Can­cer roulette

The Compass - - OPINION -

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-and-an­chor 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.

Rus­sell Wanger­sky is TC Me­dia’s At­lantic Re­gional colum­nist. He can be reached at rus­sell.wanger­; his col­umn ap­pears on Tues­days, Thurs­days and Satur­days in TC Me­dia’s daily pa­pers.

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