# Cancer… What Is It? A Word From A Doctor Language: en Author: by Vincent “John” Waldron MD Gladys, VA Original issue: The Heartbeat of the Remnant, Spring 2023, Number 1 Source pages: 29–31 Read article: Original PDF: Spring\-2023\-Remnant\-web\.pdf [The Heartbeat of the Remnant, Spring 2023]() “Why don’t we have a cure for cancer yet?” My patient asked me\. I shrugged\. “There are lots of different kinds of cancer,” I said\. “For some, there are cures, while for others we are still learning how best to treat them\.” “I think,” my patient said with the confidence that he was supposedly sharing a top\-secret theory\. “I think there actually **is** a cure for cancer, but the drug companies just don’t want us to know about it\.” I shook my head\. “I think we are doing the best we can,” I told him\. “We’ve come a long way when it comes to treatment of cancer, but we still have a long way to go\.” Cancer is a scary illness\. One Christian man told me that he wasn’t afraid of dying, but if he had a choice, he would choose almost any other way to go than to die of cancer\. More than that, it is something that seems mysterious\. More people seem to be getting it, yet no one really knows why\. In this article, I would like to take some time to explore what cancer is, and to discuss cancer screening tests\. In the second part \(in the next issue\) Lord willing, I will discuss some of the treatments available for cancers\. I will mention here that I am a family doctor\. I have cared for many patients with cancer, but I am certainly not an oncologist, nor do I know everything about cancer\. What I understand, I am willing to share\. ## What is Cancer? As with many things, we can trace the beginnings of cancer back to the fall of man in the Garden of Eden\. We know that God created humans perfectly\. As originally created, not only did they not have cancer, but they also would not have gotten it either\. In order to understand what cancer is, we need to understand how normal tissue and cells behave\. Normal cells live for a period of time and then die\. This process is called apoptosis\. It makes certain that there is a constant turnover of cells\. It also prevents one type of cell from getting “out of line” and beginning to grow in a place where it doesn’t belong\. Every time our cells divide, they copy their DNA into the daughter cells\. Usually this happens without error, but occasionally there is an error in the copy process\. We call these errors *mutations\.* Cancer cells are cells that have lost the normal brakes on their behavior\. Because of mutations in their DNA, they no longer have a limited life span, nor do they observe the limits of where they belong within the body\. Instead, they begin to encroach on surrounding tissues, pulling in additional blood supply and nutrients in the process\. Cancer cells can enlarge locally, or they can spread through the lymphatic system or circulatory system to distant parts of the body\. When cancer cells end up in other locations than where they originated, we call it metastases\. The type of cancer is determined by the type of cell that is multiplying out of control\. Doctors don’t generally talk about “skin cancer,” even though there are cancers that originate in skin cells\. Instead, they classify these cancers into basal cell carcinoma, squamous cell carcinoma, and melanoma—each one referring to a different kind of skin cell\. Each one of these skin cancers acts differently\. Basal cell carcinoma and squamous cell carcinoma get bigger in a local area and seldom spread elsewhere, while melanoma is very prone to spreading to other parts of the body\. Additionally, how a cancer responds to treatment is going to be based on the type of cell that it comes from, not simply the organ where it originates\. ## Causes of Mutations… We do not know how common cancer was in the days before the flood\. I would speculate that it was fairly rare\. We know that before the flood, men lived to be very old—often into their 900s\. Mutations must have been rare\. Their DNA was closer to the original genetic specimen of mankind \(and thus, to perfection\) than ours is in the 21st century \(AD\) Therefore, the chance of genes mutating and abnormal genes popping up was much less than it is now\. ## …Environmental Factors Beyond that, something must have happened around the time of the flood that increased the rate of mutations\. Perhaps there was an increase in radiation levels\. Maybe there were genetic changes that gradually caused cancer to show up\. Cancer is not mentioned in the Bible, although it is possible that Hezekiah’s “boil” could have been some kind of cancerous growth\. It is also possible that some of the diseases that affected the Philistines when the ark of the covenant was in their land were cancerous tumors\. People began dying at younger ages after the flood and by soon after the time of Abraham, they were seldom living much past their one hundredth year\. Today, we know that things which damage a cell’s copying mechanism and its DNA increase the risk of cancer\. The most well\-known of these is radiation\. After the atomic bombs were dropped on Hiroshima and Nagasaki, survivors were noted to have significant increases in certain kinds of cancer\. Leukemia \(cancer of the blood\) was the most common type of cancer, followed by cancer of stomach, lung, liver, and breast\. Radiation isn’t something that most people deal with on a regular basis\. However, if you work in an x\-ray department or if you needed to have radiation to treat some type of cancer, it is possible that you have been exposed to much higher levels of radiation than the general public\. There are plenty of other things that are associated with increases in cancers\. Exposure to ultraviolet light increases the risk of skin cancer and is a big reason why doctors recommend sunscreen and protective clothing while enjoying the sunshine to limit ultraviolet exposure\. Finally, there are plenty of chemicals that are present in different types of work that can increase the risk of cancer\. ## …Unhealthy Foods Foods that are high in nitrites increase the risk of intestinal cancers\. Nitrites are typically present in smoked and cured meats\. So, to be healthy, people should limit their intake of these foods to none or at the very least, a very limited percentage of the overall diet\. ## …Certain Prior Diseases Another thing to mention is that certain types of infections can increase the risk of cancer\. Epstein Barr virus, which causes infectious mononucleosis, has been associated with certain kinds of lymphoma\. Hepatitis B and C increase the risk of hepatocellular carcinoma \(liver cancer\)\. And Helicobacter pylori infections in the stomach are associated with stomach cancers\. It is important to remember that just because someone has had one of these viruses it will not necessarily cause them to get cancer from that infection\. Rather, it simply increases the risk that the person infected will get cancer at some point in the