What is Cancer?
Cancer is a horrible disease that’s killing people at a record rate. A hundred years ago, 1 in 100 people got cancer. Now, we’re approaching 1 in 2 people getting cancer in their lifetime.
So, what is cancer? Cancer is a broad term used to describe more than 100 different variations of a single disease. While it is a disease of extreme complexity, we can describe it very simply as cells going rogue.
The building blocks of life
Cells are the basic building blocks for living organisms. It is estimated that the body has between 40 and 100 trillion cells. Each of these cells performs specialized functions in the body, but all contain the same basic structures and mechanisms, such as a surrounding membrane, a nucleus containing DNA, and mitochondria, which produce energy for the cell.
Groups of specialized cells form tissues and organs, which perform specific and essential tasks within the body. So while, for example, a cell from the lung performs different functions than a cell from the liver, the individual cells, themselves, share similar characteristics.
One of the similarities that all cells share is their life cycle. This life cycle is divided into three phases: interphase, mitosis, and cytokinesis. Interphase accounts for the majority of a cell’s life, as it performs specific, specialized functions and takes in nutrients, preparing to ultimately divide into two daughter cells.
Mitosis is the process by which cells begin their duplication, replicating their DNA. Following mitosis, cells enter into cytokinesis, during which time individual cells will split completely into two separate cells, each containing identical copies of the original DNA.
DNA, or deoxyribonucleic acid, is the hereditary information inherent in cells and forms what are called chromosomes. Contained inside the body’s 46 chromosomes are instructions for creating and maintaining life. As we know, 23 chromosomes are contributed by Mom and 23 chromosomes are contributed by Dad. These chromosomes are contained inside the nucleus of virtually every cell in the body. You can think of DNA as the master code for your body. DNA is comprised of chains of four nucleotides, called adenine, cytosine, thymine, and guanine. The way these four nucleotides are arranged on the DNA strand is how the information inherent in DNA is coded. The sequence of these four nucleotides along the strands of DNA are read by our body, similar to the way a computer reads binary code consisting of ones and zeros.
Genes control your physical features, such as height, eye color, and hair color. Genes also control the basic functions of cells, such as energy production within the cell, protein synthesis, and other functions. The collections of genes make up individual chromosomes, which can be thought of as an entire computer program, with many commands and functions.
Our cells are very adept at replicating DNA during the process of mitosis, even though this process of DNA replication occurs many, many times. For the most part, this process is extremely accurate. However, sometimes mistakes occur. Usually, mistakes are corrected when they happen via inherent proofreading mechanisms, but sometimes these errors go undetected.
When genes become altered or damaged, it is known as a mutation. These mutations in the genetic code can affect the subsequent cellular function, and because cellular mitosis creates (mostly) perfect replicas of DNA, those mutations ultimately get passed on to the cellular offspring — referred to as daughter cells. Often times, genetic mutations go unnoticed and affect parts of the genetic code that do not control any sort of vital function. However, because genes control everything a cell does — including its division and lifecycle — if enough mutations occur in the right place, cancer can form.
The Hallmarks of Cancer
Once cancer has begun, we see specific changes in cancer cells that distinguish them from normal, healthy cells. In a landmark study published in the journal Cell in 2000, researchers Douglas Hanahan and Robert Weinberg defined the underlying principles common to all cancer cells. There are six principles in total, which distinguish malignant cells from normal cells.
- First, cancer cells have self-sufficient growth signals. Normal cells are reliant upon external signals to grow. In contrast, cancer cells stimulate themselves to grow and multiply.
- Second, cancer cells are insensitive to anti-growth signals. Normal cells have what is known as tumor suppressor genes, which restrict their growth. Cancer cells have altered tumor suppressor genes, which means that the “stop growing” signal is not active.
- Third, cancer cells possess the ability to evade apoptosis. Normal cells undergo apoptosis, or programmed cell death, to protect the body. Cancer cells do not undergo this cell suicide, making them immortal.
- This is related to the fourth characteristic of cancer cells; cancerous cells have limitless replicative potential. Normal cells have a predetermined number of times they can undergo cell division before dying. This is known as the Hayflick limit. Cancer cells do not have this barrier, meaning that they can divide indefinitely (and thus continue to multiply).
