Both my parents died of cancer (mom-cancer of the uterus, dad-lung cancer). My father-in-law also died of cancer (metastasized to many parts of his body) a couple of months ago. My mother-in-law had cancer when she died although it wasn’t listed as cause of death. One of the Thai aunties that took care of my wife when she was a kid died particularly painfully from cancer. The list could go on and on. When I heard that yet another one of our acquaintances discovered that they had cancer I decided to spend some time learning more about the disease.
One of the sources of information I looked at was the Ken Burns series The Emperor of All Maladies (based on the book by Siddhartha Mukherjee). It was a history of attempts to find a solution to cancer. That history is a series of episodes of hope followed by ultimate disappointment. It ends with the another hope that immunotherapy will end up being the answer but that we are not there yet.
In doing some online searching it seems that many of the folks that I listen to on other health topics point to a book called The Metabolic Theory of Cancer by Thomas Seyfried M.D. Unfortunately, this book is quite expensive, over $100. I may yet read it, though – I recently got a library card from my local library and I will see if I can borrow it from there.
In the meantime, another book frequently mentioned alongside the Seyfried book was Tripping over the Truth. That one wasn’t nearly as expensive so I started with that one.
Like The Emperor of All Maladies, Tripping over the Truth contains a history of the fight against cancer. However, it doesn’t end with the view that immunotherapy is the most cutting edge way to combat the disease.
Part one details how cancer became known as a genetic disease.
The story starts in the 1700’s where a London surgeon named Pott noticed a sharp rise in painful scrotal warts among young boys indentured as chimney sweeps. He had a theory that soot was causing what ended up being cancer. This was the beginning of realizing that an external agent could cause cancer.
Moving forward to the 1800’s, the ability to view cells under a microscope led a german doctor named Hansemann to notice a key difference between the chromosomes of cancer cells and those of normal cells – rather than symmetrical they were in complete chaos. The linking of Pott’s idea that external agents could cause cancer and Hansemann’s observation of chromosome damage became known as the “somatic mutation theory” (SMT).
In the 1900’s, a doctor, Peyton Rous, went to work on a ranch in order to recover from a surgical accident and started experimenting on tumors in hens. He found that he could induce cancer in healthy hens by transplanting cells (eventually isolated down to a virus) from the cancerous tumor of a sick hen. This led to the question of how both external agents and viruses could both be causes of cancer.
Meanwhile, in Germany, Otto Warburg – an accomplished scientist – switched his interest from biochemistry to medicine. His ambition was to figure out how to cure cancer. He noticed that , although cancer cells and normal cells generated the same amount of energy, the way they generated energy differed from healthy cells. Cancer cells were generating energy anaerobically through fermentation of glucose rather than aerobically as normal cells did. He also made other observations including the observation that when normal, healthy cells were deprived of oxygen for a period of time they turned cancerous. In 1931, Warburg received the Nobel prize for his work on cellular energy. He believed until his death that this was the cause of cancer. However, the scientific establishment fixated on SMT and Warburg’s theory was discounted and marginalized. With the discovery of DNA in the 1950’s and the rise of genetics, the idea that DNA alteration was central to cancer became the widely accepted theory.
In the 1960’s, a molecular biologist, Harold Varmus, took a class on the exploding field of tumor viruses which gave him the idea that cancer-causing viruses might hold the answer to the problem of cancer. Looking for a lab to work in, he joined with Michael Bishop. Bishop’s lab was already working with a virus known to cause cancer. They had two hypotheses: 1) we all carry genes that could be activated by carcinogens to produce cancer and 2) genes were inserted into us by viral infections to produce cancer. To test this, they isolated the single gene in the virus known to induce cancer and found that gene was present in every bird they tested and other animal species as well. When they repeated the experiment with the complement virus (all genes that weren’t the cancer causing one) they didn’t find that one in any other species. They had shown that the cancer-causing portion of the virus was a distortion of DNA present in all species. This cemented the primacy of SMT in the scientific community. No one disputed it.