Cancer and genetics – Cancer 4

//Cancer and genetics – Cancer 4

The prevailing theory of cancer, accepted by practically all the oncologists and researchers in the world, over the last 5 decades is that cancer is a genetic disease. This is termed the somatic mutation theory (SMT), which theorizes that a cell develops mutations that allow it to become cancerous. This requires multiple ‘hits’. That is, a single mutation is rarely sufficient to provide a normal cell everything it needs to become cancerous. For example, a normal breast cell may develop a mutation that allows it to grow, but it needs other mutations to escape detection by the immune system, grow blood vessels etc. So it needs multiple mutations to become a problem cancer.

So the basic theory of SMT is that

  1. Cancer is derived from a single cell that has accumulated multiple DNA mutations
  2. Normally, cells don’t grow all that quickly.
  3. Cancer is caused by mutations in the genes that control cell proliferation and growth

This is the basic theory I was taught in medical school. This is the prevailing paradigm of cancer, which essentially colors how all data is interpreted. If you get the paradigm wrong, everything else that follows is wrong. Just as in nutrition and obesity – if you follow the ‘calorie’ paradigm, then everything is interpreted in the view of calories. Get that wrong, and you get the current obesity epidemic.

In 1971, US President Richard Nixon declared war on cancer. This was his ‘moon shot’ even if he didn’t call it that (Joe Biden would be more explicit and call it that). The amount of resources poured into understanding cancer over these last 45 years is staggering. Yet we are no closer to a cure than we were in 1971. Sad, but true. The only way to have such a crappy, crappy result is to start from the wrong paradigm.

So, while there have been major advances in understanding cancer at a genetic and molecular level, there is little good news on the clinical front, with a few exceptions, such as in certain leukemias. This success has elevated genes to a special revered status in the public perception of cancer. This translates into research funding to tackle the genetic basis, such as The Cancer Genome Project, all of which takes our ‘eye off the ball’ with regards to other factors equally important for cancer development. It’s a distraction. In fact, the relatively minor importance of genetic factors in common cancers is plainly evident to see.

The clearest evidence against a predominantly genetic basis for cancer comes from twin studies. Identical twins share identical genes, but and also share similar environmental influences if brought up together. Fraternal twins only share 50% genetic material on average, the same as any siblings. By comparing these two groups, you can get an idea of how important genetic factors are to the development of common cancers such as breast, colorectal, prostate etc. Luckily, in Sweden, Denmark and Finland, they keep registries of these twins and data on 44,788 pairs of twins were reviewed. The effects were defined as genetic, shared environment (eg. passive smoking, similar diets) and non-shared environment (eg. occupational exposure, viral infections).

The overwhelming majority of the risk in the causation of cancer is NOT genetic. This holds true even for breast cancer where we often think of the BRCA1 gene as a ‘breast cancer death sentence’. In fact, this only accounts for an underwhelming 27% of risk. This holds true for all cancers. For most cancers the attributable risk is only 20-30%. Environmental risk factors accounts for the majority of risk in all cases of cancer.

This is clear from migration studies. As we previously saw, the risk of breast cancer in a Japanese woman in Hawaii is far higher than that of a Japanese woman in Japan. Clearly, the genetics are identical but the environment is not. The overwhelming problem is environment.

In 2004, in the New England Journal of Medicine, Dr. Willett, from Harvard, published a small article noting the rising incidence of breast cancer in Japan. From 1946 to 1970, the incidence of breast cancer more than doubles. That might be interesting, although by itself you might believe it to be the effect of Enola Gay’s fiery kiss (the atomic bomb). But what is fascinating is that increased height is consistently associated with increased risk of breast cancer. What’s the link?

If you look at the steady increase in height in Japanese women, it parallels the rise in breast cancer. Once again, it must be an environmental effect – mostly diet related. One common factor may be levels of insulin-like growth factor 1. If you have higher levels of hormones producing growth, you will get increased height, but also set the stage for other things that grow. Things like breast cancer.

Height is not the only thing growing in children. If you have eyeballs that grow too large for their optimal focal length, then you get myopia, or near-sightedness. Over the past few decades we have seen a huge increase in the number of myopia cases.

Look around. I wear glasses. I got teased mercilessly as a child in public school because well, I was a nerd. But more than that, I was one of the very few kids wearing glasses. How about today? Looking around my son’s class, (yes, I somehow suckered my beautiful wife into marrying little old nerdy me) I estimate that a third of the class wears glasses. Nobody gets teased for it, because everybody wears them. Last year, my 9 year old niece wore glasses with clear lenses simply as a fashion accessory. Why has myopia increased so much? It is not genetic, obviously, since it happened within a generation. We’re lucky we haven’t spent millions of research dollars with experts trying to ‘prove’ that myopia is a bunch of random mutations that happened simultaneously in the world.

The answer is not actually known, but I suspect that excessive growth factors, including insulin may play a large role here. Too much growth, in general, is not always good. Yes, people got taller. But they also got more myopia and breast cancer.

