What Is Cancer ?
By
Professor Serge Jurasunas
This
is a good question since the disease today has already reached an
alarming proportion. Who doesn't have a friend or relative diagnosed
with cancer, who is either sick or dying? It causes pain and
suffering and despite the repeated expectation by medicine to cure
cancer it is a complete failure, even
for many oncology doctors who have yet to find an answer or somewhere
else to turn?
First of all, cancer is not a new disease, since the earliest known description of a tumor appears in several Egyptian papyri , discovered late in the 19th century. Two of them are well known, the Ebers medical papyrus (Herbs and Incantations) and the Edwin Smith papyrus (Surgical document from the 16-17 Dynasties) were written around 1600 BC and are believed to date from sources as early as 2500 BC.
First of all, cancer is not a new disease, since the earliest known description of a tumor appears in several Egyptian papyri , discovered late in the 19th century. Two of them are well known, the Ebers medical papyrus (Herbs and Incantations) and the Edwin Smith papyrus (Surgical document from the 16-17 Dynasties) were written around 1600 BC and are believed to date from sources as early as 2500 BC.
The word cancer was originally coined by Hippocrates who referred to the
tumor by calling it Karkinos or crab in the Greek language, meaning a swelling
masse that can penetrate into tissue. Later on, the Roman encyclopaedist Celsus,
in De
Medicina, translated Karkinos into the Latin word cancer. Today just to
hear, “You have cancer,” creates a state of fear among people.
So what is cancer? Answer: A local disease, a cellular disease or also a whole disease? Cancer is a multi-factorial disease but particularly a cellular disease caused by a number of aggressive exogenous and endogenous factors and a deficient defense and cellular mechanism that sometimes come with hereditary risk. The more people you have in your family with cancer, the higher is the risk to develop a cancer or tumor. Today new lines of research show that Cancer is a disease of the cell cycle and failure of checkpoint and of apoptosis, called natural programmed cell death. Before a cell divides the DNA is checked to make sure it has replicated correctly. If the DNA does not copy itself correctly, or cells divide incorrectly then a gene mutation can occur. Abnormal cells are promptly eliminated by this mechanism that is activated by the P53 tumor suppressor gene. One particularity of cancer cells is their refusal to die, thus escaping from apoptosis because of the failure of the tumor suppressor genes controlling cell cycle and apoptosis. P53 mutation occurs in more than 50% of all cancer and appears necessary in many types of cancer. Not only does P53 mutation impair the destruction of abnormal/cancer cells but also acquires as we say oncogenic properties that activate tumor growth and invasion.
So what is cancer? Answer: A local disease, a cellular disease or also a whole disease? Cancer is a multi-factorial disease but particularly a cellular disease caused by a number of aggressive exogenous and endogenous factors and a deficient defense and cellular mechanism that sometimes come with hereditary risk. The more people you have in your family with cancer, the higher is the risk to develop a cancer or tumor. Today new lines of research show that Cancer is a disease of the cell cycle and failure of checkpoint and of apoptosis, called natural programmed cell death. Before a cell divides the DNA is checked to make sure it has replicated correctly. If the DNA does not copy itself correctly, or cells divide incorrectly then a gene mutation can occur. Abnormal cells are promptly eliminated by this mechanism that is activated by the P53 tumor suppressor gene. One particularity of cancer cells is their refusal to die, thus escaping from apoptosis because of the failure of the tumor suppressor genes controlling cell cycle and apoptosis. P53 mutation occurs in more than 50% of all cancer and appears necessary in many types of cancer. Not only does P53 mutation impair the destruction of abnormal/cancer cells but also acquires as we say oncogenic properties that activate tumor growth and invasion.
What
Can Cause Mutation?
Answer:
Radiation, tobacco, pollutants, insecticides, chemicals, viruses and
bacteria. There are four important letters that make up the entire 3
billion letter genetic code and they are Adenine,Thymine, Guanine,
Cysteine or ATGC. Any change or error in the position of the four
letters lead to DNA mutation (P53 mutation) and starts to disrupt
the cell cycle. Radiation, excessive oxidative stress can damage the
DNA components and conducts to mutations.
How
Does a Cancer Start?
