The Cancer Enigma: “If There’s No Magic Bullet, is Prevention the Cure?”

Joseph R. Anticaglia MD
Medical Advisory Board

Nobel Prize laureate Paul Ehrlich coined the term “magic bullet” in 1900, meaning a way to kill (bullet) a specific target (magic). He thought it might be possible to target and kill bacteria with a single agent without hurting the body itself.

His hypothesis became a reality nine years later when the drug Salvarsan became the first effective treatment for syphilis. This led to the development of antibiotics and the mindset among researchers for many years that a particular drug could pinpoint and kill a specific disease.

Scientists thought that the magic bullet concept, which was successfully used by doctors to kill the microbes of infectious diseases, could also be used to wipe out cancer. They spent many years and governments billions of dollars trying to find “the” magic bullet to overpower and defeat cancer.

Although there have been advances in immunology and target therapy and doctors have been successful in treating certain tumors, cancer remains the second leading cause of death in the United States. At present, there’s no magic bullet to prevent or cure the majority of cancers.

Raymond Chang MD in his book, The Anti-Cancer Cocktail, talks about the idea of combining drugs and alternative therapies (cocktails) to treat patients with cancer. This concept is not new or unique.

Dr. Chang argues for the need of different combinations of drugs (not necessarily new ones) to treat cancer because of its complex biology and the unsatisfactory results of conventional treatments. The successful “cocktail” approach to manage the HIV in the 1990’s was a wakeup call on how to treat this disease.

The Challenge Posed by Cancer

Many factors influence how cancer gets started in the body. It can crop up in any organ and damage cells. Oncologists write and talk about the initiation, promotion and progression of cancer to malignancy, three stages of cancer development.

Initiation

The formation of cancer and how it behaves depends on factors within and outside the body. Most cancers happen by chance-mutations (alterations) within the body. On the other hand, many factors outside the body are known to be instigators of cancer. For instance, excessive exposure to ultraviolet radiation from sunlight is associated with melanoma and asbestosis exposure with mesothelioma, a form of cancer often found in the lungs.

People with a family history of cancer are more likely to develop certain types of cancer (breast, ovarian, colorectal cancers). Many of these individuals have benefited from genetic counseling and DNA testing.

A 42 year old Chinese engineer complained of spitting up bright red blood. Examination of the nasopharynx, the area behind the nose, demonstrated a growth most likely to be a tumor. The biopsy performed in that area tested positive for cancer. Ethnicity plays a role in cancer. The Chinese have an increase incidence of nosopharyngeal cancer.

Infections can be initiators of cancer. Viruses such as hepatitis B and C can cause liver cancer and HPV (human papillomavirus) can lead to cervical cancer. H. pylori, a bacterium, is associated with stomach cancer. Even certain parasites have been implicated as causing bile duct and gall bladder cancer.

Inflammatory diseases can increase your risk of cancer. For instance, Crohn disease and Ulcerative colitis are associated with intestinal cancer. Excessive radiation exposure, because of medical reasons or by accident, increases the likelihood of cancer.

Hormonal imbalances predispose to prostate or breast cancer. We’re familiar with lifestyle choices such as smoking and obesity and how they contribute to cancer. Also, exposure to toxic chemicals, pesticides in the work environment has been linked to cancer.

A study reported an increase risk in common cancers in night shift women workers. Breast, skin and intestinal cancers were found to have a higher incidence in these workers.

Promoters

Once a cell has been altered by an initiator, promoters cause rapid cell growth. Estrogen is a hormone that promotes the proliferation of mutated cells and the development of tumors. Consistent contacts with other initiators promote malignancy.

Progression

Progression describes the stepwise transformation of benign tumors to malignant ones. Some cancers make the transformation to malignancy in a matter of months. Other cancers are slow growing tumors taking years to become deadly.

Cancer’s deadliness is more than abnormal cells gone wild with uncontrolled cell division. Its lethal DNA and genes have the capacity to set in motion the invasion of tissues and to spread to distant parts of the body. It has the ability to resist treatment, a tendency to mutate and to recur. Most of the time, it has outfoxed scientists by turning on the cancer cell proliferation genes and turning off the cancer suppressing genes.

Yes, cancer is a complex problem with no simple answers. Dr. S. Mukherjee in his book, The Emperor of All Maladies, also writes that many oncologists have shifted away from the notion of a magic bullet for the treatment of cancer. He states that, up till now, prevention is the cure for the majority of cancers.

People can play crucial roles in the battle against cancer. Consider that lung cancer kills more people in America than any other type of cancer. In the United States, every year, 200,000 people are diagnosed with lung cancer and 150,000 die of lung cancer in the same year. And 80% per cent of lung cancers are due to smoking. It’s obvious to quit smoking, better yet, never start smoking to avoid becoming a death certificate!

Besides lung cancer, individuals can prevent other cancer initiators from entering and ravaging the body. It’s a win-win situation for individuals and society.

References

  1. Yuan, X et al’ Night Shift Work Increases the Risks of Multiple Primary Cancers in Women; Cancer Epidemiol Biomarkers Prev. Jan 27, 2018
  2. CDC; Lung Cancer Is the Biggest Cancer Killer in Both Men and Women; July 19, 2018
  3. Raymond Chang; The Anti-Cancer Cocktail’ 2012
  4. Siddhartha Mukherjee, The Emperor of all Maladies; 2010

This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.