- The fifth hallmark of cancer cells is that they possess what is known as sustained angiogenesis. Normal cells are restricted by their nearby blood supply. In contrast, cancer cells have the ability to promote angiogenesis, which is the formation of new blood vessels. Cancer cells use this additional blood supply for nourishment to grow and spread.
- Finally, the sixth hallmark of cancer cells is that they invade nearby tissue and can spread to distant sites (metastasis). (1)
Why Can’t Our Body Defend Against Cancer?
Our immune system is particularly adept at fighting off infections, including viruses and bacteria. The immune system recognizes these as foreign to the body and creates antibodies that kill these organisms, subsequently protecting us from infection, or fighting infections when they do occur. Many people, particularly in the natural health community, assume that the body’s natural defense mechanisms work much the same way in defending against cancer.
This misconception has led to many saying that a strong immune system is the best defense against cancer; the stronger the immune system is, the more likely it is to recognize cancer when it forms and eliminate it accordingly. It is true that when the body does recognize cancer, it will eliminate it, which has led to the theory that we all develop cancer cells at some point in our lives.
The thought that our immune system regularly protects us from cancer by eliminating malignant cells before they grow into something life-threatening is an interesting one, but this approach fails to recognize how complex cancer is. Unfortunately, cancer is remarkably good at cloaking itself from our immune system, and this has nothing to do with how strong or weak our immune systems are.
A lot of specificity goes into training our immune system’s cells. For example, some are trained to fight bacteria, some are trained to fight viruses, some are trained to fight fungus, some are trained to fight parasites, and some are trained to fight allergens. The way these cells are trained is that they are exposed to antigens in the lymphatic system. Antigens are structures which are visible on the surface of certain pathogens. When our trained immune cells recognize these antigens within the body, they realize that they are supposed to attack that pathogen, and the body rallies to do that.
Cancer cells, however, are largely devoid of foreign antigens. There is nothing protruding from a cancer cell that signifies to the immune system that it is bad. Cancer, after all, is technically self, and with only very few exceptions, the immune system recognizes no distinction between a cancer cell and a normal cell.
Once cancer has begun, there really is no way to reverse the process; cancer simply must be killed. Ultimately, our immune system is ill-equipped to fight cancer the way it fights infections or other diseases. The answer to preventing and treating cancer does not necessarily lie with a stronger immune system, although that is an important component to overall health. A healthy immune system simply does not mean you can prevent cancer from forming, and strengthening your immune system following a cancer diagnosis will not cure the disease.
Cancer as a Metabolic Disease
Conventional oncologists and cancer researchers have placed the focus on the genetic component to cancer, and this has been the paradigm for years. In their view, cancer is a genetic disease, and this view predominantly informs their approach to treating cancer as well as the research that goes into cancer.
Integrative oncology maintains a different view of the nature of what cancer fundamentally is. We have described how outside influences, including natural and man-made agents, are often the cause of the genetic insults that instigate the formation of cancer. In addition, we have described the role that prolonged stress may play in the process of cancer development.
All things accounted for, we know that genetics can only be blamed for less than 10% of all cancers. Even then, genetic cancers are likely the result of genetic damage initially incurred by environmental factors and then passed down from parents to children.
I approach cancer from a different perspective. Cancer is much less of a genetic disease than it is a metabolic disease; the genetic component to cancer is merely a result of our cells’ metabolic processes — the processes by which our cells make energy — becoming interfered with, or compromised, by a variety of factors and agents. This view, however, is not without precedent and has been supported by a variety of researchers through the years.
Among those is Otto Warburg, a German physiologist, and medical doctor. In 1931, he received the Nobel Prize in Physiology or Medicine, a prize for which he was nominated for 46 times. Dr. Warburg did quite a bit to advance our understanding of cancer. What ultimately earned him the Nobel Prize was discovering the way cancer cells make energy or ATP.
Dr. Warburg wrote that “The first phase (of cancer cells’ origination) is the irreversible damage to respiration (metabolism).” (3) Normal, healthy cells are very good at producing ATP. Our healthy cells go through a multi-step process to create energy and typically produce around 32-36 units of ATP. Cancer cannot do that; it is not nearly as efficient. Cancer goes through a very small part of that metabolic process — only the first step, known as glycolysis.
