Cancer, Public Health, and Death

I never really knew anything about cancer. There’s zero of it in my family. No one I knew or loved growing up died of it; not a grandparent, great grandparent, uncle, or cousin – on either mom’s or dad’s side – with one exception. My dad’s sister, an aunt I knew well, died in her late-40s (I think) of breast cancer. Otherwise, nothing.

As a consequence, over time by a kind of osmosis, I came to think that cancer was likely a genetic disorder, with the possible odd case from some environmental exposure, like asbestos or some other serious carcinogen. I remember some discovery in the Nineties or the Aughts seemed to “prove” that cancer was a “genetic disorder.” For whatever it’s worth, if you search with Google using “cancer as a genetic disorder,” you get 66,000,000 results, with websites like Susan G. Komen, the National Institute of Health, the Mayo Clinic, and many, many others, all discussing the BRCA1 and BRCA2 genes, which synthesize proteins that suppress tumor growth by repairing damaged DNA. Epidemiological studies show a strong link between a mutation on these genes and increased risk of breast cancer, in both men and women. So, there we go: cancer is just a case of bad genes or unlucky exposure… and so goes the current zeitgeist. We’ll come back to this in detail a bit later, but for now suffice it to say that the majority of work around cancer centers on the belief that cancer’s cause is a genetic mutation issue.

“Public health” is a fascinating concept, but unfortunately it’s a lot like every other word that you put “public” in front of… I invite you to try ‘bathroom,’ ‘transportation,’ and ‘nudity’ and run them around in your mind for a bit as a mental aperitif. ‘Schools,’ beaches,’ and ‘pools,’ fare only slightly better, but a pattern starts to emerge.’Public Servant’ is the one I’d really like you to mull over for a bit; after that, ‘public health’ falls right in line. Some of you may be offended by that, but that because you’ve been programmed – quite hard – to believe differently. I’m going to try to convince you of that with this one example that likely goes against what you’ve been told or to think. Suspend your disbelief for a minute.

There’s a Mister Death Here….

