Cancer and Health 101

Cancer is a very common entity in today's society, unfortunately.  I'd say that on average at least 3-4 people out of 10 knows someone or has someone close to them affected by this horrible disease.  We see it on the news, hear about research that may be going on as well as advances and see fund raisers almost every weekend.  The question, at least in my mind, is "are we getting closer to a cure"?

As a veterinarian and someone that works closely with the general public, we have close contact with cancer patients of all types, stages and species.  That someone may be a client or the patient themself.  The disease intrigues me on many levels and my honest opinion to the above question is that we are no closer to finding that cure now than we were 20 years ago.  The therapies discussed at our veterinary conventions are nothing new, with the exception of possible changes in chemotherapy combinations or the use of newer radiation type therapies.  In the end, we have to ask ourselves if we are saving lives, improving lives or just making things worse?  The last report that I saw regarding human cancers was that the overall 5 year survival rate has barely budged.  This is frustrating to me as a veterinarian, researcher and cancer patient myself, considering the large amount of money that is raised and put into research on a yearly basis.  Why are we not closer now than 10 or 20 years ago?

Cancer is complicated topic and when I am asked by clients whether if I think we will ever find that 'cure', my answer is always a resounding "NO".  This is not due to politics or greed in the pharmaceutical venues, but more so because cancer is very complex in its pathology.  Research focuses and discovers certain methods of attacking cancer cells, but their approach is usually through a single pathway and to me there is no single pathway that is going to eliminate the disease.  I am not trying to be depressing in my views, but more realistic and feel that we need to see the big picture if we are going to produce results.

The act of carcinogenesis (birth of cancer) is based essentially on 2 or 3 stages, dependent on what you read.  The first stage is "Initiation" and involves the exposure of the cells to a certain initiator such as a chemical, toxin, radiation or even a virus.  This initiator then inflicts irreversible genetic changes to the affected cell resulting in a permanent mutation, which will be passed onto future daughter cells should that mutated cell replicate.  The initiators affect the cells generally at a DNA level, affecting protooncogenes or tumor suppressor genes, which may then impact certain growth factors, receptors, enzymes, or transcription factors that influence cellular growth and replication.  The second stage is "Promotion", which can be viewed as either a stage by itself or stage 1 and 2 as some promoters can be initiators themselves. In the promotion stage, various promoters affect the mutated cells at either a cellular receptor level or through gene expression, causing the cell to essentially begin to replicate uncontrollably.  The final stage "Progression" is the stage at which a benign tumor transforms to a malignant tumor, which then demonstrates an increased growth rate, invasiveness and metastasis.

Now, many people have either had an animal affected by cancer or have known an individual with cancer, but few have seen cancer itself as a tumor.  Let's look at a case in a dog, to demonstrate how cancer can appear and progress.  In order to know abnormal, one has to know normal.

To the right is an image of a dog's chest or thorax in a lateral view, meaning with them lying on their side.  This is not the most ideal image in terms of totally healthy anatomy, but will work for the purposes of demonstration.  I don't have this image marked for anatomy, but hopefully we can all see the heart and the black areas around the heart are the lungs.  Air shows up as black in an x-ray and anything showing up as white is essentially something that is denser than air.  Take a good look at this image, then compare to the next one to see the differences.

To the left, we have a chest radiograph of a canine patient with metastatic cancer.  In this image, I do have some markers showing the trachea and the heart, but also have red arrows which indicate the metastatic lung tumors that have developed.  When you compare the two radiographs, one can easily see that there is something in the lungs that is showing up as white, nodular type of lesions.  It essentially is not as black was what the normal radiograph demonstrates.  Something is 'added' to the lungs and in this case it is likely small nodular growths.


Cancer is an interesting subject to me because of its complexity.  I am certainly not an oncologist and do not claim to be one, but I do have a different approach to cancer in myself and my patients.  I tend to look at things in a more simplified manner and understand that there is a higher complexity to the disease than what I describe here. All too often chemotherapy and radiation therapy are utilized to battle cancer.  One has to look at what the purpose of these two methods is and overall, the intent is to destroy or kill the cancer cells. Often times, these modes of therapy do more harm than good, affecting normal cells as well as cancer cells, depleting the patient of vital energy and impacting the immune response negatively.  Analyzing this theory, we have to go back to the 3 stages of cancer development.

It has been said that in the average human or animal body, thousands of cells become 'cancerous' on a daily basis.  The question comes as to why some people develop cancer and others do not.  One of our most important defense mechanisms behind cancer development is our immune system.  It is the job of the immune system to recognize mutated or abnormal cells and remove them from circulation.  Knowing this, we have to re-look at the first stage of cancer development.  If we are exposed to an initiator and there is cellular damage or mutation and cancer development, one has to raise two questions.  First, why did the immune system not remove these cells from circulation and second, how is chemotherapy or radiation going to alter this stage?  This is the bottom line stage and we have to look at this stage as the source of potential therapies, at least in my eyes.  Of course, it is not the only stage, but one that I feel is important to prevention as well as managing the disease.

More to follow in the coming week....

All our best,

Tom Schell, D.V.M.
www.curost.com