Missing the Soil for the Seeds in Cancer Research – By Claudia Fischbach | September 18, 2015

While we generally consider soil as the dirt on which we walk and that we use to grow our plants, it also serves as a useful analogy for cancer. One of the most dreaded maladies of our time is like a seed, and it can only take root if we provide the right kind of tissue in which it can nest. And that’s exactly what’s problematic with most cancer research and almost all anti-cancer therapies, including chemotherapy and radiation. They emphasize the seeds and disregard the soil.


Although largely ignored for more than a century, the “seed and soil hypothesis” of cancer is not new. It was contrived in 1889 by the English surgeon Stephen Paget, who found that the spreading of tumors to other places in the body, a process called “metastasis,” does not occur randomly.

Instead he suggested that tumor cells, which have dislodged from their initial mass, only grow in a distant organ if that organ offers the right soil. Owing to the revived interest in the seed and soil hypothesis over the past few decades, we now know that the same is true for tumor initiation. Young and healthy microenvironments can prevent cancer. Damaged soil, on the other hand, can facilitate tumor development by cells that would not form a tumor otherwise.

An exclusive focus on cancer cells is an incomplete analysis, as not everyone carrying faulty genes will acquire cancer. For example, a large fraction of women carrying a mutation in the BRCA gene similar to the one Angelina Jolie has will not develop breast cancer. On the other hand, women without obvious genetic abnormalities may still get the disease as only 5-8 percent of all breast cancer cases seem to be linked by genetic mutations.

The underlying conditions—the soil—significantly contributes to these clinical outcomes and receives little scrutiny.

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Do Doctors Overscreen for Cancer? – By Quora Contributor May 2015

A U.S. government committee recommended new mammogram screening guidelines due to overtreatment concerns. Photo by CristinaMuraca/Shutterstock

A U.S. government committee recommended new mammogram screening guidelines due to overtreatment concerns.
Photo by CristinaMuraca/Shutterstock

This question originally appeared on Quora, the best answer to any question. Ask a question, get a great answer. Learn from experts and access insider knowledge. You can follow Quora on TwitterFacebook, and Google Plus.

Answer by David Chan, M.D. from UCLA, Stanford oncology fellowship:

The issues surrounding early diagnosis of cancer are very complicated. The short response is that it depends on which patient and cancer.

The long version is that there are many cancers being diagnosed, including low-grade prostate cancers in older men and preinvasive breast cancers in older women, that don’t need to be diagnosed and don’t need to be treated. These low-grade cancers have a natural history way beyond average life expectancy, so the large majority of these patients will die of other causes before they have symptoms from their cancers.

This kind of analysis led to the controversial guidelines from U.S. Preventive Services Task Force, the national screening task force, to eliminate PSA blood test screening in the large majority of men for prostate cancer and also to increase the time between mammograms in women to every two years and to stop mammogram screening altogether after the age of 75.

So what we have are two tests (PSA and mammograms) that have been demonstrated to diagnose cancer early, yet a U.S. government committee has recommended reducing their use, dramatically in the case of PSA, because of concerns with overtreatment, costs, and toxicity and morbidity resulting from overtreatments.

The very big problem with these guidelines is that they completely discount those aggressive cancers that are going to be diagnosed too late. Guidelines like those from the task force are population recommendations, but we all know younger men who die of prostate cancer and similarly women of all ages who die from breast cancer. Many cancer specialists and patients would prefer to know about the aggressive cancers and to make educated, informed decisions on not treating the low-grade cancers.

Within the next couple of years, there will be a large number of molecular blood tests that will develop cancer DNA or RNA. These tests are often referred to as liquid biopsies. The tests will be very accurate in finding all sorts of cancer early. Both that’s going to lead to a very major problem.

Liquid biopsy technology will often find a cancer way before, maybe many years before, it’s detectable by endoscopy, MRI, or CT scan. This will lead to a huge freakout factor for patients and their doctors who find abnormal liquid biopsy tests and multiple normal scans. Although it’s certainly possible that the liquid biopsy tests will be so accurate that they can also predict whether the cancer is aggressive or low-grade.

An additional issue is that MRI and CT or PET scans are computer-generated images with low sensitivity. The software isn’t able to detect small areas of abnormality, so the images appear normal when in fact small cancers are present. CT and PET have high levels of radiation and can’t be used for routine testing except when cancer risk is high, such as lung cancer screening in older smokers.

This answer is for general informational purposes only and is not a substitute for professional medical advice. If you think you’re having a medical emergency, call 911 (in the United States) immediately. Always seek the advice of your doctor before starting or changing treatment. Quora users who provide responses to health-related questions are intended third-party beneficiaries with certain rights under Quora’s Terms of Service.