Chilling Scenes of Dreadful Villainy: Room For One More, Part 18 : Mr Death - The Grim Reaper ...
I have to admit, I kinda have a fetish for the CDC’s annual mortality statistics. It’s probably not healthy, but I can’t help myself. Did you know that roughly 2.8 million people die in the United States every year? That was (roughly) the number in 2017: 2,813,503. It’s been going steadily up for quite some time. In 2000, the CDC says it was 2,403,351. When I first started looking into those numbers, I was like, “Holy hell!! Almost 2.5-3 million people croak every year?!?” My first thought was that there couldn’t possibly be that many old people just timing out every year. I didn’t know just how depressingly correct I was.
People lose their minds about assault weapons and school shootings; it dominates almost all of our political discourse, media coverage, protests, but if we’re really interested in addressing “public health” concerns, we should start with the most deadly things, right? I mean, if you were dealing with all of the problems in your yard, for example, you would start with the most pressing problem, the most pervasive pest or threat, most whatever and at least address that first, and then maybe work backwards down the list from worst to least bad, right? You start by trying to plug the largest hole in the sinking ship, not the smallest; nor is it the time to address the paint scheme, while the water overwhelms the bilge pumps.
Assault weapons aren’t even a blip on the radar of “public health” if we measure that by who’s dying and we’re all about saving lives. For example, in 2011, “assault weapons” (yes, the term also deserves the quote marks) “killed” (and so does that) fewer than 323 people. How do I know it’s fewer than 323? There were 12,664 murders in 2011 reported according to the FBI’s Uniform Crime Report. 6,220 were committed with handguns — about half of the total. By comparison, a rifle of any type was used on only 323 people, but rifle murders aren’t split out by “assault rifle” (as it’s been politically defined) versus regular, plain old garden variety rifles. It is a certainty, however, that “assault rifles” are a smaller subset of total rifle/long-gun deaths, so it is undoubtedly less than 323.
For a random comparison, there were 32,479 fatalities involving motor vehicles in 2011, according to the Nat’l Highway Transportation Safety Ass’n (NHTSA). That is two orders of magnitude more, and while we certainly spend some time on anti-DUI laws and some media campaigns around motor vehicle deaths, would you be willing to bet a paycheck that as a nation we’re spending roughly proportional amounts on the two as “public health” concerns? Me neither.
But what about cancer? It dwarves even highway deaths by an order of magnitude and a multiple. According to the American Cancer Society’s numbers, in 2017 there were 600,920 deaths from cancer in the U.S.; the worse news is that there were also 1,688,780 new cases of cancer in 2017. The CDC’s data is usually close to the ACS’, but it’s in a format I can’t pull on a Mac, so let’s just stipulate that cancer caused a BIG chunk of that 2.8 million, especially when compared to “scary guns” – which have been called an “epidemic” and all kinds of other apocalyptic language – or even motor vehicle deaths, or just about anything, with the exception of a cluster of related illnesses, diabetes, coronary artery disease, stroke, et al, all of which account for another big chunk of that 2.8 million. My concern for this piece, however, is cancer.
According to the World Cancer Report, in 2012 there were 14.1 million new cases of cancer globally, estimated to have caused 8.2 million deaths. It is believed (annually) to constitute 14.6% of all human deaths, or about 1  in every 7. Given that list also includes things that kill people on a large scale, such as war and famine, cancer isn’t merely significant, it is the modern plague.
And not to pile on, but the recent claims of good news on cancer deaths is pure PR and tells us a lot all by itself about how we’re doing in fighting cancer. From just one of many recent media pieces touting the “good news” surrounding cancer:
From 1991 to 2016, the U.S. cancer death rate dropped steadily by about 1.5 percent per year, resulting in an overall decline of 27 percent during the 25-year-period, according to the report from the American Cancer Society (ACS). That translates to an estimated 2.6 million fewer cancer deaths than would have been expected if death rates had remained at their peak level, the researchers said.
(My italics on the important part that hides the misdirection above it.)
Understand what this means, only that the growth rate of fatal cancer is slowing. In reality, where we count each individual loss of life as a death, the number of people who died from cancer last year (2018) was higher than it was the year before that. Which was higher than the year before that. And on and on, etc. In the CDC Mortality statistics, you will find that “malignant neoplasms (C00-C97)” – that’s the CDC’s code for cancer – were 599,108 in 2017; In 2018, it was 599,274, or another 166 MORE people died of the same effing thing.
But hey, rates are dropping! I love it. Dr. Thomas Seyfried covers this quite well in this lecture. Go to the one-minute mark and he has the cancer statistics from the American Cancer Society, along with an in depth explanation on his slide entitled “Is the War on Cancer Going Well?” The data covers 1990-2015 and shows that by any honest analysis, the answer is a resounding “No.”
We have more new cancer cases every day and more cancer deaths per day, year over year over year – the numbers go in only one direction and it isn’t down – yet somehow we’re told there is good news(!) by the media. So good, in fact, that people are fighting to take ‘credit’ for it. The headlines on the search I put in “cancer death rates lower” in DuckDuckGo produces these absurdist results: “Trump appears to take credit for lower cancer death rates” from USA Today; “Trump Took Credit for Lower Cancer Death Rates. Advocates Say Not So Fast” from the NY Times; and “Trump makes misleading brag about lower cancer deaths…” from Politico (notice how in Politico, it has now been changed from “rates” to just “deaths”, which is completely and totally wrong), all which also tells us a lot about the tenor of our age. Try to imagine any other statistic involving dead Americans where the politicians and Media are arguing over who should get the credit for higher numbers…but MUH lower rates, Ozy! 
Cut to Walter Kronkite: “Good evening, America. Here is the news for today, April 23, 1970. Great news this evening from the Vietnam War where death rates have gone down for the third straight year! That’s right, compared to the peak in 1967, we here at CBS Evening News are happy to report that the death rate has dropped yet again! President Nixon has publicly claimed credit for the plummeting rates, while democrats in Congress have publicly chided the President for taking credit…” etc.
That should tell you everything you need to know about how we’re doing in the fight against cancer. It’s government-fueled propaganda. (I’ll explain why that is later during Tin Foil Hat Adjustment time).
Part of the terror with cancer, as opposed to school shootings, motor vehicle deaths, or even war, is that the latter three feel controllable. Yes, yes, we’re all aware that driving is statistically dangerous, but… at least I’ve got my hands on the wheel! I have some control. School shootings could also be solved, we tell ourselves, with – go ahead and say it, I know you know the line – “common sense GUN CONTROL!!1!1!” Cancer, however… well, as I note above, it seems to be just a matter of random chance. Nothing you can do about it, so no sense in really getting worked up until and unless it strikes someone you know.
…But what if that weren’t the case? Hypothetically speaking, what if our sense of the causation of these things were wrong? And how might one investigate to see if cancer might be caused by something else besides bad genes or repeated exposure to a toxic substance? Where does cancer even come from? Has it existed in every society, everywhere, throughout all of human history?? What is the earliest recorded case of cancer? These are the kinds of questions that were bumping around in my head, but that I had never really given much thought until a work trip some years ago took me to Omaha, Nebraska.

