Cancer Is Not Caused By Mutations

This quote is from... 1974 but yet most people rather "believe" in bullshit than understand the complexity and complex systems. 

We find ourselves at the present time in the era of molecular biology, and we are perhaps unduly influenced by the genetic code as the dominant principle in biology. Perhaps, in a decade or two from now, the dominant principle may shift to another plane, which in turn will influence our speculations about tumor causation.

- Biochemist Isaac Berenblum, 1974

Once again, I am learning all this after Max...

Similarly, instead of simply targeting the cancer, altering the microenvironment to disfavor its proliferation may provide a more viable long-term strategy, as the former immediately selects for resistance, accounting for the difficulty in keeping a patient in remission. Highlighting the importance of the microenvironment in regulating development, homeostasis, and cancer, biologist Mina Bissell writes,

“The sequence of our genes are like the keys on the piano; it is the context that makes the music.”

Cancer depends on context, as should our approach to treatment.

Of particular interest is the discrepancy between cancer frequencies at different sites. For example, colorectal cancer is very common while small intestinal cancer is 100 times less common despite the fact that the small intestine is five times longer (30 feet versus 6 feet for the colon) and characterized by nearly identical rates of mutation as the colon. The microenvironments are strikingly different, however, with the colon being host to more diverse and numerous microbiota. In addition, colorectal cancer almost exclusively occurs in the distal colon rather than the proximal colon where fermentation is greatest and short-chain fatty acid (SCFA) concentrations are typically higher. Lack of sufficient dietary resistant starch may prevent production of a short-chain fatty acid called butyrate, which lowers colonic pH, prevents pathogen invasion, and appears to preclude carcinogenesis, lending further evidence to the role of the colonic ecosystem in preventing or promoting cancer. To further illustrate the importance of the tissue microenvironment, Bissell expounds,

“Indeed, how else would one explain the tissue specificity of heritable cancers, for example, BRCA1 and breast cancer, where, despite mutations in all of more than 10 trillion cells, the tumors are not only tissue specific but also formed from just one or a few cells of those tissues?”