Millions of people die from different cancers all across the globe and perhaps more so than in the past, and hundred thousands of scientists, experts and clinicians work to treat these merciless killers of human lives, and billions of dollars have been spent on such cures, but not much success in a considerable scale has been achieved! Why? We like anybody else have no claim of knowing the answer. But we will put some ideas and concepts forward that may shed some lights on the right path of discovery of the causes of cancers so to make the possible treatments and preventions more plausible. For cancers like any other diseases, one need to first identify the pathophysiology of the condition. Moreover we need to work and invest more on prevention of different disorders including cancers if possible than on treatments as often it is too late to do much when the disorder or in this case cancers have done the damage and the tip of the iceberg is out of the water!
Cancers happen when cells of a tissue or organ start acting odd, e.g. increasing in numbers, change in sizes, and excessive pigmentation. Cancers do not happen over night and without any precedence, but have stages of development. The first stage is “Dysplasia” that means cells get distorted and go out of their normal process of living, with any of the above changes. This stage is still cellular and is not usually recognized and diagnosed clinically, unless accidentally through check ups by pap smear or biopsy.
The second stage in cancer development is “carcinoma in situ” where the cells lose their tissue identity and revert to a primitive cell form that grows rapidly and with abnormal regulation. At this stage, the cancer remains localized, and does not yet invade and pass the basement membrane into the surrounding tissues. At this stage the cancer could be clinically identified, diagnosed and treated with relatively good prognosis.
The third or last stage of cancer development is the “invasive carcinoma” that the cancerous cells metastasize and invade the surrounding and even far tissues. Unfortunately this is the stage that even in our highly modern era, most cancers are diagnosed and treated late, when the prognosis is fair to poor and the survival rate very low. In this final stage, the surgical removal of cancer is not sufficient but chemotherapy and radiotherapy are required, but with those all there is meager chance of long survival!
The above obvious scientific facts and information up to here, could be found in many medical books, journals, papers and sites. But what is not much talked about, what is the predisposing factor(s) to the first stage of cancerous machine and what makes the first throttle of such engine to start. While some cancers may have genetic precedence, the majority of cancers seem to be developed during the living life and has not been written much by the genetic writer. In other words, we need to identify the causative agents that turn on the dysplasia, as the starter of the cancerous machine!
Any insults such as infections of traumas could be such triggers or predisposing factors to turn on the dysplastic machine and initiate the development of cancers. One of the most common and well known of these insults is the Human Papilloma Virus (HPV) that predisposes to the development of cervical cancers in young women. This is now so well known and documented that the vaccination of young women is strongly recommended by health agencies of developed countries. Although HPV infection is involved in more than 90% of cervical cancers, not everyone with the infection would develop it. Other factors in developing cervical cancer is weak immune system and starting sex at early age and having multiple sexual partners that all increase the risk of HPV infection and others and also are sources of traumas to the cervix. Therefore the story of cervical cancer is a good example to pay attention to the role of trauma to a specific tissue in the development of cancers. The role of trauma is not well recognized that will be more here in this prologue and in discussion about different cancers will be elaborated, though this could be somewhat not an easy task to identify the role of traumas and other insults in every cancer’s development.
A good example of trauma other than in cervical cancer, by having many sexual partners, is in the case of skin cancers. It is also well known that the insult or trauma by sun, through repeated and high dose of sun exposures, for example in the farmers and residents of sunny places, could increase the risk of skin cancers. Another common example of trauma/insult as precipitating factor in development of cancer is the causal relationship between smoking and lung cancers! But smoking is not yet well recognized as an insult and trauma to the lungs, but its relationship as a possible trigger to the development of lung cancer has been documented.
While the causes of almost all cancers could be related to traumas and insults including infections, the cancers of reproductive organs, e.g. breast, ovary, uterus and prostate seem to follow a different etiologic path. The cancers of reproductive system as it is noted in their own posts, follow the rule of “use or lose”, i.e. lack or low use of the reproductive organ could lead to aberrant cell division and cancer. For example lack of breastfeeding could lead to breast cancer and low ejaculation could cause prostate cancer, both at an older age when these organs are in low functioning or downward stages.
In the articles on the oncology of this section, we will attempt to identify the specific traumas/insults causing different tissues’ cancers. Upon identify and scientifically validating the predisposing factors, e.g. insults/traumas in development of different cancers, the focus of the medical arena should drawn basically to the prevention and removal of such factors. Therefore the future of management of cancers should be prevention not treatment as it is in the present time. This shift in strategy, by educating the public about the role of different predisposing factors, e.g. traumas/insults, hence prevention of cancers will save millions of lives, sufferings and capitals!
Dr.Mostafa Showraki, MD, FRCPC Lecturer, University of Toronto,School of Medicine,Author: “ADHD:Revisited” Book “adhdrevisited.com”/”medicinerevisited.com”
- Showraki, Mostafa. “Breast Cancer:Revisited”. medicinerevisited.com.
- Showraki, Mostafa. “A new look at Cancer”. medicinerevisited.com.
- Showraki, Mostafa. “A new look at infections”. medicinerevisited.com.
- Showraki, Mostafa. “Trauma and insults”. medicinerevisited.com.
- Showraki, Mostafa. “Ovarian and endometrial Cancers:Revisited”. medicinerevisited.com.