I have no specific answer, but our knowledge of cancer is rapidly progressing, so most books will probably start to see errors pop up in their text as time goes on. This seems like the kind of thing you'd have to update pretty regularly.
Wiki link says that was published in 2010, a lot has happened in the field in 13 years. That predates whole classes of immuno-theraputics like grafting B-Cell (cells that produce antibodies) receptors onto CD8+ T cells (cells that kill infected cells), which I forget the name of.
There are hundreds of thousands of trucks in the USA alone with emissions bypass chips or devices that are rolling carcinogen generators on all the roads.
Leaded fuels is still sprayed everywhere for decades by propeller aircraft, across entire neighborhoods near airports in the USA
Fracking with toxic chemicals is done in or near populations.
Socializing the cost of cancer while privatizing profit is all what the USA is about.
Can't say "we didn't know" anymore. We know, we just don't care as long as it's not themselves.
By your link, nearly every European country, save Ireland and Hungary, have lower rates of cancer. America is the 5th worst out of 50, so 90% of the countries on the list are doing better than America.
The highest cancer rate for men and women combined was in Denmark at 334.9 people per 100,000.
The age-standardised rate was at least 300 per 100,000 for 10 countries: Denmark, Ireland, Belgium, Hungary, France, The Netherlands, Australia, Norway, France (New Caledonia) and Slovenia.
I read this article yesterday, helped me a bit. My 62yo father was recently diagnosed with multiple myeloma when a vertebrate in his back basically disintegrated. Spent his whole life as a fine finishing carpenter. When he was in his 20s he just wore flimsy paper masks, and I don't know if ever wore gloves when using stains and lacquers.
We always joked he was going to get something from the chemicals, not so funny now that it hit.
You’re probably in the process of learning this now, but in case you’re just getting started: effective multiple myeloma treatments are being approved at an astonishing rate. It was a death sentence 20 years ago. Now it’s indefinitely treatable for many people.
A close family member was diagnosed 5 years ago and went through a stem cell transplant at Dana farber and the cancer still hasn’t returned…although statistically by now I believe it should have. But when it does return there is now a massive menu of next treatments for her that will likely hold it at bay.
Things are changing so fast now that I’m not sure the stem cell treatment is the first step.
I wish the availability of those treatments would trickle down regular hospitals in non-US countries as well. I keep reading about all this amazing work being done, and yet my local hospitals in Estonia most likely haven't heard of them, or can't afford to implement it.
What does that mean for someone in Europe with cancer? They have to spend their life savings and sell their house for a trip to a US hospital to get treated?
As a doctor, why bother spending your time learning about exotic foreign cancer treatments that aren't available in your country, and your patients couldn't afford if they were?
It would be nice if doctors did anyway, but I can certainly understand why they wouldn't.
I think the European health systems simply refuse to buy the relevant drugs at the prices being charged, and the producers refuse to reduce prices for them.
The US health system is criticized for being expensive, but some of that is from the US effectively bankrolling the development of these new treatments, which the rest of the world gets after some delay.
Exactly this. The hospitals will simply say that the treatments are too expensive and that they lack the funds, and you are on your own. In fact it's so bad that even basic chemotherapy is only covered to a certain point, and if you are not cured in that time, you have to pay additional runs of chemo from your own pocket, even though we have "national healthcare free for everyone who pays taxes".
What's the best way to get up to date info for specific cancers? A relative has one (bladder) but web search does not seem to suggest anything effective for his version apart from bladder removal.
> It was a death sentence 20 years ago. Now it’s indefinitely treatable for many people.
Wow. That's great to hear. 25 years ago I was in the midst of losing a close family member to multiple myeloma. I'm glad that the prognosis has improved so much since then.
Thank you! This makes me feel good. He is going for the stem cell viability test in January, at Vancouver General after some chemo so fingers crossed. He heard a story of a friend of a friend who has lived so far 7 years so it gave him hope, initial diagnoses was very scary.
I lost a close relative to MM about a year ago, but he lived an almost normal life with it for about 16 years. It seems like the recent advancements in car-t therapies are even more promising than some of the stem cell treatments, so there are lots of options out there and more are coming online rapidly. Sending good vibes to you and your dad.
Tangent to this, I've always wondered whether stimulant drugs like ADHD meds, also stimulate the metabolisms (incl. reproduction rate) of bacteria and/or parasites living in your body. (Dopamine and its receptors are really, really old, evolutionarily; at least some prokaryotes produce dopamine and have dopamine receptors. All eukaryotes definitely do — which includes all parasites.)
