Bad Luck

Most of the scientific and medical community would agree that cancer is a genetic disease. Recent scientific publication (ref-1) went deeper to point to this direction, even further, cancer is also a “statistical” disease, a result of  genetic gambling bad luck.

Think of the six billion nucleotides that must be replicated in each cell at each cellular division, multiplied by the billions of cell divisions every minute of our full length of lifetime. Something must go wrong, just by the sheer number of events, nothing is perfect, there are always some wrong nucleotides that are incorporated into the newly formed stretch of DNA in the newly formed daughter cell. There is of course a massive effort of the countless proteins monitoring the cell division and the DNA replication to catch the error and repair the mistake. But there is just one point, when just one DNA replication mistake is not corrected and the new incorrect peace of little nucleotide remains in the replicated stretch of DNA and keeps being replicated through the subsequent cellular divisions. This change in the DNA sequence might be irrelevant, just becomes a variant, just a variation, part of our diversity. This change in the DNA sequence might be good, like changes a protein function resulting in a physiological change, in other words change in the phenotype, resulting in an advantage for the individual, like a longer neck of the giraffe, reaching higher level of leaves on the tree, more delicious food, making the giraffe being better fed, stronger body, longer survival and healthier babies, all carrying the new variant for the longer neck, sounds familiar, they are making the evolution.

Just sometimes, this change in the DNA becomes a “mutation”, that is a bad word, we know that something is wrong with mutation. What if a mutation happens in a protein that promotes cell division or growth and that mutation makes that protein super active, than cell starts multiplying like crazy. Or what if a mutation happens in a protein that slows down cell division or growth and that mutation makes that protein totally inactive, that cell also grows faster because nothing to stop it. In the very complex cell there are many proteins that carry either of these functions, promotion of growth or arresting the growth. What if there are 50-100 or even more of these proteins are mutated as it is shown in the Cancer Genome Landscape study (ref-2). Bad Luck: Cancer. The recent study (ref-1) says 65% of cases of cancer is associated purely with the number of cellular divisions characteristic of those type of tissues, more division, more errors, more cancer. The other 35% of cancer cases are still could be linked with environmental or inherited factors.

So, what can we do? I thought environmental factors make us sick, you know, tobacco as the first villain, or the sunshine with the ultra violet irradiation, alcohol, processed food, chemicals, pesticides, the mercury in the fish and arsenic in the soil and the bad air we breathe in, you read the media, how to avoid these abrogating factors and instead how to lead a healthy life style. Oh come on, it is only bad luck, I will indulge in the half a pound medium-rare red juicy hamburger, and I will have the beer today, even if it is weekday, instead of my regular sugary sodas, than I will have my Cuban cigar (it is legal by now) on my beautiful, sunny California patio, to get some suntan, it looks good on my face.

There are half a million unfortunate death from cancer every year in USA. Something like 150 thousand of the cancer deaths can be linked with environmental and inherited factors but the other majority of them is linked with bad statistical luck. Even the 150 thousand cancer deaths like the smokers and the suntan worshipers must have extra bad luck, because most of the smokers and most of the beach goers don’t die from cancer or don’t even have cancer, so these are the people with the good luck.

There are 1 in every 3 people diagnosed with cancer in their lifetime, about 100 million people in USA. What can we do with these people, including myself, 1 in 3 is huge, I am included, for sure. Maybe I can fine-tune my odds by not smoking, avoid sun, eat healthy food, drink some red vine (that is part of good diet) and do my regular exercise. But we have just seen from the brilliant publications referred, that it is still better to have good luck than to have bad luck.

I am not a doctor, not a holistic healer, not even a lifestyle coach, but I am a next generation sequencing scientist with major interest in cancer research. Scientists are making huge progress in cancer research, however, we are not curing cancer yet, probably we don’t even understand exactly what the molecular mechanism of cancer is. So what can scientists say, only the scientific facts, what they find, even if it sounds scary, bad luck or good luck. Yes, we can say that cancer is a statistical genetic disease. The best we can do right now is to do early diagnosis, including for example next generation sequencing of our circulating blood DNA to catch the early signs of our bad luck, identifying the cancer associated mutations in our blood DNA sample and take preventive actions. Cancer maybe not curable right now, but cancer death could be avoidable by early detection of actionable mutations and by potential targeted therapy .

Reference:

1. Variation in cancer risk among tissues can be explained by the number of stem cell divisions; Cristian Tomasetti, Bert Vogelstein; Science 347:78, 2015

2. Cancer Genome Landscapes; Bert Vogelstein, Nickolas Papadopoulos, Victor E. Velculescu, Shibin Zhou, Luis A. Diaz Jr., Kenneth W. Kinzler; Science 339:1546, 2013

Tibor Gyuris

Personal Genomics Blogger

2015. January 5

“Knowledge is always good and certainly always better than ignorance”–Sergey Brin

“Possideo genes ergo sum”—Anonymous Roman Philosopher