This scientist thinks cancer can be prevented— and even cured — through diet

“Diet can be used to prevent and reverse cancer just like it prevents and reverses heart disease,” he said. “A diet high in animal protein increases the amount of carcinogens going to the cells. It increases the enzyme MFO (mixed function oxidase) that causes increased carcinogenic activity.”

T. Colin Campbell (Gage Skidmore)

But in the end, T. Colin Campbell is a consummate researcher. When his findings belied one of his own foundational beliefs about nutrition, Campbell found himself standing alone at a crossroads: continue a respected and tenured academic career at a prestigious school or go public and advocate for scientific findings that counter established tenets of nutrition, contradict government dietary guidelines, are misunderstood by the medical establishment and belie the marketing claims of major food corporations.

Campbell says he chose the truth. In response to a comment that he picked a fight with a billion-dollar industry, Campbell said, “No, it’s a trillion-dollar industry.”

The professor emeritus in nutritional biochemistry at Cornell University said research has proven that consumption of animal products, including meat, fish and dairy, triggers chronic diseases and impaired health and poses a greater risk than heredity or environment. He has linked casein, a protein in milk, with breast cancer. His lifelong professional focus has been cancer and nutrition, and Campbell says that our national and global fight with cancer has targeted the wrong enemy.

Though he is scholarly and genteel, Campbell is not reserved. He’s impatient and blunt. He dismisses the Atkins diet, Paleo diet, South Beach diet and high protein diet. He’s not a supporter of celebrity physicians who prescribe diets of wild salmon, expensive grass-fed beef and costly nutritional supplements. He comes down firmly on the side of health for everyone, not just the wealthy who can afford pharmaceutical supplements of questionable health benefit and expensive prescription medications for blood pressure, cholesterol and diabetes.

Campbell advocates disease prevention at the end of a fork. He was prominently featured in the award-winning documentary Forks Over Knives, and is the focus of a new documentary Plant Pure Nation, due out in early 2015 and produced by his son Nelson Campbell.

Colin Campbell discounts physicians as reliable sources of nutritional advice for their patients. Physicians, he said, received minimal to no nutritional education in medical school and have not generally conducted investigative laboratory research themselves.

Campbell, however, has spent more than five decades in laboratory research, much of it publicly funded. He’s adamant the public has a right to know his results.

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DNA project ‘to make UK world genetic research leader’   1 August 2014 Last updated at 02:04 ETBy James Gallagher Health editor, BBC News


Just one human genome contains more than three billion base pairs – the building blocks of DNA

A project aiming to revolutionise medicine by unlocking the secrets of DNA is under way in centres across England.

Prime Minister David Cameron has said it “will see the UK lead the world in genetic research within years”.

The first genetic codes of people with cancer or rare diseases, out of a target of 100,000, have been sequenced.

Experts believe it will lead to targeted therapies and could make chemotherapy “a thing of the past”.

Just one human genome contains more than three billion base pairs – the building blocks of DNA.

Unchecked growth

Breast tumour
Genetics is furthering the understanding of breast cancer

This four-year project which will look at 100,000 genomes is being run byGenomics England,.

Pilots have been set up at centres across England – including sites in Newcastle, Cambridge and London – and the first genome was sequenced on 30 May.

The project has now passed the 100 genome mark, with the aim of reaching 1,000 by the end of the year and 10,000 by the end of 2015.

The genome of a patient’s tumour will be scoured for differences with the genetic code of their healthy tissue.

People with rare diseases, usually children, will have their DNA compared with that of close relatives.

University scientists and a drug companies will be allowed to access the data for their research.

They argue that understanding DNA will soon play a role in every aspect of medicine from cancer to cardiology.

Cancer is one of the main areas the project will focus on.

Tumours are caused by mutations in DNA which lead to abnormal cells growing unchecked.

Previous genetics research has shown how different cancers can be – for example that breast cancer is not one disease but at least 10 – each with a different cause, life expectancy and needing a different treatment.

And the development of targeted drugs such as Herceptin, only given if a patient’s breast tumour has a certain mutation – has been possible because of genetics research.

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How Big Pharma Holds Back in the War on Cancer – 04.23.14 – Jake Bernstein, Propublica

The Daily Beast

Big Pharma’s focus on blockbuster cancer drugs squeezes out cheaper treatments. The result, one researcher says: ‘If we’re winning the war on cancer, we’re not winning that fast.’

