ANTICANCER RESEARCH 19:4907-4912
(1999)
Summary
Despite intensive effort to cure breast cancer, treatment generally fails,
as evidenced by the age adjusted mortality from breast cancer. For 60 years,
breast cancer mortality remained virtually constant. As treatment failed
to improve the life prospect of the average patient, it is based on false premises,
e.g., Halsted's hypothesis, according to which the tumor is the only threat
to the patient. Yet there is more to cancer than just the tumor. Two hallmarks
of cancer, cachexia, and paraneoplasia, are usually ignored, since it
is assumed that they are caused by the tumor. But, what if it is the other way
around, and cancer is first of all a cachexia accompanied by a tumor? At least
this could explain why in most cancers treatment fails.
Cancer is a chronic systemic disease with local manifestations. Like arteriosclerosis,
that is also systemic and manifested solely by its local manifestations, e.g.,
stroke and myocardial infarction. In the same way as treatment of an ailing
heart does not cure the underlying arteriosclerosis, tumor removal does not
cure cancer, since being "metabolically" systemic.
It is proposed here that carcinogens, deplete a vital substance and induce
a metabolic deficiency that ends in cachexia. In order to survive, the
organism grows a protective organ, the tumor, that replenishes the missing
substance. During pre-clinical phase of cancer, deficiency is slight and compensated
even by a minute tumor. With time it gets worse and the tumor has to grow more
and more in order to make up for the loss, causing pain and secondary damage
to vital functions. The patient seeks help and the disease starts its clinical
course. When deficiency worsens, the patient becomes cachectic and dies.
Such a metabolic relationship exists in pernicious anemia, that illustrates
how a tumor might be protective. Cancer is viewed here as pernicious cachexia
induced by the loss of a vital metabolite and compensated by the tumor.
Until the discovery of the missing substance, treatment ought to preserve the
tumor and alleviate its secondary manifestations.
Depth of systemic disease is represented by darkening color.
Cancer is a systemic disease manifested by
three features:
1. Cachexia, or body wasting.
2. Para-neoplasia, manifested by hormonal dysfunction and nerve conduction
disturbances.
3. Neoplasia, the tumor.
Cancer starts as systemic deficiency. Initially it is is compensated. Then para-neoplastic
symptoms accompanied by weight loss, may appear, and organism grows a tumor.
When tumor is detected, cancer starts its clinical course. It ends as cachexia.
New epidemiological analysis supporting this hypothesis
1. For three years following breast cancer
surgery patient mortality rises whereupon it declines.
2. Tumor ablation is followed
by a rising metastatic rate.
Physician
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