But that the environment is the overwhelming risk factor and not genetics is not news.

Even as early as 1981, Sir Richard Doll and Sir Richard Peto of Oxford University, looking at the causes of cancer suggested that 30% was attributable to smoking, but that 35% was due to diet. In 2015, researchers looking back at this seminal work suggested that these estimates were “Holding generally true for 35 years”. This report was commissioned by an office of the US Congress mostly to look at the role of occupational risk (asbestos).

Smoking was the most important risk factor, but diet ran a very close second at 30%. What exactly was the problem with the diet, the researcher could not determine at that time. The other major risk was occupational exposure (20%), including asbestos, dust, radiation. Infection was a small player at 10% including bacteria (H. Pylori), and viruses (Human Papilloma Virus, Hepatitis B and C, Epstein Barr Virus).

That leaves a minuscule 5% of population attributable risk to everything else including genetics, bad luck, chance and the like. This leaves over 90% of the risk of cancer as occupation, but more importantly preventable. This directly contradicts the prevailing feeling that cancer is mostly a genetic lottery and this learned helplessness that there is nothing to be done to avoid the second largest killer of Americans.

It is clear that any preventive effort must focus on these factors identified. There is little controversy that

  1. We should stop smoking.
  2. We should avoid harmful occupational exposures (eg. asbestos).
  3. We should try not to get infected with bad viruses and bacteria/ get vaccinated.

Therefore, any efforts must focus squarely upon the diet, because anything else, including trying to ‘hack’ your genetics will have minimal benefits. The link between diet and cancer is a singularly important one, but singularly ignored in the rush to proclaim cancer as a genetic disease of accumulated random mutations.

 

2017-10-12T17:31:42+00:00 31 Comments

About the Author:

Dr. Fung is a Toronto based kidney specialist, having graduated from the University of Toronto and finishing his medical specialty at the University of California, Los Angeles in 2001. He is the author of the bestsellers ‘The Obesity Code’ and ‘The Complete Guide to Fasting’. He has pioneered the use of therapeutic fasting for weight loss and type 2 diabetes reversal in his IDM clinic.

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31 Comments on "Cancer and genetics – Cancer 4"

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Roger Bird
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As I have looked at you, Jason, and listened and watched you for the past year and a half, the the word “nerd” never entered my mind. What did enter my mind was the word “hero”. You are saving the lives of thousands of people and eventually millions of people. That is what heroes do, particularly when they risk their standing among their backward colleagues.

Raj
Guest

100% agree!

Jimmy Sutton
Guest

Well of course cancer is genetic, how else can you build an entire (billion dollar a year) industry if you can get rid of it by simple dietary changes, nobody makes any money that way!

Dr david berman
Guest

As a physician who has been interested in nutrition and exercise, I strongly agree and I believe our diets have played a huge role in the rise of cancer, obesity, heart disease etc

Otto
Guest

Thank you for another fascinating & illuminating post. I always look forward to them!

Gerald Soulodre
Guest
On the topic of vaccines, Calgary, Alberta … My spouse was diagnosed with Lower Motor Neuron Myopathy (roughly 1/2 of ALS) in April, 2011. On December 19, 2012, approx. 6 hours after administration of the flu vaccine by a member of the home care team, she died. At the time, she was on near continuous bipap, her lung capacity 0.42l (less than 20% of normal). Her death was listed as due to cardiac arrest. When the medical investigator showed up in less than an hour of her passing, I may have been too stunned to relay accurately to him that… Read more »
Linda Abernethy
Guest

I agree with your concerns re: vaccination. It certainly should be a voluntary procedure-anyone who wishes to be vaccinated should be able to receive a vaccination. If they are so very effective, those people will be “safe”. No one should be coerced or forced to be vaccinated.

Francine Calamia Kuzma
Guest
Francine Calamia Kuzma

There is much controversy in item #3, getting vaccinated as prevention to bacteria and viruses. I’m surprised you are a proponent of this.

Roger Bird
Guest

Our collective disapproval will propel Dr. Fung to look closely that the vaccine issue and make up his own mind. Hopefully it will not influence his judgment, even though I also agree that vaccines are very problematic. I want him to be someone who thinks for himself; just about everyone starts out in a scientific revolution being on the wrong side. I have complete confidence that Dr. Fung will make the right decision.

Luke McMahon
Guest

Likewise. Might I suggest that Dr.Fung have a look at some of the videos of Dr. Susan Humphires who is also a nephrologist. Here is her take on vaccination and there are many talks of hers on Youtube. http://drsuzanne.net/dr-suzanne-humphries-vaccines-vaccination/

Geoff SMith
Guest
Very good as usual! I wish to challenge one thought….paradigm might be a better word and as you said if the paradigm is wrong everything that follows is….. I don’t smoke so I have no skin in the game but I doubt smoking is the issue with cancer. Just look at the older people from Blue zones that are over 90 or centenarians. Most of them smoked since childhood and have no cancer. What they do have in common no matter where they are from or what they eat is that they have very low insulin levels and very low… Read more »
Julie
Guest

Or possibly people from the blue zones smoked tobacco that wasn’t laced with a million chemicals.

