The Cancer Code: A Revolutionary New Understanding of a Medical Mystery

by Jason Fung

NOTE TO READERS

PART I CANCER AS EXCESSIVE GROWTH

(Cancer Paradigm 1.0)

1 TRENCH WARFARE

in medical research, opinions that dissent from the specified narrative are not welcome. This problem cuts across entire disciplines, such as the study of obesity, type 2 diabetes, and yes, cancer.

OBESITY

Few can admit that the advice to “eat less, move more” doesn’t work. Yet the crucial first step toward solving the obesity epidemic is to admit to our shortcomings.

obesity is a hormonal imbalance rather than a caloric one.

As the brilliant economist John Maynard Keynes is quoted as having said, “The difficulty lies not so much in developing new ideas as in escaping from old ones.”

TYPE 2 DIABETES

According to the CDC, about one in ten Americans suffers from type 2 diabetes.

this number has risen steadily over the past few decades, with no salvation in sight (see Figure 1.1).

Figure 1.1: Number and percentage of U.S. population with diagnosed...

we in the medical community (researchers, doctors) simply maintain the position that type 2 diabetes is a chronic and progressive disease, and that’s just the way things are.

None of this is true. When a patient loses weight, their type 2 diabetes almost always improves.

as with obesity, if we cannot acknowledge that the prevailing treatment protocol falls far, far short of acceptable, then we will continue to be powerless to help those suffering.

CANCER

progress in cancer research has lagged behind that of almost every other field of medicine.

3 In the article, Dr. Bailar noted that from 1962 to 1982, the number of Americans who died of cancer increased by 56 percent (see Figure 1.2). Adjusting for population growth, this still represented a 25 percent increase in the rate of death from cancer, at a time when death rates from virtually every other disease were dropping quickly; crude death rates from causes other than cancer had decreased by 24 percent.

In recognizing the failures of the medical community, Dr. Bailar bravely took the first step to making progress in the war on cancer.

Figure 1.2: Cancer deaths in the U.S., 1900–2000.

The war on cancer was reinvigorated by the continuing revelations from the study of genetics that took place throughout the 1980s and ’90s. Aha, we thought, cancer is a genetic disease.

Figure 1.3: Comparison of annual deaths from heart disease and cancer, 1969–2015.

By the mid-2000s, hope for the war on cancer was fading quickly. Then a strange thing happened. We started winning.

A NEW DAWN

The most pressing question in cancer research is the most elusive: what is cancer?

But what was cancer? It was a nebulous adversary, with hundreds of different variations to discern. Wars on murky ideas, like the wars on poverty, drugs, and terrorism, generally end in frustration.

Over the last one hundred years, our understanding of cancer has undergone three major paradigm shifts. First, we considered cancer a disease of excessive growth.

Next, we considered cancer a disease of accumulated genetic mutations that caused excessive growth.

Cancer is, improbably, a disease unlike any other we’ve ever faced. It is not an infection. It is not an autoimmune disease. It is not a vascular disease. It is not a disease of toxins. Cancer is originally derived from our own cells but develops into an alien species. From this paradigm of understanding, new drugs have been developed that threaten, for the first time, to end this war in the trenches.

2 THE HISTORY OF CANCER

While all types of cancer are different, this book attempts to discuss the origins of cancer as a whole, looking at the similarities among cancers rather than the differences.

This is the fundamental question of this book: What turns normal cells into cancer cells in some people in some situations, but not others?

Cancers were simply cells, albeit bizarre-looking cells with unregulated growth. This is what I call cancer paradigm 1.0, the first great modern paradigm of understanding cancer. It is a disease of excessive growth. If the problem is too much growth, then the obvious solution is to kill it. This logic gave us surgery, radiation, and chemotherapy, and is still the basis of many of our cancer treatment protocols today.

SURGERY

RADIATION

CHEMOTHERAPY

CANCER PARADIGM 1.0

3 WHAT IS CANCER?

In 2000, they decided to codify the principles of malignant transformation, publishing in the journal Cell a seminal paper titled “The Hallmarks of Cancer.”

THE HALLMARKS OF CANCER

Despite the hundreds of different types of cancer, all cancers share most of these eight commonalties, which are all critical features for survival of cancer cells.

Without most of these eight hallmarks, cancer would no longer be cancer.

The Eight Hallmarks of Cancer Sustaining proliferative signaling; Evading growth suppressors; Resisting cell death; Enabling replicative immortality; Inducing angiogenesis; Activating invasion and metastasis; Deregul...

Hallmark 1: Sustaining Proliferat...

Hallmark 2: Evading Growth Suppressors

Hallmark 3: Resisting Cell Death

Hallmark 4: Enabling Replicative Immortality

Hallmark 5: Inducing Angiogenesis

Hallmark 6: Activating Invasion and Metastasis