During glycolysis, a cancer cell essentially burns sugar for energy, and it only produces 2 units of ATP. This is the primary way by which cancer can make energy, and it is a very labor-intensive process. It is also a very important distinction between a normal, healthy cell, and a cancer cell.
This discovery led to some of the ways we can find cancer in the body; on a PET scan, we observe cancer cells consuming radioactive glucose at a rate far faster than healthy cells. Dr. Warburg was convinced that the damage to cellular metabolism was at the root of cancer development. He wrote that “If the explanation of a vital process is its reduction to physics and chemistry, there is today no other explanation for the origin of cancer cells, either special or general. From this point of view, mutation and carcinogenic agent are not alternatives, but empty words, unless metabolically specified.” In other words, what Dr. Warburg believed his research pointed to was that genetic mutations were the result of a cell’s metabolism is compromised.
Dr. Warburg made other important discoveries related to cancer. Along with his discovery that cancer cells preferentially consume glucose for energy, Dr. Warburg also realized that cancer cells do not thrive in oxygen-rich environments. Hypoxia, or lack of oxygen, does much to contribute to the creation of cancer cells.
Another important metabolic feature of cancer, Dr. Warburg discovered, is that cancer’s energy production results in a significant amount of lactic acid. This is why we see a lot of acidity in and around cancer cells, and one reason why many talk about the importance of pH, or alkalinity vs. acidity when it comes to cancer.
Building on Warburg
Dr. Thomas Seyfried of Boston College believes that many of the hallmarks of cancer, such as the genetic abnormalities, are all downstream of the primary issue, which is the interference of cellular metabolism, primarily through the repeated damage to mitochondria, where cells produce energy. (4)
In light of the fact that genetics play a less pronounced role than we have been led to believe, and that we know a variety of agents can elevate levels of inflammation in cellular habitats, and that inflammation ultimately leads to the degradation of the cell and its ability to produce energy, the view that cancer is more metabolic than genetic comes into sharper focus. Our toxic bucket may overflow when our cells’ energy production is disrupted, causing our cells to mutate simply in order to survive.
Feeling as if your health is exclusively bound to your genetics is simply misguided. The fact is that you do have significant control over many aspects of your health. Certainly, there are aspects of your genetics that you cannot change; you cannot biologically increase your height, change your hair or eye color, or your fingerprint. What we do know, however, is that our environment can have a profound impact on our genetics. There is a mounting body of scientific evidence to support this.
Genes can be thought of as a light switch, which can either be turned on or off. Our genes are constantly changing and adapting to their environment, even on an hour by hour basis. Our cells, and subsequently our genes, can be subjected to a hospitable environment, with good conditions, or an inhospitable environment, with less than optimal conditions.
By creating beneficial conditions in the body, it is possible to essentially “turn off” bad genes, and “turn on” good genes. These conditions are highly influenced by our choices via nutrition, stress, how much we exercise, and many other factors. This means that it is no longer acceptable to think that we are beholden so strongly to our genetics.
Much of the research is arriving at a similar consensus; there are factors outside of DNA itself that dictate how our genes are expressed. This is in stark contrast to the attitude held by many researchers, doctors, and particularly oncologists, for many, many years — many of whom still hold onto this antiquated belief today.
(1) Hanahan D, Weinberg RA. The Hallmarks of Cancer. Cell 2000; 100 (1): 57-70.
(2) Urbina, Ian. “Think Those Chemicals Have Been Tested?” The New York Times. The New York Times, 13 Apr 2013. Web. 26 July 2017.
(3) Warburg OH. On The Origin of Cancer Cells” Science 1956; 123(3191): 309-14.
(4) Seyfried TN, Shelton LM. Cancer as a Metabolic Disease. Nutr Metab (Lond) 2010; 7:7.
Integrative Oncology
A different view of the nature of what cancer is, fundamentally
Viewing Cancer as a Genetic Disease
The last few decades of research have centered largely on the genetic component of cancer. Since it is understood that a mutation in the genetic material triggers the formation of cancer, most of the research into cancer has centered on understanding the mechanisms that are the result of damaged DNA. In the last 20 years, researchers have made tremendous strides in understanding the genetics of cancer.
