Every now and then, someone gets lung cancer who never took a single puff on a cigarette. Why? To understand the answer, consider poker. You can study dozens of books on how to play to win, practice for 10,000 hours, pay hundreds of dollars to learn all the secrets from the professional players. But none of this will help you if the dealer gives you junk cards. To look at this another way, there are some people who start chain smoking at twelve and live to be 90 with no trace of cancer (perhaps breathing through a tube in their throat, but no cancer). That’s like a rookie at the poker table being dealt a straight flush. Long story short: cancer is not always the patient’s fault, and a lack of cancer is not always indicative of a healthy lifestyle.
Researchers have found plenty of environmental agents that can mutate DNA. For example, exposure to UV radiation is one of the more notorious risk factors for skin cancer. But there are a few people who worship the sun and never get skin cancer. In addition, most children have not had extensive exposure to environmental carcinogens, yet, tragically, they can still get cancer. In 2014, it was estimated that 15,780 children and adolescents ages 0 to 19 years would be diagnosed with cancer and nearly 2,000 would not survive. Facts such as these support the notion that cancer is largely due to bad genes, not necessarily the environment.
Scientists at Johns Hopkins recently set out to tackle the question by constructing mathematical models of the disease. Their findings might take you by surprise: in the majority of cases, the reason why a cell starts running all the red lights is due to a random mutation that occurs during cell division. In other words, lifestyle choices and even your genetic makeup play a lesser role in your chances in getting cancer. Let that sink in for a moment: RANDOM mutation - not mutation caused by UV light, engine exhaust, or some other carcinogen. Since the mutation appears to be a random mistake made by cell division enzymes, the authors dubbed this "bad luck".
This new study reminds us that every cell division contains an inherent risk that the daughter cell acquires a mutation that makes it divide like gangbusters. This doesn’t mean you should grab a carton of Marlboros to smoke as you suntan on the beach while devouring a couple extra-charred burgers for lunch.
Highlighted in this study was the finding that not all cell types give rise to cancer equally. Not surprisingly, tissues with a higher number of stem cell divisions are more prone to cancer, which explains why we don’t hear a lot about duodenum cancer. Importantly, the researchers identified several types of cancer that are influenced more by our lifestyle choices or inherited mutations: colon cancer, basal cell carcinoma, and lung cancer.
The findings essentially assert that since cells divide they are veritable time bombs. Somewhere down the line a mistake is going to happen regardless of environmental insults, and if that mistake occurs in the wrong gene, cancer can ensue. These are noncontroversial statements and not news to most people. However, the idea that "most" cancers are due to "bad luck" is a more controversial conclusion. A major limitation is that the model did not incorporate some of the most common cancers, such as breast and prostate cancer, because the frequency of stem cell divisions is unclear. Readers would be wise to check out this article by David Gorski at Science-Based Medicine, which provides detailed insight into the strengths and weaknesses of the experimental design. The World Health Organization was so opposed to the message this study sends that they issued a press release critical of the study.
|Obi-Wan (Ben) Kenobi famously said, “In my experience, there’s no such thing as luck.” Some scientists who take issue with the Hopkins study would agree with Ben.|
At the end of the day, since we don’t yet know how all genes operate, much less which ones you might have in your DNA, it is wise to take common sense steps to minimize your exposure to known carcinogens and take advantage of tests designed to detect cancer at its earliest stage. Bad luck may be a major factor in cancer, but there are plenty of simple lifestyle changes you can make to try and beat the odds.
Contributed by: Bill SullivanFollow Bill on Twitter.
Tomasetti, C., & Vogelstein, B. (2015). Variation in cancer risk among tissues can be explained by the number of stem cell divisions Science, 347 (6217), 78-81 DOI: 10.1126/science.1260825
Ward E, DeSantis C, Robbins A, Kohler B, & Jemal A (2014). Childhood and adolescent cancer statistics, 2014. CA: a cancer journal for clinicians, 64 (2), 83-103 PMID: 24488779