I was a cancer patient fighting for my life.  When I lived many years past my expected survival, I was able to again plan for my future.  I was going to two universities at the same time, Purdue University for an advanced practice nursing degree, I wanted to become a Clinical Nurse Specialist.  I wanted to become an Oncology Clinical Nurse Specialist, so while I was going to Purdue, I also enrolled in Loyola to get my Graduate Certificate in Oncology.  I learned so much at Loyola, it was an excellent school.  In learning about oncology, I learned that cancer is a very inteligent disease.  this is why it cause so much death, why the disease is so difficult to control, to cure.

Cancer is a genetic disease.  This doesn’t mean we get it from the genes we get from our parents.  Only a small amount of cancers, 5-10% are caused by genes we inherit.  Most cancers don’t run in families.  If you have a cancer like breast cancer that occurs in several people of every generation of a family, and they get it at a young age, then you may have the inherited type.  Inherited cancers strike at an earlier age and are often more aggressive. If in every generation a few members get cancer, but they are different cancers, it probably is not related to genes that are inherited from parents, cancer is probably not “in your family”.   Most cancer comes from genes that become altered, or mutated, as we grow and as we age.  Actually, the number one risk factor for cancer is growing older. This graph shows how cancer rates rise as we age.  The median age for a cancer diagnosis is 66.  The median age at diagnosis is 61 years for breast cancer, 68 years for colorectal cancer, 70 years for lung cancer, and 66 years for prostate cancer.   But some of us our diagnosed earlier, I was diagnosed 26 years before the median age.

This graph shows cancer related to age.

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Normal cells have a definite life span, and after a certain number of times of dividing, they die, they don’t live forever. They are programmed to die.  When they come into contact with other cells, or cells that are different from their organ, they stop growing, they don’t want to get in the way.  They stay near the organ they are a part of.  Every cell has a gene that protects it from cancer, the P53 gene.  If the P53 gene notices that something is wrong with a cell’s genes, (a cell’s DNA), it makes that cell stop dividing until it repairs itself.  If the cell can’t be repaired, it causes the cell to die.  This protects us from cancer. Our normal cells and our normal genes are also very intelligent.

But in may cancers, at least 50%, the P53 gene is mutated, it is broken and can’t do it’s job, so cancer is allowed to grow in a cell.  The cancer cell doesn’t die, it keeps on growing.  In people who don’t inherit a P53 gene from one of their parents, they can develop a disease called La Fraumeni,  In this disease, a single person can have multiple primary cancers.  I’ve know two people with this syndrome, they have new cancers of different organs that pop up every year or two. One had 5 different cancers, the other 7 if I remember right,

Normally the immune system tries to kill cells that are abnormal, “foreign”, but cancer cells coat themselves to avoid our immune system.  Cancer cells don’t respond to our body’s signal that tell a cell it is getting too close to another organ and to stop reproducing, cancer keeps growing enough to interfere with another organ’s function.  They don’t need to stay near their organ of origin, like a normal cell, which is why lung cancer can grow in the bones and brain. When a cancer cell leaves it’s original organ, the lung or the colon, it also leaves its source of blood supply, its access to circulation, but cancer cells are able to trick the body into producing blood vessels that supply the tumor with oxygen to keep it alive. The abnormal genes in cancer cells keep mutating and the cancer keeps changing to outsmart our treatments, which is why a chemotherapy can initially be very effective against a cancer, then stops working; the mutated genes allow the cancer cell to become immune to the chemotherapy.  Normally, cells respond to signals that tell them to stop growing or slow their growth.  They respond to signals that tell them it is time to die.  Cancer cells respond to none of these signals, they grow rapidly without stopping and never die.  Our very intelligent bodies are overcome by a smarter disease.

Chemotherapies try to target how cancer cells respond to the bodies signals, they try to make cancer cells behave normally and kill themselves. They try to stop cancerous tumor from creating their own blood supply.  There is work trying to repair mutated P53 genes, if that happened, cancer rates might drop by 50%.

It’s a tough battle.  And it turns out that each cancer is it’s own disease, sometimes requiring a different treatment than every other cancer.  Every cancer is different from another cancer so cancer can be considered 200 different diseases.  To complicate it even more, one type of cancer, say lung cancer, might be genetically different in two lung cancer patients, so their might be 100 types of just lung cancer.  Interesting, in one lung cancer clinical trial, 90% of the patients didn’t respond to the new chemotherapy, but 10% almost seemed to have their cancer cured!!  The 10% that responded had different lung cancer genes than the 90% who didn’t respond, their cancers had mutated differently.   While it would be wonderful to find just ONE treatment that cured ALL cancers, that is unlikely to happen.  I think that people who are waiting for a cancer cure are waiting for the one big bullet that will cure all cancers, and that won’t likely happen.  But wouldn’t it be great if it did?  I there were one pill or one treatment that cured appendix cancer and lung cancer and colon cancer and leukemia?

Let’s hope.  Maybe one day there WILL be a cancer cure.