Presuming by "regular cells", you mean non-gamete diploid cells in a multicellular organism, I don't think so.
Outside of the CNS (which does its own special things with dopamine), dopaminergic compounds generally just increase cellular metabolic rate — which basically translates to any given cell (that has a dopamine receptor) doing "its job" faster: consuming resources and producing waste faster, and thereby doing more of whatever chemistry those resources are consumed to drive. (If you think of a cell as a control system seeking equilibrium, dopaminergic-receptor activation forces the cell to take in, through endocytosis, more input chemicals to some of its key internal reactions than it's "ready" for, throwing it out of equilibrium — so it then tries to quickly react those chemicals away to get back to equilibrium.)
IIRC, independent of CNS signalling, liver cells exposed to dopaminergic compounds produce more bile per second; muscle cells gain more contractile tone (which is why digestive peristalsis speeds up, and also why you might start stressing your jaw muscles); and a number of other things.
Replication (i.e. cellular division) isn't the inherent "job" of any single cell within a multicellular organism. Cells do divide, but they don't inherently divide — they do it in response to specific chemical messengers from the greater organism letting them know that it is in need of more of that kind of cell within the tissue that cell is located in. (Cells not waiting for these signals to divide, is in part what cancer is!) So I wouldn't think that there's any (diploid) cell in a multicellular organism that reproduces more when prodded with stimulants. Haploid cells (gametes), maybe — but even those only divide on command, IIRC.
Bacteria, on the other hand, aren't just cells, they're single-celled organisms — where they use their metabolism not to passively obey orders "from on high", but to actively attempt to grow and distribute their genetic material. So it would be intuitive to me if making them metabolize faster, made them do organism-level things like reproduction faster. But I don't know for sure.
I do know, though, that most parasites, e.g. tapeworms, are complex enough that they respond to dopamine pretty much exactly the same way humans do: dopamine triggers CNS signalling within them, which increases their level of behavioral arousal, which in turn motivates them to use more of their organism-level resource stores over the short term in seeking to eat, seeking to reproduce, and in doing anything else they care about doing.
Anecdote: something exactly like this seems to have been true for me until recently — but with sugar.
I recently had a very strong course of antibiotics for a resistant infection. Completely destroyed my gut flora. Had two weeks of terrible, Chron's-like digestive issues afterward, before things settled down. Whatever grew back is very likely brand-new colonization, not regrowth.
Before I got sick, if I didn't have at least a certain amount of sugar per day, I'd start to feel inflamed all over my body—especially in my face and my joints. I drank a lot of soda throughout the day; ate chocolate to "feel better" each night before bed; etc. Any time I was travelling away from access to these foods, and so eating "better", I felt worse.
After getting sick + taking the antibiotics + re-seeding my gut, the "demand" my body had for sugar seems to have completely evaporated. Coke/Pepsi, which just tasted "good" to me before, now tastes horribly saccharine-sweet, to the point that I can barely stand it. Less-sweet stuff still tastes fine — sugar isn't inherently gross to me now, it's just suddenly gross in large amounts. And so I find myself consuming a lot less sugar now, to seemingly absolutely no ill effect.
thanks for posting that! i had a wild ride after a course of antibiotics as a kid too, and it definitely showed me the level of agency you can truly have when half of your cellular structures are 'foreign bodies' :)
> re-seeding my gut
hope to see more research around this: metabolic pathways are getting well understood, and we may find some more interesting interactions/shortcuts we can offload to bacteria already present in our body
I suspect a lot of people would benefit from "nuke it all and start over" treatments.
Get a bunch of kimchi, leafy fibrous veggies, etc, in for the new seeding. Natto, soy sauce. Basically re-make yourself in to a Japanese or Korean person, diet wise. You may end up much thinner and healthier as a result.
As much as the article frames carcinogenesis as an active process, couldn't there also be a whole class of immunotoxins - the exposed of which could disrupt the body's ability to identify and eliminate neoplasms?
Maybe this illustrates a gap in my physiology/immunology knowledge, but I thought that neoplasms were routinely identified and eliminated by the immune system. A disruption in this immune-system neoplasm detection homeostasis could make certain non-mutagenic chemicals effectively appear as carcinogens.
Not sure if you're in the US _and_ watch network TV (by accident, here) but there is endless advertising for immuno-suppressant drugs for plaque psoriasis, during which they say these drugs can increase the chance for cancers.
