Bovine biology series
Part - 20 Cancer
I do not know much about cancer in humans. Fortunately, my family has been spared of this relatively common malevolence. I am sure, however, that as I age, its malice will creep up on me as the years of age accumulate.
My earliest remembrance of cancer in cattle goes back twenty-two years. I was a dairy science student at Cal Poly, a junior as I recall, and during a cold and rainy day in San Luis Obispo, I stood next to a veterinarian while his sharpest knife exposed to my eyes the inward world of the body cavity. He pointed to the lungs. "Obviously, this old cow has a bronchogenic carcinoma".
I nodded, barely able to pronounce the words let alone understanding them. While this cow had died of a toxic reaction from still-retained afterbirth, inside of her too was a cancer. One that she somehow held in check. One that no doubt taxed her immune system to its fullest. I still to this day believe that this cow died of a multitude of maladies, each one of them drawing energy and resources from the immune system as well as the other organs of the body. Then finally overwhelmed, the immune system, and the body could not keep up. The toxins may have killed her the day before, but it was a long progression of time over which other combatants in her environment cascaded upon her. She was old too. The lesson, of course, is that eventually the body does wear out regardless of our efforts to stave the inevitable of death.
Cancer is defined as a neoplastic (the growth of new cells) disease that is usually fatal. The word cancer is derived from the Latin word "crab". [Why "crab"? Well, ancient doctors did not do autopsies on humans, so when they tried to describe a particular disease, the one in which seemingly crept out of the body in many locations with hard clumps of tissue resembling crab legs, this they called karkinos, or in modern day language, cancer]. Similarly, cancer may be described as a malignant tumor that has explosive ability to grow (neoplastic) and spread systemically (metastasis). A malignant tumor is a growth of cells that tends to become progressively worse and can (usually) cause death. Metastasis is a word used to describe the transfer of disease from one part of the body to another. Thus in metastasis, a disease which has originated in the thyroid gland may metastasize itself in the adrenal glands. This is accomplished after the diseased cells, for instance, gain entry way into the bloodstream. Once here, they can relocate to almost anywhere in the body.
With some of these terms defined, let us take a closer look at cancer.
We begin with the ever-so-important stem cells. They are the youngsters of the cellular world, in that stem cells are the precursors of new tissue. We know that the body cells are constantly dying and being replaced. Thus we may say the very instant we are born, certain cells begin to die. As I sit her and write these words into the computer, some brain cells have died. Some blood cells have died. Some muscle cells have died. Deep in the tissues of these organs and tissues are stem cells, the actively reproducing progenitors of a healthy body. As we age, the stem cells become ever-so more important in keeping up with replacing dead cells so that we may live. And because there is a limit to this biologic demand, the body soon wears out and dies.
In the healthy body, stem cells mature. As they do, they are called upon for more specialized service. For instance the stem cells of the bone marrow may be drawn into the immune system to become a white blood cell and deal with an invading bacteria. The stem cell may become part of a muscle fibril, so that we runners can rebuild our legs after a particularly long and hard run. Or still another example is that stem cells may rebuild the liver itself if a part of it has been atrophied due to its overuse in dealing with alcohol detoxification.
But there is a tradeoff. It is that as these cells are called into their area of specialization, they do not continue to proliferate in numbers because they have a more primary duty......fighting bacteria, moving a leg up and down, or forming glycogen from glucose freshly taken from the digestive system.
In this way, cells are born, usually divide, replicate, grow in numbers as their primary duty. But at a certain timely point, they shift duties towards a more specific one. We might think of our own life as an analogy. There is a time for us to reproduce, but at a certain point, baring medical heroics, our bodies are more suited for other things. Such as contributing to society in another manner. Simply stated, there is a time for reproduction and there is a time when it is not appropriate.
Scientists and medical doctors call this process of stem cell growth its ability or capacity to differentiate. Anything blocking the ability or capacity of a group of these young, immature cells from making the progression into healthy adulthood is called a tumor (or neoplasm).
A tumor, then, is a clump of cells that has been blocked in developing fully.
