Why Cancer Theories Matter

By Linda L. Isaacs, M.D.

In this series, I have reviewed theories of how cancer forms, including issues with and alternatives to the Somatic Mutation Theory, the most commonly accepted hypothesis. If you need a refresher, click here.

But why does all this matter? For a clinician like myself, this discussion can seem like a pointless academic exercise. I’m sure that many laypeople would agree. Here, I will discuss the practical significance in terms of the medical-industrial complex.

From college to retirement, scientists have been told that cancer develops because of genetic damage. The experts awarding funding for research rely on that model. As a result, any proposed method of treatment that differs will be summarily dismissed. This includes pancreatic enzymes, discussed here, because the underlying theory about how pancreatic enzymes might work does not involve the Somatic Mutation Theory. Since the theoretical underpinnings were unfamiliar, some in the medical community have been reluctant or have even refused to read the case reports of patients successfully treated with pancreatic enzymes.

If cancer forms as a result of mutations in the genetic material, as the Somatic Mutation Theory states, then developing cancer is the result of an unlucky series of events. Once those mutations have occurred, that cell and its progeny will remain cancerous no matter what. Since the “unlucky series of events” is unpredictable, prevention is not possible, aside from avoidance of known carcinogens such as smoking. Historically, the medical community has focused on finding cancer early through screening, and then eradicating cancer cells, no matter how harsh the treatment.

Surgery and radiation have been mainstays of cancer therapy for more than a century because they either remove or destroy cancerous cells. This can be curative if cancer is localized.

Chemotherapy affects all rapidly growing cells, both cancer cells and normal cells (such as the lining of the intestinal tract, red blood cells that carry oxygen, white blood cells that fight infection, or platelets that control bleeding). Side effects, such as anemia, infections, bleeding, or damage to the intestinal tract, limit how much chemotherapy can be given. And while chemotherapy works for some cancers, in many others, it has only short-term or no results.

The new immunotherapy agents work by increasing the activity of immune cells. This can help patients when the revved-up immune system attacks cancer cells, but harm them due to attack on normal cells. Genetics of the cancer cells can help determine whether immunotherapy will be effective or not.

The influence of the Somatic Mutation Theory is most clear in the development of “targeted” treatments. With the explosion of genetic sequencing over the last few decades, scientists in both academia and pharmaceutical companies are hunting for mutations specific to cancer cells. By identifying unique metabolic pathways of cancer cells, they hope to design “targeted” molecules that will interfere with those pathways while leaving normal cells alone.

Nonetheless, most “targeted” cancer therapies have significant side effects. If the genetic changes in cancer are due to reversion to an embryonic pattern or an unmasking of genes that are also expressed in normal cells, “targeted” treatments will not be as targeted as was hoped. Many billions of dollars have been spent on these efforts. “Targeted” therapies are very profitable for pharmaceutical companies.

Why did I review all this? There is a very large and very lucrative cancer industry that depends, to a greater or lesser degree, on the assumptions about cancer derived from the Somatic Mutation Theory. That can explain the resistance to any questioning of that theory, or any therapy that does not hinge on it. Prestige, academic appointments, finances, funding, all are at risk for a scientist who steps outside the mainstream on this topic.

Next Section: Practical Implications of Cancer Theories

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