future\. ## …Unhealthy Habits One last thing to mention is that certain toxins dramatically increase the risk of cancer\. An obvious one is tobacco use, which strongly increases the risk of lung cancer, throat cancer, and even bladder cancer\. Alcohol is another risk factor\. Alcohol increases the risk of mouth and throat cancers, gastrointestinal cancers, and liver cancer\. There really isn’t a safe amount of exposure to either of these toxic agents, but certainly the higher the level of exposure, the worse it is\. ## Screening for Cancer There are many tests available that claim to be able to screen for a variety of cancers\. Most of them are at least a little effective at identifying cancers at an early stage\. However, there are a few problems with some of them which indicate that a certain test is ineffective at truly helping with the screening process\. A good place to start is to simply think about what a perfect screening test would look like\. This will help us to see where tests might be beneficial or not\. A perfect screening test is going to have a number of features\. First, it will have no false positive or false negative results\. In other words, everyone who tests positive with the test will have cancer and those who test negative will not have cancer\. Next, the test will identify the cancer at a point early enough in its development that it is easy to treat\. The test will be cheap and minimally invasive, and it will require minimal exposure to radiation\. Unfortunately, no test that we currently do for screening totally meets these criteria\. For one thing, many tests produce both false positive and negative tests\. These are both problems\. The issue with a false negative test is obvious—it leads to someone thinking they don’t have cancer when they really do\. A false positive test on the other hand leads to higher anxiety levels along with the cost and dangers from whatever ongoing testing is necessary to let a patient know that they don’t really have cancer\. An example of a bad test, in this respect, is the CEA\-125\. CEA\-125 is a chemical that is made by some types of cancer\. Oncologists use this level to track a patient’s response to chemotherapy\. It would make sense that you could use this as a screening test for these cancers, but it simply doesn’t work\. Many people have elevated CEA levels, even though they don’t have cancer and on the other side, plenty of GI \(gastrointestinal\) cancers don’t make this chemical at all\. Testing lots of people with CEA\-125 testing will lead to more scans and biopsies, but it is doubtful if it would have a significant impact on death rates from cancer\. Another issue has to do with a particular cancer itself\. In order for a test to be helpful, the cancer needs to have a long progression through precancerous stages until finally it develops into full\-blown cancer\. An example is colon cancer\. Most people who develop colon cancer have precancerous polyps several years before they get the cancer\. This is why colonoscopies can be effective at preventing the progression to colon cancer\. If a patient has a colonoscopy, the doctor can detect the presence of polyps\. More than that, he can remove the polyps through the scope, hopefully stopping the progression to cancer\. One last, related point is that there needs to be some benefit to early detection of cancer\. If a new test can detect cancer six months earlier than existing tests, people will live an average of six months longer with the cancer than before, even if nothing else changes\. The question is whether diagnosing the cancer earlier leads to more effective treatment\. Can you take it out before it spreads to the lymph glands and thereby completely avoid the need for chemotherapy? If treatment and response rates are the same regardless of the stage at which you diagnose a cancer, then screening doesn’t really make sense\. The United States Preventive Services Task Force is a volunteer panel of experts that have reviewed the literature on a variety of tests\. Based on the studies that have been conducted regarding the available tests, they make recommendations about the various tests and how often to use them\. This panel tends to be more conservative in their recommendations than many cancer societies\. For instance, they recommend ***every other year*** for the use of mammograms for women between the ages of 50 and 75, as compared to the ***yearly*** screening recommended by other groups\. With each recommendation they give a grade of how good the studies are which support that specific recommendation, along with links for those studies\. Their recommendations are well researched\. This is helpful for low\-risk people trying to decide what testing to do\. If someone has a high risk because of family history or exposures, their recommendations are less helpful\. ## Cancer Challenges People often discuss cancer as though it was a single entity\. As before mentioned, cancer is not just one thing\. Skin cancer behaves differently from lymphoma, which in turn behaves differently from sarcomas\. The chance that there will ever be a single treatment for all cancer—the “Cure for Cancer” which people talk about, is unlikely\. An even bigger challenge when dealing with cancer cells is that they are very similar to our normal cells\. Basically, we are trying to poison the cancer just a little more than the rest of our normal tissues\. There are a number of different treatments that are currently available\. In Part 2, we will address some of the different options available today and some others that may become available in the future\. ## Final Thoughts There are a few things that come to mind when contemplating the subject of cancer\. We do not need to live in fear or make choices out of fear\. *Fear thou not; for I am with thee: be not dismayed; for I am thy God: I will strengthen thee; yea, I will help thee; yea, I will uphold thee with the right hand of my righteousness –Isaiah 41:10\.* I don’t think that we should fatalistically allow anything to happen that might, simply because it is “God’s will\.” We need to make wise choices, then having done so, we should not live in a state of anxiety\. *Therefore take no thought, saying, What shall we eat? or, What shall we drink? or, Wherewithal shall we be clothed? \(For after all these things do the Gentiles seek:\) for your heavenly Father knoweth that ye have need of all these things\. But seek ye first the kingdom of God, and his righteousness; and all these things shall be added unto you\. Take therefore no thought for the morrow: for the morrow shall take thought for the things of itself\. Sufficient unto the day is the evil thereof –Matthew 6:31\-34\.* Finally, if we can, through wise decisions, prevent a certain cancer from forming or spreading, that seems like a reasonable goal\. None of us will live forever in this body, but if we can die of something other than cancer, that seems like a good goal too\. May God give us wisdom to care for the body which He has given us\.