There are two kinds of tumors.
The first is a benign tumor. This group of cells is much less harmful of the two tumors. In a benign tumor, the cells may grow very slowly, they do not invade neighboring tissue, they may be surrounded by fibrous material helping to arrest its travel to other tissues, and it is almost never fatal. Many such benign tumors may exist in the body, a lump here, a clump of hard tissue there, but they are held in check both physically and immunological. Thus a lump in a woman's breast may be determined to be benign, or the lump next to a lymph node under a mans arm may be determined to be benign, and the doctor will measure the size of these hard tissues or lumps. Generally if they do not grow, they are held in check by the body. The reasons they are there are not always explainable. Sometimes medicine is like that. We are thankful for the remarkableness of our body to deal with healing itself and replacing itself. The little lumps here and tissues there are just part of the whole. We survive in spite of them.
The malignant tumor, however, is quite another story. What is it that makes a tumor malignant instead of benign? Perhaps it is in our genetic makeup. An example of this may be breast cancer in a woman. Generation after generation of woman in the same family deals with breast cancer. With each new generation, the replication of DNA code is transferred onward, and with it the various snippets of code which endure towards the genetic and finally the physical expression of breast cancer.....the lump discovered at the age of forty-two.
Or a malignant tumor may be the result of an environment. Such is the case in the Appalachian coal mines, where the irritation of coal dust inside the delicate lungular tissue, hour after hour, day after day, aggravates the very life-giving breath of each diaphragm movement. Finally at the age of fifty one, the coal miner is overcome with lung cancer and dies for lack of absorbed oxygen even thought the lung capacity is filled with the gas. It cannot get into the bloodstream.
Or maybe there are other reasons, none by themselves capable of causing a malignant tumor, but collectively they do. For instance the type-A personality, who is under a great deal of stress, suffers from a mid-life crisis that overwhelms his diet from the ingestion of poor food choices. The "good life" has added around his mid-section the tissue of adipose cells that squeeze and compress the internal organs of his body cavity. The heart works harder. The muscles move more body weight. Until finally the immune system is overwhelmed as well. Perhaps at this juncture the body stem cells in a particular location are blocked and as such, a tumor is formed. Maybe it is in the deepest recesses of the bowel. Here, digestion is interrupted. There is blood in the stool. Pain in the gut. The tumor, however, grows, expands, run amok by consuming tissue in every direction.
Four months later from a hospital bed our overweight but highly successful and very well to do man lays with excruciating pain. He would trade it ("it" is all material wealth) all for another chance. But there is no second chance. The body, in this man's case, wore out too quickly; the speed of which was exacerbated by a lifestyle of accumulations, the summation of which the body could not keep up with. Cancer, the malignant tumor found in the bowel, become the final expression of many years abuse.
The malignant tumor, appropriately called a malignant neoplasm, is characterized by cells that do not differentiate. The cells are like youngsters that never grow up. Constantly staying young, all they want to do is reproduce, for at this stage of stem cell blockage, the cells are not allowed to grow up and do the work for which they were intended. As a clump of cancer cells, they run wild, uncontrolled and reproducing without any rules guiding them.
As a result, a malignant tumor does not contribute anything to the body. This tumor takes everything, giving nothing. A malignant breast tumor does not contribute to lactation. A malignant lung cancer does not contribute to the gaseous exchange of respiration. A malignant colon tumor does not participate in absorption of water from the bowel. Simply said, malignant cells and the tumors they make up only want to do one thing: reproduce. Thus they are reproductive and not productive in the body.
Another factor in dealing with malignant tumors is their lack of maturation. As such, they just go on and on, never maturing and dying. Malignant cells do not reach the point of finality like healthy cells.
The unfairness of life is certainly found in cancer cells. For not only do they stop normal tissue from being replaced, they almost never die, thus tumors of malignant cells live an immortal life.
Such is the case with treating cancer. Cancer is, then, determined to destroy life. Not only that, they are nomadic by nature, in that metastasis of cancer cells can destroy the body on many fronts, many tissues and many organs. If there is a victory, it is in death of the body, for when the body dies the cancer dies. But what a price to pay!
