Is there a solution to the puzzle that is cancer? The fundamental … – Sciencenorway

Jarle Breivik is critical of claims that we are approaching thesolution to the cancer puzzle.

The solution to the puzzle is not what we think it is, Breivik, aprofessor of medicine, says. In a book with the name The solution to thecancer puzzle, he explains the fundamental cause of the disease and why asociety completely without cancer is perhaps not something we should wish for.

New advances are constantly being made in cancer treatment. Fortunately,twice as many people survive their diagnosis today as did 50 years ago,according to the Norwegian Cancer Society.

But that doesnt mean that we are about to be rid of this plague. It isestimated that the number of cancer cases will increase as we approach 2030.This is because the population is growing and the proportion of elderly peopleis increasing.

The better we get at treating cancer and other diseases, the longer welive, and the more cancer there will be in the population, Breivik said.

This is the paradox, because cancer is closely linked to ageing and to thehistory of how our biology has developed over time, according to the Professor.

Breivik is head of department at the Department of Behavioural Medicine atthe University of Oslo.

Why does cancer even exist? Why are our own cells suddenly transformedinto something resembling a monstrous parasite that destroys the body from theinside?

Let's say it like it is: Cancer is cruel, Breivik writes in thebook.

He remembers his first encounter with cancer.

As a young medical student, he was carrying out a dissection at theDepartment of Anatomy at the University of Oslo.

We were assigned a large, old man who had donated his body to science,Breivik said.

Over several weeks, Breivik and his fellow students worked their way throughvarious parts of the body with scalpels, scissors and tweezers.

It was a fascinating journey where we were constantly surprised byhow ingeniously the body is organized, recalls Breivik.

The book Lsningen p kreftgten (The solution to the cancer puzzle) was written by Jarle Breivik and was published in 2022. (Photo: Pitch forlag)

But a little way into the chest cavity they discovered something thatdidn't add up.

The nerves and blood vessels disappeared into a grey shapelessmass. The trachea and oesophagus were surrounded by the same stuff.

When the students put their scalpel into this tissue, it made a crunching sound, as ifthey were cutting sandstone. It was cancer.

The tumour had arisen in the intestine and then spread to other organs,such as the lungs and lymph nodes in the chest cavity. The cancer had grownwild, Breivik writes.

Cancer develops from the body's own cells, and the chance of the cellsrunning wild increases with age.

You don't necessarily die from it, but with it.

A centenarian who has not been diagnosed with some form of cancer hasprobably just not been examined well enough. And that is probably the best forall parties, Breivik writes in his book.

Artistic illustration of cancer in the body. (Illustration: Kateryna Kon / Shutterstock / NTB)

The fact that we age and get cancer is due to how the human body has beendeveloped over millions of years of evolution, explains Breivik.

Life, and how it has evolved and developed, is driven by the ability ofgenes to copy themselves.

It started with small proto cells. Through evolution, genes developedincreasingly better and more advanced ways of copying themselves.

Cells began to cooperate in large colonies and formed advanced organismssuch as animals and humans. This was driven by the fact that the organisms thatwere best at reproducing and surviving passed on their genes.

We often talk about our genes. But really, we are their body. Theyhave developed ways to ensure we copy them on to the next generation, saysBreivik.

The most fundamental reason why humans and animals get cancer because ofthe way our genes go in two different directions a few days afterfertilization, Breivik said.

While one copy of the genes is carried by germ cells on to the nextgeneration, another copies itself to all the cells that form the skin,skeleton, brain and all the other organs in the body.

The body cells are a dead end for genes, because sooner or later they willdie. Only the genes that accompany the germ cells are passed on.

The body's cells are like an ant colony with soldiers and worker ants whodo the work so that the queen ants, the germ cells, will continue and make newanthills somewhere else, Breivik said.

Theres no genetic advantage for the body to live for 200 years.

As soon as we've had children, we've pretty much done what our geneshave created us for. But since children need a lot of follow-up and care, itsclearly an advantage for parents to live long enough for their offspring totake care of themselves, Breivik said.

Some studies show that having grandparents can also be a biologicaladvantage.

But having 16 surviving great-great-grandparents, who also need food andcare, is not necessarily an advantage for the gene's ability to copy itself andpass itself on, Breivik said.

Our cells are therefore genetically programmed to die and waste away as weage.

Cells that have errors in this program develop into cancer, Breivik says.