Michael Retsky awoke from surgery to bad news. The tumor in his colon had spread to four of his lymph nodes and penetrated the bowel wall. When Retsky showed the pathology report to William Hrushesky, his treating oncologist, the doctor exclaimed, “Mamma mia.

“Michael had a mean looking cancer,” Hrushesky remembers.

Retsky didn’t need anyone to tell him his prognosis. Although trained as a physicist, he had switched careers to cancer research in the early 1980s and spent more than a decade modeling the growth of breast cancer tumors. During his treatment, he joined the staff of one of the most prestigious cancer research labs in the country.

In the absence of chemotherapy, there was an 80 percent chance of relapse. Even with therapy, there was a 50 percent chance the cancer would return. The standard treatment was brutal. Six months of the highest dose of chemotherapy his body could withstand and, after that, nothing but hope.

Like many cancer patients, Retsky didn’t much like the odds. Unlike most cancer patients, however, he had the knowledge to question them. His own research had sown doubts that standard chemotherapy, as used the world over to treat colon and some breast cancers, was always the best approach. In collaboration with Hrushesky, the two devised an inexpensive, low-impact chemo treatment following surgery that dripped smaller doses of the drug into his body over a longer period of time.

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In Hawaii, a healthcare system apart – By Noam N. Levey April 4, 2014, 11:34 p.m.

The state’s trailblazing system and widespread insurance coverage mean its residents are some of the nation’s healthiest. But that only underscores the disparities across the U.S.

Hawaii healthcare

Myra Williams, a breast cancer survivor, does yoga behind her home in Kailua, Hawaii. Her cancer was discovered during a routine mammogram. Such screenings are readily available in much of the state. (Christina House / For The Times /September 4, 2013)

HONOLULU — When the giant kapok and nawa trees that tower over the Queen’s Medical Center in downtown Honolulu were planted more than a century ago, Hawaii faced a health crisis.

Many on the islands, including the queen who founded the hospital in 1859, feared that native Hawaiians, devastated by smallpoxmeasles and other illnesses brought by foreigners, were in danger of dying off completely.

Today, the people who walk under these trees are some of the healthiest in America.

Hawaiians live longer than their counterparts on the mainland. They die less frequently from common diseases, such as breast and colon cancers, even though these cancers occur more often here than in most other states. They also pay less for their care; the state’s healthcare costs are among the lowest in the country.

Hawaii’s success owes much to the state’s trailblazing health system and its long history of near-universal health insurance.

Forty years ago, the state became the first to require employers to provide health benefits, codifying a tradition that grew out of Hawaii’s agrarian past, when sugar and pineapple plantations employed doctors to care for their workers.

That system has led to some of the highest rates of coverage and best access to medical care in the country.

“There has always been a mentality here that if you are sick, you go to the doctor. It’s just part of the culture,” said Myra Williams, 64, who has lived in Hawaii for 35 years and was recently treated successfully for early-stage breast cancer.

Nearly 99% of the patients at the cancer center at Queen’s have health coverage, a level unheard of at most urban medical centers on the mainland.

Healthcare in America is a tale of two countries.

Residents of the healthiest communities live as much as 14 years longer on average than those in unhealthy places. They are a third less likely to die from treatable illnesses such as breast cancer, childhood measles and diabetes, according to data from the Commonwealth Fund, a foundation dedicated to improving the healthcare system.

Big variations in poverty, education and diet may explain part of this divide. In Hawaii, the large share of residents of East Asian descent, who have lower mortality rates for many diseases, may also have an impact.

But differences in local health systems nationwide — including disparities in insurance coverage — also likely play an important role, according to an analysis of local and national healthcare data, a review of academic studies, interviews with scores of experts, and visits to communities across the country.

Nearly everyone is covered in the nation’s healthiest places, including Hawaii, Massachusetts and parts of the Upper Midwest. By contrast, fewer than 7 in 10 working-age adults have health insurance in parts of Texas, Florida and the Deep South — areas with some of the highest rates of death from preventable illnesses.

In Texas, which has the lowest rate of insurance coverage in the nation, residents are 40% more likely to die from breast cancer than they are in Hawaii, according to federal cancer data.

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Breast Cancer Impacts Sexual Health – By Madhulika Sikka MARCH 12 2014 11:45 PM

Illustration by Roberto de Vicq de Cumptich

Adapted from A Breast Cancer Alphabet by Madhulika Sikka, out now from Crown.

