Cancer roulette

To me, both sides of the argument actually make sense — but first, the two sides themselves.

Not long ago, within the last couple of weeks in fact, a mathematical modelling study of cancer patients came to the conclusion that a vast number of cancers are just the result of bad luck.

On the other side, physicians who treat cancer didn’t take long to kick back: afraid that people might take the “bad luck” explanation as a justification to behave any way they liked, the physicians were quick to point out that there are direct causal links between certain exposures and certain cancers. Smokers tend to get lung cancer, for example, and those who love the sun face increased risks of skin cancer. Don’t get me started on specific things like asbestos.

Clearly, the cancer physicians are right, and are rightly pulling out their hair: certain exposures lead to increased risks of certain cancers. Full stop. But the obverse is also true: all smokers don’t get lung cancer, and all sun worshippers don’t develop melanoma. In fact, almost everyone knows an outlier — someone who smokes like a tilt and seems to be fine, for example.

I think there’s actually some middle ground here — but my idea is not really all that scientific.

I think of it all as a giant crown-andanchor carnival wheel, except one you don’t want to win.

Every day, we do things that spin the wheel: I like salami and other preserved meats, things that contain nitrites. As the Canadian Cancer Society points out, “The evidence is convincing that eating processed meat increases the risk of colorectal cancer. The reasons why eating processed meat increases the risk of colorectal cancer are currently being studied.”

A couple of slices of Genoa salami, and another spin.

You can smoke, and take the extra spins of the wheel that smoking entails. You can be exposed, day after day, to industrial contamination from a local plant — some of the exposed people might get cancer, others won’t. For those who do, a cell clicks over and starts the chain.

My mother, a biologist by training, used to use scientific-grade carbon tetrachloride as a spot remover. The U.S. Environmental Protection Agency describes it like this: “Studies in animals have shown that ingestion of carbon tetrachloride increases the risk of liver cancer. EPA has classified carbon tetrachloride as a Group B2, probable human carcinogen.”

Maybe that mutagen triggered the cancer she developed.

Or maybe she — and my dad, for that matter — lost on the spin of the wheel that was the 1985 diethylene glycol adulterated wine scandal. I know they drank some of the wines — they pointed out one night during dinner, and, scientists both, emptied their glasses. Maybe that was the chemical spin that launched their eventually fatal tumours. Who knows?

I remember writing about people who were accidentally exposed to polychlorinated biphenyls — PCBs — and feared they’d get cancer, while at the same time having an electrical engineer tell me he didn’t believe that PCBs were a problem, and that he and his crew had washed their hands in PCB-laced transformer oil to get the creosote off their skin. I know another petroleum industry engineer who won’t let even a trace of refined petroleum products touch his skin, from Varsol to gas to anything in between.

You spin the wheel, you take a chance. A cell mutates in one of a number of ways, and you’re off to the cancer races.

What you do control, to some degree, is the number of spins you take. You lower your chances by not spinning the thing so often. But you just might lose on the very first spin.