Rethinking Tumor Growth | Part 1 - Where Does Cancer Begin?

I have shared my thoughts on tumor growth and cancer without a unifying framework. If you have ever had the nagging thought that the current cancer paradigm is incomplete, this is for you.

Setting the Stage

When discussing cancer with most people, including colleagues, it quickly becomes apparent that we approach the topic from entirely different perspectives. This disconnect is often evident on the faces of those I converse with - puzzled, confused, and perhaps even wary.

"What is this person talking about?"

To illustrate the reason for this, consider the following definitions of cancer:

Wikipedia defines cancer as "a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body."

The American Cancer Society describes it as "a group of diseases in which cells in the body change and grow out of control. Most types of cancer cells form a lump, or mass called a tumor."

These definitions are consistent across virtually every mainstream source of medical information.

Excluding certain malignancies like leukemia and lymphoma, cancer is generally characterized as starting with an abnormal cluster of cells that can proliferate, become locally malignant, and eventually metastasize to other parts of the body. This concept forms the foundation of the modern oncology paradigm.

Cancer is understood to:

1. Begin with a limited number of cells

2. Grow out of control and eventually cause death

Our treatment approach is based on this framework:

1. Identify malignant cells

2. Surgically remove them

3. Apply chemotherapy and radiation as needed

Why this framework?

The answer is a little complicated.

To a great extent, modern western medicine takes an egotistical view of the body.

In this perspective, there is the individual, complete with well-defined boundaries. Everything else is considered foreign.

For instance, immunology is frequently taught with a militaristic approach. The immune system produces foot-soldiers (white blood cells) responsible for patrolling borders and detecting foreign intruders.

Upon identification, these foot-soldiers combat the invaders while simultaneously alerting the immune system to add the foreigner's fingerprint to its database for continuous surveillance.

This concept is particularly evident in infectious disease, where the body is perceived as being invaded by foreign entities that must be eradicated using drugs.

Though the list goes on, this unspoken belief structure pervades much of modern medicine's thinking and has seeped into our comprehension of cancer as well.

Cancer diagnoses are typically confirmed visually. Even if a blood test initially indicates the presence of cancer, the subsequent step involves locating the cancerous cells.

This process requires a series of visually confirmatory tests including radiologic imaging, endoscopic evaluations, and tissue sampling for microscopic examination.

And, would you look at it!

Does this tumor look out of place?

This alien-appearing entity seems to be growing out of our normal body. But, how did it get there?

Unfortunately, numerous fields in medicine, including oncology developed alongside genomics.

Historically, this has resulted in the study of oncology being significantly influenced by the genomics industry. The genomics sector is highly lucrative, via research grants, diagnostic tests, and treatment approaches – all wildly expensive.

As a consequence, if genomics were to dominate any field of medicine, it would become a financial goldmine for many.

That is precisely what has happened.

Cancer research rapidly embraced the idea that tumors arise due to genetic mutations. The theory suggests that a randomly placed mutation may adversely impact a gene responsible for promoting or inhibiting cell growth.

If both are affected, we are off to the races.

Throughout the history of cancer research, several such concepts have been proposed, with the two-hit hypothesis being a commonly taught concept.

This is how most people studying and treating cancer perceive the process:

x → Mutagen → Mutation → Tumor → Cancer

This narrative is compelling and has gained significant traction.

What's the problem?

This story fails to thoroughly examine the causal chain of events.

Where did the mutagen (the agent causing mutation) come from?

Solve for x.

A Short Story

The implications of my perspective on cancer may face considerable pushback, primarily because it challenges the application of science within medicine.

Having clarified the dominant view of cancer, I'd like to propose an alternative framework for understanding tumor growth.

But first, a brief story.

The nervous system is my specialty. I studied it in undergrad, conducted lab research in medical school, and specialize in it as a doctor.