We have 30 trillion cells, all of which contain two metres of DNA, whichagain consists of six billion nucleotides. These are the "letters" inthe genetic code that must all be copied every time a cell divides.

As we age, more and more errors can crop up in the copying of the code.

The genes have developed several control mechanisms to prevent us fromdeveloping cancer early in life, including DNA repair, programmed cell deathand immune cells that attack and kill cancer cells.

But some cells trick these mechanisms, survive and gradually develop intocancer.

It is always the "smartest" cells that survive, and Darwin'sprinciple of evolution by natural selection also applies inside the body,Breivik said.

As soon as they get a chance, they copy themselves. Cancer is preciselythe opportunity the genes in the body's cells have to copy themselves for aslong as they can, he said.

As with other brutal realities in nature, no malice is involved.

Genes are simply indifferent, Breivik said.

So what do we need to solve the cancer puzzle? Breivik says there are twopossibilities, in principle.

The fundamental problem is how our body is put together, which is as atemporary cell colony that will pass its genes on to the next generation, hesaid.

The first possibility is therefore to make the body immortal using biotechnology, Breivik said.

This may sound a little utopian. But we are developing increasinglyadvanced technologies to reprogram or replace the cells in the body as they age,he said.

For example, work is being done to grow new organs in laboratories and tofind medical treatments that slow down ageing.

By removing ourselves from natural biology, one might be able to extend life and prevent diseases such as cancer in the future. But this will create other issues, Breivik writes in his book. (Illustration: Marko Aliaksandr / Shutterstock / NTB)

In principle, cancer could be avoided by constantly renewing the cells inthe body, according to the professor.

It will hardly be cheap, and one can wonder what kind of world we will livein if no one dies. Or will the rich become immortal, while the poor die asearly as before? Breivik asks.

At the same time, it is not necessarily the body that we are mostconcerned with taking care of. It is the soul, or self, that we really want totake care of.

The problem is that the body takes our identity with it in death. Thesecond and ultimate solution would therefore be to get rid of our bodiesand move into the digital world.

Today's developments in biotechnology and artificial intelligence areredefining what it means to be human. But where are we really going? asksBreivik.

He warns that the solution to the cancer puzzle could be theend of humanity as we know it.

This is because we are actually the problem, he said.

Lars Andreas Akslen is a cancer researcher and professor at the Universityof Bergen.

He says that the understanding of cancer that Breivik presents, about howthe body is put together and our history of development, is not particularlycontroversial.

I think there is a lot of sense in this explanation, he said.

He agrees that there will probably be more cancer in the future as lifeexpectancy increases.

If you imagine that we have the constant pressure from environmentalinfluences, then I think it is a completely logical prediction that there willbe more cancer in society as a whole as people get older, he said.

What Breivik writes about as the solution and future possibilities withbiotechnology is a serious problem that has more to do with just cancer, Akslensaid.

There is great development potential going forward in this vein, which canaffect both our susceptibility to cancer and other diseases, he said.

This is an extensive problem both when you look at ethics and the economy and that the elderly will displace the young, he said.

Akslen points out that the increase in cancer cases applies to many, butnot all types of cancer.

Just think of cervical cancer, which has a curve that goes completely theother way as a result of screening and the HPV vaccine programme, he said.

The incidence of stomach cancer has fallen sharply as the ulcer bacterium hasbecome less common and can be treated effectively.

Theres also been constant progress on the treatment side.

This is what the whole world is working on, finding ever new and everbetter treatment regimens that can do one of two things, either remove thecancer cells completely or keep the disease in check, Akslen said.

There are a number of examples of this. Just think of childhood leukaemiaand testicular cancer, which used to be fatal diseases, but now the patientscan be cured, he said.

Other treatments can keep the cancer at bay.

Breast cancer is one example, where many people can live many, many yearswith this as a chronic disease, he said.

My experience after being in this field for a long time is that you neverreally know where the advances will suddenly come from, Akslen said.

He doesnt think we will find one solution that will make cancer no longera feared disease. The multiple forms of cancer are too different for that.

Evolution takes place in a cancerous tumour, much like how bacteria andviruses change and evolve to bypass antibiotics or vaccines.

This is the frustration with cancer and cancertreatment. It's so unpredictable. Cancerous tumours are like a kind ofevolutionary magicians that constantly try to find new loopholes in the fightagainst the host organism, he said.

Translated by Nancy Bazilchuk

Read the Norwegian version of this article at forskning.no

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Is there a solution to the puzzle that is cancer? The fundamental ... - Sciencenorway