What is cancer?

Otto Warburg was a German scientist of Jewish descent, the son of a famed physicist, Emil Warburg, who counted Albert Einstein among his friends, and had two of his students later win Nobel prizes, in physics and chemistry. The younger Warburg was already a star in academia by the time WWI began and he astounded everyone in his family and at the Kaiser Wilhelm Institute where he worked by volunteering for the German Army. In the field, he was promoted to a position as a cavalry officer in the famed Prussian Guards and won the Iron Cross for bravery. When the war looked all but decided, Einstein himself wrote to Otto at the front in an attempt to convince the younger Warburg to “support our efforts in securing your personal safety” and accept a reassignment back to Germany, lest a mind such as Warburg’s be lost in “that big scuffle.” Fortunately for the world, Warburg returned home and thence back to the Kaiser Wilhelm Institute, where he would later be the head under Adolf Hitler. Warburg would go on to receive 3 separate nominations for the Nobel prize in distinct areas of study, including winning the vaunted prize in 1931. That Nobel came as a result of research Warburg did in the early 1920’s.

In a paper published in 1924, Otto Warburg proposed the following:

“Cancer, above all other diseases, has countless secondary causes. But, even for cancer, there is only one prime cause. Summarized in a few words, the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by a fermentation of sugar.”

This was news to me when it was first pointed out by my good friend and mentor, Greg Glassman (yes, that guy). We were traveling together and, like most trips, it meant time to talk about a variety of subjects, after which I usually had some hours of homework to do. In this instance, we were discussing nutrition on our way to a quasi-political speaking engagement in Omaha, Nebraska, to a relatively ‘libertarian’ think-tank (the Platte Institute) and the subject of nutrition was at the forefront of Greg’s talk.

“Look up Warburg on cancer,” my friend adjured me. “You won’t believe it.”

It turns out that no one has ever disproved, or even disputed, Warburg’s Theory. I’m elevating it to that level because it is certainly more than conjecture or hypothesis, though maybe not quite Law, but modern PET scans are based upon, and constitute at least partial proof of Warburg’s claim. The process by which the tumor “lights up” on a PET-scan referred to as “the Warburg effect.” Positron Emission Tomography consists of injecting or drinking a short-lived radioactive tracer isotope into the blood’s circulation. From wikipedia:

The tracer is chemically incorporated into a biologically active molecule. There is a waiting period while the active molecule becomes concentrated in tissues of interest; then the subject is placed in the imaging scanner. The molecule most commonly used for this purpose is fluorodeoxyglucose (FDG), a sugar, for which the waiting period is typically an hour. During the scan a record of tissue concentration is made as the tracer decays.

So what does that mean? Well, as Warburg pointed out, cancer cells don’t function the way normal cells do. Cellular respiration in a non-cancerous cell generally occurs by a process known as glycolytic oxidization – glycolysis, for short. In short, the cell takes blood sugar – glucose – and breaks it down into component parts to produce adenosyne tri-phosphate, ATP. ATP is the energy molecule that drives all biological processes. ALL. Even plants use sunlight to produce ATP in photosynthesis – while that is a very different chemical process than humans, the point is that ATP is the energy-producing molecule of all living things. Click here for a good, quick and dirty on ATP.

Healthy cells in humans can also produce ATP from the other two macronutrient molecules of the human diet, lipids and (under unusual circumstances) proteins. Cancerous cells, however, cannot produce ATP from anything other than glucose. Let me say that again for emphasis and also add a minor caveat: (the vast majority of) cancerous cells cannot produce ATP from anything except blood sugar; not from lipids, rarely from proteins. Cancer cells are also much more metabolically active than normal cells. They preferentially consume glucose over normal cells, in some cases by more than 200 times the rate. Thus, in a PET scan, the cancerous tumor cells gobble up more of the radioactive sugar, which “lights them up” as the isotope decays, producing the 3D image of the tumor. This is “the Warburg Effect.” So, the takeaway point is that cancer cells live on blood sugar, have a much higher metabolism than normal cells, and also don’t die – they do not undergo “apoptosis” – which is why they result in masses, or tumors, inside of their hosts.