I'm in the US, but I don't have a television. That's an interesting point.
I considered, but left out Cyclosporine, Tacrolimus, Mycophenolate Mofetil, and
glucocorticoids as examples of medications that potentially increase cancer risk due to immunological effects. I was thinking more along the lines of chemicals with unknown immunotoxic effects ex: environmental exposure, but medications are still a good category to identify.
It's entirely possible that our work to make gasoline vehicle emissions "cleaner" cause this as a side effect. The particulate sizes are so tiny now and we don't know what it does. This may be why the massive drop in cigarette smoking doesn't seem very well correlated with lung cancer rates.
Can you explain why so many people get lung cancer when they're non-smokers? We've even massively reduced the risk of radon exposure to these people. They don't inhale asbestos. What is causing it?
> In the United States, about 10% to 20% of lung cancers, or 20,000 to 40,000 lung cancers each year, happen in people who never smoked or smoked fewer than 100 cigarettes in their lifetime
There is a huge and very strong correlation between less smoking and lower lung cancer rates. You claimed otherwise, that's what I was referring to. Of course some people still get it without smoking.
Here's the point I'm trying to articulate: we used to blame nearly all the non-smoker lung cancer incidents on 2nd hand smoke. Smoking was everywhere. It was terrible. I hated it so much.
Now smoking has dropped significantly and smoking indoors and in many public spaces is banned. But the non-smoker lung cancer rates don't appear to be dropping accordingly.
Did we replace the 2nd hand smoke with some other cancer causing particulates? Or were we wrong about 2nd hand smoke and there was something else in our environment the whole time?
It could be replacement of some sort - car usage has gone up continuously, and we inhale a lot of exhaust in cities. Maybe it was exhaust the whole time?
I’d also be interested to see the data you’re referencing on lung cancer rates in non-smokers.
Or perhaps our understanding of cancer as a genetic disease is fundamentally flawed. There ARE mutations that ARE associated with certain cancers, but that might be the wrong level of biology to look at for a more fundamental understanding of what it is and how it works: https://pubmed.ncbi.nlm.nih.gov/33961843/
48 comments
[ 3.2 ms ] story [ 117 ms ] thread[0] https://en.wikipedia.org/wiki/The_Emperor_of_All_Maladies
https://www.pbs.org/show/story-cancer-emperor-all-maladies/
https://www.propublica.org/article/how-we-created-the-most-d...
There are hundreds of thousands of trucks in the USA alone with emissions bypass chips or devices that are rolling carcinogen generators on all the roads.
Leaded fuels is still sprayed everywhere for decades by propeller aircraft, across entire neighborhoods near airports in the USA
Fracking with toxic chemicals is done in or near populations.
Socializing the cost of cancer while privatizing profit is all what the USA is about.
Can't say "we didn't know" anymore. We know, we just don't care as long as it's not themselves.
https://en.m.wikipedia.org/wiki/List_of_countries_by_cancer_...
Here is a more informative source:
https://www.wcrf.org/cancer-trends/global-cancer-data-by-cou...
The highest cancer rate for men and women combined was in Denmark at 334.9 people per 100,000.
The age-standardised rate was at least 300 per 100,000 for 10 countries: Denmark, Ireland, Belgium, Hungary, France, The Netherlands, Australia, Norway, France (New Caledonia) and Slovenia.
We always joked he was going to get something from the chemicals, not so funny now that it hit.
A close family member was diagnosed 5 years ago and went through a stem cell transplant at Dana farber and the cancer still hasn’t returned…although statistically by now I believe it should have. But when it does return there is now a massive menu of next treatments for her that will likely hold it at bay.
Things are changing so fast now that I’m not sure the stem cell treatment is the first step.
Good luck to your dad.
It would be nice if doctors did anyway, but I can certainly understand why they wouldn't.
The US health system is criticized for being expensive, but some of that is from the US effectively bankrolling the development of these new treatments, which the rest of the world gets after some delay.
Edit: Bacillus Calmette-Guérin (BCG)
Wow. That's great to hear. 25 years ago I was in the midst of losing a close family member to multiple myeloma. I'm glad that the prognosis has improved so much since then.
Outside of the CNS (which does its own special things with dopamine), dopaminergic compounds generally just increase cellular metabolic rate — which basically translates to any given cell (that has a dopamine receptor) doing "its job" faster: consuming resources and producing waste faster, and thereby doing more of whatever chemistry those resources are consumed to drive. (If you think of a cell as a control system seeking equilibrium, dopaminergic-receptor activation forces the cell to take in, through endocytosis, more input chemicals to some of its key internal reactions than it's "ready" for, throwing it out of equilibrium — so it then tries to quickly react those chemicals away to get back to equilibrium.)