Geoff SMith
Guest

Absolutely they would have had unlaced tobacco

John Irving
Guest

Dr Jason Fung – grateful for your insights and blogs. Wrong paradigm indeed….

Nick Papageorge
Guest

Brilliant 🙂

Duong
Guest
Could you do some research about curing myopia by natural methods? I believe Big Optical is nothing better than Big Food and Big Pharma as they’ve been trying to hide and oppress any free/low-cost natural methods. Like the vicious cycle of insulin and obesity, the more you wear glasses, the more serious your myopia will be. Your eyes will be weaken overtime. I got rid of my glasses. I am trying to follow Dr.Bates methods for several weeks but have made no improvement yet. What could be the root cause of myopia (lack of natural sunlight, long exposure for artificial… Read more »
Don
Guest

Very good question about a natural way to cure myopia. I am curious if anything noted during an eye exam could indicate a connection with insulin resistance? Thoughts? I have been told during an exam that some of the blood vessels in my eyes were squiggly shaped. The optometrist told me that could indicate a heart condition…just curious if insulin resistance could also cause it. I am about 30 lbs overweight…have a fatty liver and would eat any carbohydrate over protein if I had a choice.

Paula
Guest

This is available in the public domain. Look up nutrition and physical degeneration. Google it it is so amazing. Weston A Price discusses diet in relation to myopia way back when

Linda Abernethy
Guest

Read “Cancer as a Metabolic Disease” by Thomas Seyfried or “Tripping Over the Truth” by Travis Christofferson. The later is in a story format and not quite as technical as the former.

Juan Bucio
Guest

Thank you for the information that you have been giving I really appreciate it all and I live my life with the guidelines given by you in these blogs and your book The Complete Guide to Fasting. I have also have been doing IF for a year and feeling good. I am 26 now and hope to keep this new life style for the rest of my life.From 200lbs to 165lbs and holding.

-Juan B.

Lynne Gray
Guest

Please!! Get vaccinated??? Have you reviewed the documentary “The Truth About Vaccines”? I would suggest you view this before you recommend to people that they get vaccinated.

Sergio Castorena
Guest

It’s unbelievable that you discredit Dr. Fung just for this last statement he mentioned.
Plus, vaccines have helped a lot of people worldwide

Linda Abernethy
Guest

No one discredited Dr. Fung. He’s a brilliant doctor. I think anyone desiring vaccination should certainly be free to be vaccinated. However, no one should be coerced for the sake of “the greater good”,

lorna morganL
Guest

I read it as getting vaccinated is a way to GET cancer…funny how people see things differently, even when in agreement

Paula
Guest
I have also seen the Truth About Vaccines, the Bollinger series, and in fact own it. Some stuff in there might be a tad wacky but there is a TON of stuff that is fascinating and really needs to be known. For instance the fact that the 2011 Brucewitz v. Wyeth decision by the Supreme Court ruled that vaccines are “unavoidably unsafe” and that there is a fund for harm setup from which $3.6 billion has been drawn. I don’t know when it was set up so I don’t know how far back it goes. But I know somebody whose… Read more »
jenny douglas
Guest
Dear Dr.Fung As always clear eloquently explained interesting and welcomed information. Just love your posts of information. This may be of interest, regards smoking. My mother smoked approx 40 a day, result of this, died of lung cancer at 53 years. My Grandmother, Mother of my Mother, smoked cigars all her life and lived until 95 died heart failure. I don’t smoke at all. I do feel my Grandmother is minority, of those who smoke who did not get cancer or there could be the vast difference of an ordinary cigarette compared to a cigar for example. Regards cancer cells… Read more »
Ingrid
Guest

What should we eat, or change in our diets ?

Paula
Guest

LCHF.

Paula
Guest
The 2014 book Tripping Over the Truth: the Resurgence of the Metabolic Theory of Cancer is all about this. About how we got caught up thinking everything was genetic, but when they sequenced the entire human genome, expecting to rather easily have a handle on wiping out cancer, they discovered that, genetics wise, it was totally random. The book is about how diet is most to blame: it’s the metabolic insult that causes most cancers with the genetic alterations DOWNSTREAM. This comports with Gary Taubes’ discussions of cancer in Good Calories, Bad Calories where he writes about how amazed the… Read more »
Piotr Całka
Guest

I am a cancer survivior . For many years fighting obesity with same result an do finally the idea od casting and eliminating carbs started to work mieście, thank you Dr Fung

Jorge Szmulewicz
Guest

Is there any comparative study out there performed on animals that can link the level of insulin to the development of cancer?. It would be enlightening to see if there is evidence of correlation. It does not seem to be a very complicated test to do. The only way to settle these disagreements is by building evidence.

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