Answer:
Damaged cells not destroyed continue to divide, accumulate mutations,
become less differentiated and do not respond anymore to cell
signaling pathways. They then become independent and turn
into cancer cells
that start to proliferate, build more blood vessels for growth,
utilizing degradation enzymes to expand and invade surrounding
tissues. Some cancer cells detach from the primary tumor through loss
of adhesion and penetrate into the blood or lymphatic circulation,
what we call metastasis (meaning I am here but not here anymore) and
establish secondary tumors at other locations in the body such as
the liver, lung, brain and bones, depending on the type of cancer.
After a period of dormancy cancer
cells awaken and try to form a new tumor after a lapse of time from
6 months to 6-10 years and even more. I even have a case of breast
cancer with a recurrence to the lungs, bones and brain after 15 years
of dormancy. It depends on the dormancy state and the capacity of the
cancer cells to build new blood vessel called angiogenesis, apoptotic
failure and also immune defense failure.
Development
of Cancer over Time
Cancer
metastasis prevention is totally neglected by oncology. Metastasis is
becoming a danger and responsible for 90% of cancer mortality.
Today's hallmark of cancer is reportorial, representing the essential
factors of cancer development and growth which includes P53 failure,
angiogenesis, activation of oncogenes, failure of the immune defense,
hypoxia and oxidative stress. Without tumor suppressor failure,
activated oncogenes and especially tumor vascularization cancer is
not possible.
The
immune system, particularly the Natural Killer cells (NK-cells) play
a crucial role in our defense against cancer but of course only are
activated when cancer cells are circulating or to attack a tumor.
They are known as our first line of defense against cancer. However
we know that patients with cancer have a reduced N.K cell activity
functioning only from 10-50% in comparison of a healthy person.
Oncology continues to neglect this, however recently some limited
articles are speaking about a new revolutionary treatment called
'Immuno-Oncology' to improve the standard treatment, which fact is
what my colleagues and I have already been doing for the past several
decades. Other new attractive future treatments are pointing to
reactivating the apoptotic genes like the P53 tumor suppressor gene
which I personally had already worked on for the past 10 years.
The
Mechanism of Cancer
The
mechanism of cancer is very complex since it takes an average of
about 7-14 years for tumor to reach the clinical stage of 1cm, but
grows faster for every additional cm. This means that we have a
mechanism of cancer going on but we don't know its happening, then
patients are often diagnosed at a later stage already having
developed multiple metastases to the bones, liver and even the lungs.
Why? Because the initiation of cancer and metastases invasion is
asymptomatic since the process of initiation, growth and development
is done in silence. Cancer cells first start to multiply and divide
so as to make 2 cancer cells, then 4,8, then 16,32,64, and then
exponentially to 128, 256 onward. Just realize that three quarters of
the existence of a tumor remains undiscovered before the clinical
stage. But one other important complexity of a malignant tumor is
that within the same tumor, cancer cells may be differentiated from
each other. Some cancer cells may have a high index of mutation while
others have a different growth speed cycle (10-20-30 hours) and thus
divide differently. Other cancer cells may even enter in the GO
dormant phase of the cell cycle, do not divide anymore and are
protected from destruction by chemotherapy drugs which target cancer
cells only when they divide quickly. The cancer cells with slow
division are not sensitive to chemotherapy even in the same tumor.
This is why chemotherapy is inefficient on lung cancer since these
cancer cells divide very slowly.
During
dormancy in the GO phase cancer cells active their repair mechanism
and become more resistant when they reenter the cycle sometime after
not been destroyed by chemotherapy. This is why during chemotherapy
cancer cells can spread even faster. Instead of improving patients
get worse. This is what happens after a remission where many cancer
cells enter into dormancy and then restart their cycle after few
months or a few years to form a new tumor. However it has been shown
that breast cancer recurrence for instance is associated with an
immune deficiency, where often there is a failure or mutation of the
P53 gene, mostly from bad dietary style and oxidative stress.
Therefore some cancer cells may respond to apoptosis stimuli and be
destroyed but others are more resistant, do not respond to
chemotherapy and continue to divide. After being damaged they
accumulate more mutations and become even more aggressive. This is
more less the molecular basis of cancer that of course needs more
details to explain, since a myriad of genes (oncogenes) is associates
with certain cancers, cancer stage or metastasis cancer when they are
activated, but you can view some of my lectures such as, “How
to Understand and Treat Cancer from a Molecular Basis”
or “Integrative
Cancer”, both available on Slideshare,
www.slideshare.net/sheldonstein
.
