral vascular disease.
Cystic fibrosis is a genetic disease. Gout is caused by excess uric acid. Among the common diseases, cancer stands alone. What causes it? Why does it exist? What the heck is it?
We’ve moved through three great paradigms in our understanding of cancer. Cancer paradigm 1.0 considered cancer as a disease of excessive growth. Cancer paradigm 2.0 considered cancer as a disease of random genetic mutations that caused excessive growth. Both paradigms advanced our understanding of cancer’s story, but they fell short. By pursuing the mystery of cancer’s genesis past the beginnings of humanity and right to the edge of multicellular life, cancer paradigm 3.0 has revealed fresh insight into this fascinating foe.
The seed of cancer lies in all cells of all multicellular life. Cancer is an atavism, a reversion to an earlier genetic playbook brought on by the struggle for a cell to survive (transformation). Whether that seed flourishes depends upon the environment (the soil). The most important aspect of progression are the growth pathways of the body, which are also the nutrient-sensing pathways.
Diseases of growth are diseases of metabolism. Diseases of metabolism are diseases of growth. Cancer is a disease of evolution and ecology. While there undoubtedly is yet more to discover, this new paradigm represents a huge leap forward.
These fresh new insights into cancer bring fresh new treatments. We are finally seeing decreasing rates of cancer and cancer deaths, as we understand both the benefits and limitations of screening programs. We are honing our weapons of mass cellular destruction with greater precision as we recognize their double-edged nature. Maybe we don’t need to always eradicate cancer cells. We are developing new systemic, immune-mediated weapons that will hunt down cancer cells and kill them wherever they may hide.
But one massive new obstacle has arisen. The burgeoning obesity crisis has increased the rates of the obesity-related cancers, including breast cancer and colorectal cancer. Where most cancers are gradually decreasing in prevalence, these cancers are increasing. But there is reason for optimism yet. Nutrition is our primary weapon against obesity-related cancers. By making changes to our diet, we can help to reduce the threat.
Cancer medicine has been stuck in neutral for decades as the scientific and medical communities have slowly worked their way through each paradigm. But I’m hopeful for the future because our new understanding can drive progress in ways not previously imagined. Cancer is a disease unlike anything else we face in medicine. The story of cancer is stranger than science fiction, and it took some forceful insights from an astrobiologist to guide us toward the correct path.
The recognition of a new paradigm of cancer medicine means that for the first time in decades, we stand a chance at making real progress in our decades-long war on cancer. A new hope arises. A new dawn breaks.
To all those whose lives have been touched by cancer, from researchers to doctors to patients to families, I hope this book has helped to shed some light on this deepest of medical mysteries.