There is a Greek word "anaplasia" which means "without form." In the context of malignant cancer cells, anaplastic cells are in many cases non-distinguishable from their originators. Or said another way, cancer cells do not retain a specific form or mark or shape. They are a glob of cellular immaturity. Cancer cells also operate under the guide of autonomy, a term used to describe the fact that cancer cells may (usually) show no restraint towards a particular organ or tissue. That is, they are unrestrained and without a definitive form, healthy organs and tissue do not recognize these cells quickly as a non-self cell. The damage is sometimes quick but always destructive.
Finally the destruction can be seen with the naked eye or in the case of many, felt as a lump or protrusion beneath the skin. That is if the cancerous tumor is near the surface of the body. Should it take up residence in the digestive system or lungs or internal organs, the growth of it will be unchecked until its size cannot be controlled medically.
Of course the unfair part of a malignant cancer cell is that in reproduction, it may breach the extracellular fluid (that fluid outside the cells that bath them and sustain the right electrolyte balance for exchange of nutrients and by-products), and metastasize itself in another part of the body. In the medical field, metastasis is the ultimate cruelty when cancer treatment is exercised.
Perhaps this is why cancer is dreaded by all of us.....we cannot control it easily nor can we stop its invasion throughout the body. Medical research has come along way, of course. But breast cancer and cervical cancer are still with us. Prostrate cancer and colon cancer are still with us. Lung cancer and gum cancer are still with us. As if we cannot quite catch the implicator, the malignant cell runs too fast, is too unpredictable, and reproduces too fast for us to keep it in check.
The medical treatments of radiation therapy, horrendously expensive biochemical treatments (chemotherapy) and stem cell supplementation are catching up with the runaway cancer cell.
If in our discussion of immunity, we know that we must approach the logistics of daily living holistically. This is the same for ourselves as well as any other animal, a cow included. We know for instance the danger of carcinogens in our life; we buy them over the counter as easily as we do groceries. We know for instance the danger of stress and worry and lack of sleep; but still we do keep going. And we know the dangers of an environment of diet overindulgence, a lack of exercise, a sedentary lifestyle, and yet we do not change. If cancer is to be won or at least abated, then these factors have to be included in staving off of malignant tumors. In short, the healthy immune system, in you or me or any other animal, is paramountly important.
And yet buried deeply within our genetic code may be the trigger at which after so many reproductions, the stem cell is blocked from differentiating. It begins to reproduce uncontrollably and the beginnings of a cancer cell, the clump of cancer cells then finally a tumor is formed. Perhaps benign it shall be. But even in spite of all lifestyle efforts and in spite of all preparation, a tumor might be declared malignant.
I am recalling the hands held of two women at a road race in Seattle. Here, stood a mother, a cloth towel around her bald head. Next to her, a vibrant, flat-chested woman who was her daughter, a national-class runner named Megan Otherson. Hundreds of women joined them in a Race For The Cure event. The purpose, celebrating a woman's life of resiliency from breast cancer. Megan's mother had fought breast cancer, but the metastasis of cancer cells had happened; tumors, malignant all, had appeared in other recesses of her body.
But on this cold and typically damp Pacific Northwest fall day, the celebration of life was center stage. Here, a mother and daughter held hands just prior to the firing of a starting pistol. Life today, at least, would be a celebration, an expression of a smile and the commitment to all victims of all cancers....that there was simply no better place to be than here.
I will never forget this moment.
Still, the read of this particular installment, of cancer and malignant tumors, is not an easy one. But I rather believe that we must celebrate life as these two woman did, one whom had lost all her hair and much more, but retained her dignity and respect, and the other, a slim woman wondering, perhaps, if she will have the strength to deal with such a disease should it arise in her own body. I am wondering if between them, as they stand here, their palms face to face, that there is a linkage between Mother and Daughter that medicine and science cannot explain? Indeed, can the bridge of life between generations be more than just the coils of DNA?
Perhaps celebrating this moment is all that can be explained.
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