Often
it makes a difference between a tumor diagnosed with no metastases or
a tumor already with multiple metastases. These genes or oncogenes
can be targeted using dietary active compounds such as Transforming
Growth Factor Beta (TGF.B), involved in many cellular processes
including cell growth, cell differentiation and apoptosis, but when
upregulated may to the contrary inhibit apoptosis and immune response
and associate with metastasis invasion. C-Myc is an oncogene that
normally plays a role in cell cycle progression and apoptosis but is
often overexpressed or mutated in many cancers associated with
metastasis and disease recurrence. The P53 tumor suppressor gene is
part of a network that involves the function of many genes like
TGF-B, Ras, Pten, C-Myc, while the mutation of P53 disrupts the other
genes that start to be overexpressed, which is why we say that mutant
P53 has a oncogenic function and not only associated with a failure
of apoptosis.
One
other example is the inhibition of apoptosis by survivin, a new
inhibitor of apoptosis that is overexpressed in many cancers such
breast and prostate that increases survival in cancer cells. Usually
survivin expression is detected only in cancer tissue but not in
healthy tissue and therefore is considered as a cancer Biomarker. The
percentage of survivin-positive patients (and level of proteins)
within the same tumor series is variable, ranging from 30-100%. This
reflects the genetic heterogeneity of individual tumors and
complexity of the disease, showing that each patient is an individual
and therefore needs personalized treatment. In my clinic I can
observe in similar types of breast cancer or prostate cancer the same
overexpressed survivin proteins from a middle to very high level
which in this case is an unfavorable marker of disease progression.
We have also detected very early prostate cancer in patients with a
high level of survivin proteins in their blood and treated them
successfully without undergoing surgery and chemotherapy. We have
also detected a very high level of survivin in breast disease
recurrence along with a poor response to chemotherapy. Over the years
we have accumulated enough experience with a variety of dietary
active compounds to reduce or totally eliminate survivin activity
and thus increase apoptosis and destruction of cancer cells by
chemotherapy. I have offered many other examples in some of my
lectures available on slideshare.
But
of course there is another hypothesis or set of causative factors
that associates with cancers such as mitochondrial and ATP energy
failure, along with the breakdown of the cellular respiration caused
by mitochondrial component damage and mtDNA mutation from an excess
of endogenous free radicals and pollutants. ATP energy is essential
for all cellular functions including cell differentiation, apoptosis
and even to activate the immune system. Cell
division and differentiation is 60% controlled by three DNA genomes
and remaining 40% is controlled by the mitochondrial genome that
drives the early cell division and differentiation cell performance.
Meaning the decreasing ATP energy from a cancer phenotype means less
differentiation as well as abnormal cells turning more and more into
cancer cells. So it may be
reasonable to say that cellular DNA mutation may be a secondary
result of the primary process of mitochondrial dysfunction. It's
important also to remember that apoptosis is driven by the
mitochondria and not by the cell itself that only triggers the signal
through the P53 gene, which in turn activates the pro-apoptotic gene
Bax. Bax penetrates the mitochondria through the membrane and
activates an enzyme called Cytochrome C, that's also released through
the pore of the membrane in the Cytosol activating the apoptosis
mechanism by further activating a family of proteins called Caspases.
Survivin the IAP (Inhibitor of apoptosis) that I described above
inhibits Caspases activity and counters the death of cancer cells by apoptosis. Therefore the membrane of mitochondria also plays a crucial role in the mechanism of apoptosis.
Cancer
is a Disease of the Cellular Cycle
Thus
cancer is both a disease of the cellular cycle but also of
mitochondrial failure. See my articles,“Mitochondria and
Cancer” and “The Clinical Evidence of Cellular
Respiration to Target Cancer”, both available online.