IIRC, independent of CNS signalling, liver cells exposed to dopaminergic compounds produce more bile per second; muscle cells gain more contractile tone (which is why digestive peristalsis speeds up, and also why you might start stressing your jaw muscles); and a number of other things.
Replication (i.e. cellular division) isn't the inherent "job" of any single cell within a multicellular organism. Cells do divide, but they don't inherently divide — they do it in response to specific chemical messengers from the greater organism letting them know that it is in need of more of that kind of cell within the tissue that cell is located in. (Cells not waiting for these signals to divide, is in part what cancer is!) So I wouldn't think that there's any (diploid) cell in a multicellular organism that reproduces more when prodded with stimulants. Haploid cells (gametes), maybe — but even those only divide on command, IIRC.
Bacteria, on the other hand, aren't just cells, they're single-celled organisms — where they use their metabolism not to passively obey orders "from on high", but to actively attempt to grow and distribute their genetic material. So it would be intuitive to me if making them metabolize faster, made them do organism-level things like reproduction faster. But I don't know for sure.
I do know, though, that most parasites, e.g. tapeworms, are complex enough that they respond to dopamine pretty much exactly the same way humans do: dopamine triggers CNS signalling within them, which increases their level of behavioral arousal, which in turn motivates them to use more of their organism-level resource stores over the short term in seeking to eat, seeking to reproduce, and in doing anything else they care about doing.
I recently had a very strong course of antibiotics for a resistant infection. Completely destroyed my gut flora. Had two weeks of terrible, Chron's-like digestive issues afterward, before things settled down. Whatever grew back is very likely brand-new colonization, not regrowth.
Before I got sick, if I didn't have at least a certain amount of sugar per day, I'd start to feel inflamed all over my body—especially in my face and my joints. I drank a lot of soda throughout the day; ate chocolate to "feel better" each night before bed; etc. Any time I was travelling away from access to these foods, and so eating "better", I felt worse.
After getting sick + taking the antibiotics + re-seeding my gut, the "demand" my body had for sugar seems to have completely evaporated. Coke/Pepsi, which just tasted "good" to me before, now tastes horribly saccharine-sweet, to the point that I can barely stand it. Less-sweet stuff still tastes fine — sugar isn't inherently gross to me now, it's just suddenly gross in large amounts. And so I find myself consuming a lot less sugar now, to seemingly absolutely no ill effect.
> re-seeding my gut
hope to see more research around this: metabolic pathways are getting well understood, and we may find some more interesting interactions/shortcuts we can offload to bacteria already present in our body
Get a bunch of kimchi, leafy fibrous veggies, etc, in for the new seeding. Natto, soy sauce. Basically re-make yourself in to a Japanese or Korean person, diet wise. You may end up much thinner and healthier as a result.
Maybe this illustrates a gap in my physiology/immunology knowledge, but I thought that neoplasms were routinely identified and eliminated by the immune system. A disruption in this immune-system neoplasm detection homeostasis could make certain non-mutagenic chemicals effectively appear as carcinogens.
I think that's an example of what you asked.
I considered, but left out Cyclosporine, Tacrolimus, Mycophenolate Mofetil, and glucocorticoids as examples of medications that potentially increase cancer risk due to immunological effects. I was thinking more along the lines of chemicals with unknown immunotoxic effects ex: environmental exposure, but medications are still a good category to identify.
https://www.nature.com/articles/s41598-017-03714-9
> In the United States, about 10% to 20% of lung cancers, or 20,000 to 40,000 lung cancers each year, happen in people who never smoked or smoked fewer than 100 cigarettes in their lifetime
Straight from the CDC.
Now smoking has dropped significantly and smoking indoors and in many public spaces is banned. But the non-smoker lung cancer rates don't appear to be dropping accordingly.
Did we replace the 2nd hand smoke with some other cancer causing particulates? Or were we wrong about 2nd hand smoke and there was something else in our environment the whole time?
It could be replacement of some sort - car usage has gone up continuously, and we inhale a lot of exhaust in cities. Maybe it was exhaust the whole time?
I’d also be interested to see the data you’re referencing on lung cancer rates in non-smokers.
https://archive.is/U8GJt