Six Cell Rules Broken by Cancer

How do cancer cells do their thing? Why are they so dangerous? Why can there be cancer in essentially each organ of our bodies? What makes them break the rules of cell existence? I have no answers to any of those questions, and as far as I can tell, the scientists don't know a whole lot more than I do about the origins of cancer. But, since I was diagnosed with gallbladder cancer, I have been trying to acquire a real layperson's understanding of the disease. I just read an article that helped me (although, goodness knows, I didn't understand all of it). Mostly, I really, really learned a lot from a small side box to the article entitled "Hallmarks of Cancer."

The article is in the March, 2007 edition of Scientific American, and it's entitled "Mapping the Cancer Genome," about efforts to begin mapping the genes involved with cancer as a way of learning more about the disease in general, and hopefully, ways to treat it. The project is called the Cancer Genome Atlas Project, and the plan is for it to follow the pattern established by the Human Genome Project, which completed mapping of the human genes about three years ago.

But the sidebar talks about the SIX rules of cell existence that are broken by cancer cells! How do they get away with it? Why don't our natural defenses step in after step 1, or 4, or 6 is broken? In the article itself, the author comments that "Some mutations may disable genes that normally protect against abnormal cell behavior, whereas others increase the activity of disruptive genes. Most cells must acquire at least several of these alterations before they become transformed into cancer cells - a process that can take years." (p. 52)

The sidebar begins by commenting the six abnormal capabilities listed below together give tumors their lethal power to overrun their native tissue and spread through the body.

Here are the Six Cell Rules Broken by Cancer:

1. "Self-sufficiency in growth signaling. Cancer cells amplify external growth cues or generate their own."

2. "Insensitivity to antigrowth signals. Cancer cells become deaf to quiescence cues from surrounding tissue." (I'm a little fuzzy about this one, but I think it means that cells signal each other that it's time to grow or time to stop growing, but cancer cells don't listen to the "stop growing" message.

3. "Evasion of Cell Suicide. Mechanisms that should trigger or carry out a self-destruct program in damaged cells are disabled or overriden." (This is the apoptosis I've been writing about for months.)

4. "Limitless replicative potential. Cancer cells evade intrinsic limits on the number of times a normal cell can divide."

5. "Sustained blood vessel growth. Tumors emit signals promoting the development of new blood vessels to deliver oxygen and nutrients." (This is why one of the most promising new anticancer drugs, Avastin, is in trials for most/many cancers. It was included in the clinical trial originally proposed to me last summer, and I may still add it to the regimen.)

6. "Invasiveness and motility. Cancer cells defy multiple signals and forces that hold a cell in place and prevent it from traveling to - and thriving in - other tissues." (This is the metastasis that is so dangerous to those of us with cancer, where the cells wander about the body until they find a spot to settle, divide, and grow, and become a danger to this new organ.)

Anyone reading this with more knowledge of biochemistry and these statements, please feel free to chime in!

So, today is Day 10 of this cycle, and I felt really, really tired and sleepy earlier in the day, but have felt better as the day went on. I told folks at church I felt "floppy." Now I'm not peppy, but better. I was nauseous a lot yesterday, and had better appetite today. Now I'm on the downward slope of this cycle, and hoping that each day is better than the one before. Twelve days until we leave for St. John! Yeah for sunshine and swimming!

Can Cancer Cells Change?

Let me start by saying that I have no idea of the answer to the question asked. I'm not a scientist, not a researcher, I have only a general lay understanding of what cancer cells are and how they come to be. But, in my exploration of blogs written by others with cancer, (this time from a blog by Teresa, who has oral cancer) I came across a link to a website that presents an animation of the inner life of a cell.

The animation is facinating, accompanied by wonderful piano music, and presents elements of cell life that I've never seen before. The Inner Life of a Cell is worth watching, perhaps over and over.

When I watch, I wonder if seeing the animation can somehow help my cancer cells "learn" how they are supposed to be, if they were healthy, functional cells. As I asked before, I wonder if cancer cells can learn, can change, can be different from their mutated selves. Can they be normal? So, the scientists may say not, but who knows? The more I learn about cancer and cancer treatment, the more I see that it's both a science and an art, and that so much is unknown.

I want to know more about how healthy cells function when I see this, about the elements of a cell. There is information from the producers of the animation, but it focuses more on how they created the animation, rather than the science. You can read what the animators say here. Apparently, the animation was created for Harvard University biology students.

So, I watch this animation and I wonder "Can Cancer Cells Change?" Or, do they just need to die and stop threatening the life of those, like me, that they live in?

Visualizing the Cancer

In two earlier posts, (Cancer: Call it Enemy or Call it Friend? and Naming the Relationship with Cancer, Pt. II, both from August), I wrote about the difficulty I was having trying to ascertain my relationship to my cancer. The "Cancer: Call it Enemy or Friend?" post drew quite a few impassioned responses. Those responses, my further thinking, conversations with friends, and meditation, have all helped me further clarify my relationship with the cancer.

In August, I was meditating and decided to "talk" to the cancer. At that point I didn't try to visualize it, I just had a conversation. I told the cancer not to rush, that there was no place in my body it needed to move to, and that it didn't need to be moving around. I told it that its presence endangers my life, and it needs to go. This may sound a little "rational," but it worked for me. And, I have to say that when I got my second clean scan, mid-September, I remembered that conversation, and had an odd feeling that somehow the cancer was cooperating, had been "listening." I was also struck that the oncologist said my cancer was "pokey." Just what I had envisioned!

In September while meditating, a visualization about the cancer came to me spontaneously. I imagined a beautiful sunset, full of reds, purples, oranges, pinks; a totally gorgeous sunset. I imaged the cells, arm in arm like Dorothy and the Tin Man, Cowardly Lion, and Scarecrow from "The Wizard of Oz" dancing and skipping and running toward the beautiful sunset. As they skip and dance, I wave good-bye to them, and say "Apoptosis, Guys!" (At some point in my wandering on the web, I learned that it's the word for cell death. Cell death occurs naturally and normally in our bodies as cells die and replace themselves. One problem with cancer cells as I understand it in my non-medical way, is that they reproduce quickly, and perhaps don't die as fast as we would like.)

Now here's another really odd thing. After writing the previous paragraph, I just looked up "apoptosis" in the online dictionary, and there is an online medical dictionary that has this definition: "Programmed cell death as signalled by the nuclei in normally functioning human and animal cells when age or state of cell health and condition dictates. An active process requiring metabolic activity by the dying cell . . . . Cells that die by apoptosis do not usually elicit the inflammatory responses that are associated with necrosis, though the reasons are not clear. Cancerous cells, however, are unable to experience the normal cell transduction or apoptosis-driven natural cell death process." I didn't know that! Here I've been visualizing the cancer cells having a "normal" cell death, when it seems they don't know how! Maybe they can learn!

So, when I meditate, or see the sunset, or think about the cancer cells, I wave to them, see them dancing into this beautiful sunset, and say "Apoptosis, guys, apotosis!" Is it working? I don't know, but I hope so. And, it has the added benefit of giving me a giggle as I imagine the cancer cells dancing and skipping into the sunset. Laughing is definitely good for my soul and my body. Bye, cancer cells!