This focus, however, is somewhat short-sighted because it does little to address what still lies at the root of the problem. While we understand that genetic mutations are an important part of how cancer develops, and are responsible for giving cancer cells their aggressive behavior, little has been done to address what causes those genetic mutations to begin with.
This might be a big reason why cancer prevention is rarely the emphasis when it comes to our discussion on cancer. Instead, what is communicated is that the genetic mutations that lead to cancer happen largely without any reason, and are thus outside our ability to influence or change.
The Toxic Bucket
One of the biggest problems with cancer has always been that because it is such a complex disease, any new evidence discovered that sheds light on its development, progression, or treatment immediately co-opts all the attention of everyone within the scientific community. First, it was radiation therapy at the beginning of the 20th century. Forty years later, it was chemotherapy, and 25 years after that, it was the study of genetics. We have collectively put a lot of research into money into these areas, and not without some success.
We have progressed exponentially in the field of radiology. Chemotherapy is more effective than ever before, and we have learned how to mitigate some of its terrible side effects. Today, we know so much about the genetic mechanisms that drive cancer development.
However, there is comparatively little research into — and little discussion about — what causes those genetic mutations to begin with. This is a problem because what we are missing may have more to do with what causes cancer to begin with than genetics, alone.
If our best guess is that 8 percent of cancers are genetic in origin, we can safely assume that perhaps there must be some sort of environmental factors at play in the other 92% of cancers. We have focused so strongly on understanding the genetic mechanism of cancer development that we miss what set that mechanism into motion.
Normal, healthy cells all endure a certain level of bombardment over the course of their lives. At a certain point, however, they can become overwhelmed by the repeated damage they incur from their environment. It is helpful to think of this as a bucket; if the bucket continues to get filled, eventually, it is going to overflow.
Each individual has a differently sized bucket, so to speak, and can sustain a different amount of toxic bombardment. This is why some people might get lung cancer, and others can smoke well into their old age and die of “natural causes.” For everyone, however, there likely exists a threshold; at some point, our cells cannot sustain the repeated damaged incurred from their environment.
The environment our cells are continuously bathed in eventually takes its toll on the genetic material inside our cells if that environment is less than optimal. There are a variety of ways we can create toxic environments for our cells. One of the primary ways we do this is through exposure to carcinogenic agents.
Chemical Bloom
The word “chemical” has a dirty connotation to it, although it is not a bad word in and of itself. Everything you see, smell, taste, or touch consists of a chemical composition, from the healthiest vegetable to the water you drink, to the computer you use. Even your own body has its unique chemistry. We are surrounded by chemicals.
Until recently, however, our bodies were not inundated with the volume of chemicals that we see today. The war effort in both World War I and World War II led to the discovery and use of many new chemical compounds. Following World War II, we saw rapid increases in technology and consumer products which were largely a result of research and development from the war effort.
Since then, there has been an exponential increase in the number of consumer products brought to market, and subsequently, an enormous amount of new chemicals released into our environment. It is estimated that since that time, there have been more than 84,000 unique chemicals brought to market or introduced into the environment. As little as 1 percent have been fully tested for safety. This is a staggering statistic, with potentially severe ramifications to our health. (2)
The issue really becomes that we do not fully understand what the long-term effects are of our chemically-laden environment. In spite of the hundreds of chemicals, the IARC and other agencies have deemed carcinogenic or probably carcinogenic, there remains a tremendous volume of chemicals available in some form on the market today that are either untested or not fully tested, for carcinogenicity.
Moreover, the issue is not simply whether a chemical is inherently carcinogenic, but also the dose which is required to cause damage to our cells. We simply do not know what the long-term effects of these kinds of exposure are.
Simply thinking about what we come in contact with today versus 100 years ago — from the building materials in our homes, to the cleaning chemicals used in our homes and workspaces, to the industrial chemicals necessary for our phones, automobiles and computers and other modern conveniences, to the cosmetics we use — we are bombarded with chemical exposures we would have never experienced 100 years ago.
Today, even our foods contain ingredients we cannot even pronounce. In comparison to what our ancestors experienced, the volume of chemical exposure we experience is staggering.
