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Cancer: Genes, Environment or Bad Luck

Published on 06 January 2015, by M. Tomazy.
Background:
Cancer and cardiovascular diseases are the major causes of death in the developed countries. One out of nine females will have breast cancer during her life. Lung cancer is the most common cause of death among males, even though prostate cancer is more common to affect men.

Not only cancer patients suffer during their journey of "impending death", but also their relatives expertise emotional stress. Cancer patients usually undergo "adjuvant therapy" including one or more of chemotherapy, radiotherapy, surgery or they may undergo "palliative therapy" in advanced "metastatic" cases.

How does cancer occur?
Grossly, cancer occur as abnormal tissue growth, there will be loss of the "normal texture" of the affected organ and subsequent loss of its normal function.
microscopically, abnormally increased "cell division" occur when a complex bio-chemical process fails to control cell division, i.e, "cell madness".

Millions of DNA mutations affect every human being daily, which if not controlled, will be Cancer. However, DNA polymerase is an important enzyme which "get rid" of bad mutations during cellular division. Any material interferes with DNA polymerase is called "carcinogen", such as: Asbestos, Nitrosamine of tobacco smoking, smoked meat and radiation expsure.

Genes, environment, mystery or bad luck:
Many cancers are approved to have genetic susceptibility like certain cancers of the breast (BRCA 1, BRCA 2 genes) as well as some colon cancers (Familial Polyposis).
Some scholars suggest that stomach cancer is common in Japan due to excessive raw meat consumption (sea foods).
“Two thirds of cancers are due to bad luck,” It comes from a newly published paper in the journal Science. The study, by Bert Vogelstein and Cristian Tomasetti of Johns Hopkins University, used mathematical models to look at the mutations occurring during stem cell divisions within 31 types of body tissues. What the researchers found is that, in two-thirds of the tissues observed, what determined a mutation was chance over other causes, such as environmental factors or inherited predispositions. But this does not equal to saying that two-thirds of cancers are due to “bad luck.”


Recent ethical argument:
Richard Smith, a doctor who spent 13 years as former editor of the British Medical Journal, has recently published a controversial piece encouraging people to ‘stop wasting billions trying to cure cancer’ – because it’s an ideal way to end someone’s life.

In a post for BMJ [British Medical Journal], Smith starts by quoting filmmaker Luis Buñuel. Buñuel had written about death in 1982, a year before he died. He wrote:

“An even more horrible death is one that’s kept at bay by the miracles of modern medicine, a death that never ends. In the name of Hippocrates, doctors have invented the most exquisite form of torture ever known to man: survival.”

Smith’s argument for death by cancer is that while most people say they believe sudden death is ideal, it’s very difficult for the families afterward. As for the other alternatives, Smith says:

“The long, slow death from dementia may be the most awful as you are slowly erased, but then again when death comes it may be just a light kiss. Death from organ failure – respiratory, cardiac, or kidney – will have you far too much in hospital and in the hands of doctors.”

Here’s why Smith favors cancer:

“Death from cancer is the best… You can say goodbye, reflect on your life, leave last messages, perhaps visit special places for a last time, listen to favorite pieces of music, read loved poems, and prepare, according to your beliefs, to meet your maker or enjoy eternal oblivion. This is, I recognize, a romantic view of dying, but it is achievable with love, morphine, and whisky. But stay away from overambitious oncologists, and let’s stop wasting billions trying to cure cancer, potentially leaving us to die a much more horrible death.”