Cancerland is a place where, as the late Christopher Hitchens put it, “there seems to be almost no talk of sex.” In the case of breast cancer, he was right. Now I don’t want to get all cancer competitive on you, but the discussion of prostate cancer is often accompanied by concerns about its impact on a man’s sex life. With breast cancer, if there is any discussion of sex at all, it is likely to be if you are of childbearing age, and it is more likely to be about fertility than it is about sexuality. Your sex life doesn’t come up much.

If this is not an issue for you, I applaud you.

If this is an issue for you, let’s talk about it. When the complete embodiment of your womanhood—your breasts—becomes diseased, this is not an easy thing to deal with. In fact, sex is so far from your mind that you might be asking yourself, Why is she bringing this up at all? The National Cancer Institute reports, “About half of women who have long-term treatment for breast and reproductive organ cancers … report long-term sexual problems.” So if you are going through any sexual challenges during treatment, you are in good company. But every year, hundreds of thousands of women are treated for breast cancer and come out the other side. While sex may be on hiatus during treatment, it doesn’t have to stop forever.

Lots of things can affect your sex drive when you are diagnosed with breast cancer. First, you’ve been diagnosed with breast cancer! There is nothing that can prepare you for the number that does on you mentally. This is news that you need time to cope with, and really, all your attention can be focused on that for as long as you need.

Second, if you have breast surgery, you hurt. You hurt physically because some or all of your breast or breasts have been removed. That is a whole lot of hurt, not to mention bandages and drains and general yuckiness.  I’ve tried to think of any way to interpret this immediate post-surgical period as sexy, but I really can’t. Please let me know if I am wrong. You hurt emotionally too. Not only are you in mourning for the previously healthy you, but you are in mourning for a part of your body that may have helped define your sexiness, appeal, attractiveness. It is really hard to get aroused when you are in that kind of state.

Third, you might have to undergo chemotherapy and/or radiation. How do I begin to describe the unsexiness of that? Your body is being pumped with toxic chemicals and countless other drugs to counter the effects of the toxic chemicals. Here are some of the side effects that were possible from the particular chemo that I was taking:

Nothing sexy about any of that list!

So you go through the weeks and months of surgery and recovery, followed by chemotherapy and recovery, maybe followed by radiation and recovery. During that time you will want to be loved and hugged and calmed and comforted, and maybe you will want to have sex. But maybe you won’t. This is where understanding comes in on the part of your partner. Your partner may not feel that you are deformed or unsexy or un-attractive. In fact your partner may be working hard to convince you of the exact opposite, that you are as beautiful and lovely as you were when love first struck, that a surgery like this, and the resultant nine-inch scar across your chest, and your baldness and your bloating, changes none of that. Your partner means it. You just might not be in a condition to hear any of it.

A Breast Cancer Alphabet.

Flowers. A romantic dinner. Sexy lingerie. These are just a few of the tropes that we’ve been convinced will put us on the path to wonderful sex. There is something horribly transactional about this idea, though of course in some cases they might work, though perhaps not in the way a certain ad for a men’s drug posits it: you and your partner sitting in separate bathtubs overlooking the ocean!

When dealing with breast cancer, eating a romantic dinner while wearing sexy lingerie surrounded by flowers may not be particularly effective. So often the reality of living with breast cancer—or any cancer—is not even a topic of conversation. My fellow cancer traveler Suleika Jaouad, diagnosed with cancer at age 22, has eloquently talked aboutthe impact of cancer on a young person’s sex life, and much of this is applicable to anyone of any age going through cancer. You NEED TO TALK ABOUT IT. Yeah, I’m aware that is another cliché—women like to talk, men not so much. Talk to your partner, talk to your doctors, talk to fellow cancer patients. Fixing your sex life is just as legitimate as any medical conversation you are going to have.

One of my doctors did bring it up with me actually.

DOCTOR: How is your sex life?

ME: Um, nonexistent.

DOCTOR: I know it’s hard but …

ME: It’s really hard, I feel like crap.

DOCTOR: I know, but it’s like a muscle, you have to keep using it!

There you have it, the view from a medical professional. So while not many people talk about it, a lot of the cancer literature will deal with the question of intimacy. It’s important enough that the National Cancer Institute lists intimacy as one of the parts of your life that can be severely affected by a diagnosis of cancer. And that is the first step, recognizing that your sex life, sort of like your taste buds and your energy level and your hair, is affected by your treatment. Like all of those things, it comes back. It just comes back on its own timetable. And I speak from experience.

Adapted from A Breast Cancer Alphabet. Copyright © 2014 by Madhulika Sikka. Published by Crown Publishers, an imprint of the Crown Publishing Group, a division of Penguin Random House, Inc. Reprinted with permission.

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