It does not take a statistician to realize that as the volume of available chemicals has increased, so have cancer rates. Is there a correlation between the two? It is not definitive, but it certainly seems probable.
The response from the conventional medical community about this issue of overwhelming chemical exposure is tepid, at best. The reason conventional medicine does not recognize — or at least, does not vocalize — the huge concern associated with the volume of chemical exposure people are subjected to is because it has not necessarily been proven that any of these chemicals are harmful. In other words, we have not tested a certain chemical for safety, so we do not know whether it is safe, therefore we cannot tell you that it is unsafe.
It is time to use more common sense when it comes to what we expose ourselves to, particularly as that exposure relates to cancer. It is simply imprudent to wait around for decades for scientists to conclude that a specific chemical is dangerous and causes cancer.
Toxic Stress, Toxic Lifestyle
We have all been told that mitigating stress in our life is important. There is evidence that high-stress lifestyles can induce a variety of health problems, including cancer. No one likely took this theory to its logical extreme more than Dr. Ryke Hamer, who developed a theory on the origins of cancer. Born in 1935, Dr. Hamer received his medical license at 26 and spent the next few years working in the university clinics of Tubingen and Heidelberg. In 1972, Dr. Hamer completed his specialization in internal medicine at the age of 37.
Dr. Hamer’s son was accidentally shot in 1978; four months later, he died from complications related to the gunshot wound. Understandably, Dr. Hamer and his family were devastated. Shortly thereafter, Dr. Hamer developed testicular cancer. Suspecting there was some link between his cancer and the emotional trauma related to his son’s sudden, unexpected death, Dr. Hamer began research into the connection between life trauma and the development of disease, particularly cancer.
What he purported to find was that traumatic life events set biochemical changes in motion that could lead to the development of cancer and other diseases. He developed this theory to the extent that he believed he could predict exactly what kind of cancer, and wherein the body it would develop if he knew what particular life trauma had occurred in a patient’s life.
Dr. Hamer would call this area of research German New Medicine. His theories are very controversial, so much so that his license was revoked by the German authorities. Many of the components of German New Medicine are unproven and untested. Regardless, there are many who still believe Dr. Hamer’s theories to be accurate. Regardless of how controversial Dr. Hamer and German New Medicine is, his work certainly underscores some of what our own science has said about the causes of cancer.
The body’s natural stress mechanisms have a natural, specific role that they play, such as the secretion of certain hormones, like cortisol. The problem lies with the fact that our biochemistry has done a poor job at keeping up with our modern lifestyle. Before the advent of modern life, stress hormones were triggered only as necessary, often during “fight or flight” situations.
The problem has become that because of our fast-paced, overstressed lifestyles, we constantly bathe our cells in a cocktail of stress hormones. These stress hormones, however, can become a toxic agent in our bodies when maintained at heightened levels over long periods of time. We know that this can have an effect on our genes, much the way exposure to toxic, foreign chemical agents can. If we couple this with the emotional trauma everyone experiences as a part of the course of life, it can be argued that the pressures we inflict on our own body via stress can damage our own DNA, leading to cancer.
Cancer is not exclusively the result of man-made influences, although it can be argued that manmade influences play a very significant role. We know, however, that there are natural forces and agents that have a proven ability to cause cancer. Among these: ultraviolet light from the sun, certain toxins made by fungi such as aflatoxins, and certain infectious agents like Helicobacter pylori or human papillomavirus (HPV).
The fact that natural carcinogens exist serves to underscore two main points. First, it provides proof that cancer is not exclusively a relatively new, man-made disease, something many people wrongfully espouse. Cancer has existed for millennia, something autopsies of ancient Egyptian mummies revealed. Combined with genetic predisposition, life stressors, and other factors, it only makes sense that cancer is not exclusively a manmade disease and has existed long before our ability to diagnose it.
Second, many people in the holistic medical community typically want to point the finger exclusively at man-made causes of cancer and demonize anything man-made that can treat cancer. There are plenty of so-called natural compounds that are just as dangerous — and carcinogenic — as man-made agents. This is extremely short-sighted thinking; while conventional oncology certainly has its flaws, and natural medicine certainly has its benefits that often go unrecognized by mainstream scientists, it is time to find some middle ground.