Consider further that the auto-intoxication and inflammation of the
Extra Cellular Matrix is associated with tumorigenesis. A state of
auto-intoxication and high oxidative stress triggers a chronic
inflammation that modifies the fluid consistency of the ECM, causing
an edema that leads to a total blockage of nearly all the exchange
procedures between the body and the epithelial cells and pushes an
abnormal cell with a genetic instability to become a cancer cell. In
my new book, “ Health and Disease Begin in the Colon”,
is not only about the colon but includes many other interesting
chapters associated with cancer where I fully describe how
auto-intoxication of the ECM can lead to cancer.
Today
we know that the micro-environment plays a key role in tumor growth.
We know that cancer cells are not isolated but are influenced by the
condition of the micro-environment, even when tumor needs blood
vessels in order to grow and expand. The tumor uses growth factors
available in the micro-environment to attract blood vessels. In
another one of my lectures, “The Biological Approach to
Breast Cancer”, I present the relationship between the
tumor and the micro-environment. Furthermore, inflammation of
surrounding tissue in turn stimulates the further growth of a
cancerous tumor which is associated with bad ground and bad
inflammatory foods. We need to understand dietary style and
detoxifying the body, especially the colon may be a key protection
against cancer. Diet accounts for 30-40% of cancers. Industrial food is associated with higher cancer
risk and will even rise in the future. Pollution and environmental
toxins are also largely implicated, especially insecticides which are
associated with breast and brain cancers. Scientists in the USA found
a footprint of insecticides on the P53 gene located in chromosome 17
of the cell, which offers more proof of the implication of
insecticides in causing cancer. We can discuss more about molecular
medicine and a cell's DNA, but further ask, what makes a good cell?
This depends on our food, our oxygen supply circulating in the blood,
having blood free of toxins, pollutants and bacteria, which also
depends on having a good immune system. So we need a clean colon and
to prevent auto-intoxication of the colon. This is also an important
step that we often forget about that I describe in my book. You'll
never find a cancer patient especially in women without intestinal
dysfunction and chronic constipation or patients not having
nutritional deficiency and intoxicated blood.
Cell
Cycle and Cancer
Excess
industrial foods, toxins and stress reduce the activity of the immune
system which is supposed to protect us from cancer. In the year
1900, 1 person out of 100 developed the risk of cancer, but today we
have reached 1 person out of 3, while soon 1 in 2 will develop a
cancer. While enormous progress has been done in the discovery of new
mechanisms such the cell cycle, tumor suppressor genes, hundreds of
recent articles focusing on new attractive treatments, it's still only
in the theoretical phase and not yet a clinical application since
the cornerstone of medicine is only concentrated on research and
development for new treatments of chemotherapy with hundreds of
millions of dollars invested, but in return for billions of dollars
of profit.
Little
research has been done on the preventive and therapeutic value of
food against cancer, yet we know that many foods and dietary
compounds can change genetic expression such as in brain and prostate
cancer, where cruciferous vegetables, selenium, zinc, flax seed,
vitamin D and chlorella extract offer increased protection against
cancer or may be used together with conventional therapy for better
results. We have to learn how to influence our internal landscape and
not open the door to cancer.
Today
a new science called Epigenetics suggests that many cancers may not
be caused solely by mutations in genes but by changes in how the
genes function. They can work faster or more slowly. Environmental
toxins are mostly implicated in Epigenetic change, particularly the
example of the P53 that I mentioned with a footprint of insecticides.
The gene is shut down not only by mutation but they do not produce
P53 protein. This is what I have often observed from the testing I
have done on my cancer patients. Some have a totally inactive P53
without P53 protein, while others harbor mutated P53. The epigenetic
transformation can be transmitted through several generations and
with no surprise this new generation is much more vulnerable.
Suppressed or mutated P53 is transmitted to our descendants who are
already born with a deficient or mutated P53, already on the way to
cancer. We need more attention from pediatric doctors caring for our
children. This disease can also arise much later especially if we
keep our bad life style where their parents think they are healthy
or have healthy children. However this interaction between genes and
the environment can also affect a number of susceptible persons,
while others remain unaffected.
However
my book gives all the details about the theory of cancer, about
Epigenetics and the environment, how food can modulate our genes, the
role of the P53 tumor suppressor gene and also about mitochondria and
their implication in cancer. It especially offers the reader full
details about diet, about food, juice combinations and especially
about how to detoxify the body and the colon, so you can be more
healthy and have a better chance to prevent cancer.