Is there any group of people that doesn’t get or hasn’t gotten cancer?

Time for a divergence from biochemistry for some anthropology and to begin gnawing at one of my questions above: has there ever been a “cancer-free” society? Vilhjalmur Stefansson, born William Stephenson, was a Canadian Arctic explorer. Among his journeys was a notable stay with the Inuit in the early 1900’s, right as Warburg was beginning to get his PhD in 1905. Stefansson documented that the Inuit/Eskimo diet was comprised almost solely of fish and meat, with only a rare few carbohydrates from berries during the summer months. Captain William Levitt was a ship’s captain who frequently provided supplies to Stefansson’s explorations and also helped to confirm and document the Inuit diet of high-fats, moderate protein, and almost zero carbohydrates. It turns out that several anthropological, and archaeological, studies have examined the diets for a number of hunter-gatherer societies that were very low in carbohydrates. Many of these ancient societies – much like the Inuits – were entirely absent of cancer. I’ll let the impact of that sink in. When Stefannson first reported his experiences among the Inuits, particularly their diet, scientists and the medical establishment of the day called bullshit. They simply couldn’t believe it was true. Stefansson later wrote a book called “Cancer: disease of civilization? An anthropological and historical study.” He was among the first people to coin that phrase of cancer as a “disease of civilization.”

On a seemingly unrelated note, some of the most famous archaeology – and most interesting to even the modern lay person – surrounds ancient Egyptian society. The Great Pyramids, the Pharaohs, mummies, are probably a large part of the draw, and deservedly so. What I found interesting was a backhanded comment Greg made to me a while back about the instances of cancer found among the ancient Egyptians, one of the earliest civilizations that we know of that was largely agrarian. Dr. Michael Eades, author of “Protein Power,” has discussed this on his blog:

According to the New York Times, Hatshepsut’s mummy is that of an obese, diabetic 50 year old woman with bad teeth. All the conditions that nutritionists today would have us believe would be prevented by Hatshepsut’s diet. It certainly didn’t work for her. And she is not a special case – most Egyptian mummies show the same disorders, especially the bad teeth. The skeletal remains of Paleolithic man, who consumed a meat-based diet, showed strong, perfect teeth. Bad teeth are the hallmark of carbohydrate consumption.

Obesity in Ancient Egypt, Dr. Michael Eades.

How did humans evolve to agriculture?

As a matter of human evolution, it’s easy to understand that the very beginnings of human intelligence would have consisted of socialization. It’s largely how we’ve arrived at the top of the food chain, at least on land. We certainly didn’t do so by physical prowess. Try imagining one lone human being defeating a pride of lions or tigers or even hyenas, or surviving against any of the myriad of animals in the varied environments people have lived: bears, wolves, alligators, snakes, etc. The fact is that we’re not the most physically capable species, but when we band together and use our natural gifts, we can be deadly effective. For some examples, opposable digits gave humans the ability to make complex tools, including weapons. It wasn’t just that, however. Humans also have the unique ability to throw on the run, as well as turn our torso so that we can run in one direction and throw in another, an ability no other predator has. (It may help explain why we revere football quarterbacks and baseball shortstops who demonstrate this at the highest possible level of athletic competition). We also have the innate ability to cool ourselves via sweating, which allows us to run incredibly long distances in hot conditions and persistence hunt animals to exhaustion; a near extinct skill with the advent of other means of locomotion, but in our nascent stages of development, it was the difference between eating or not, between survival and death. Then we found a way to domesticate dogs and horses and we went far beyond survival and rose to the top of Nature’s food pyramid. It’s rather easy to envision the emergence from small hunter-gatherer tribes to builders, to small villages, to larger settlements, to the invention of crude tools for digging, to domestication of beasts of burden, to subsistence farming, to larger scale agriculture, and on and on. Human evolution does not begin with agriculture; it ends with agriculture – and concomitantly larger settlements – and then come the “diseases of civilization,” diabetes et al, and cancer, chief among them.

Agriculture consists of the planting and harvesting of largely wheat or grain or corn crops, all of which share the same common nutritional property – they are carbohydrates. This is in direct contrast to the diets of hunter-gatherers that would have preceded agriculture: meat from animals, perhaps some berries, nuts or seeds (depending upon the climate), and the occasional vegetable/root/tuber growing in the wild. This is exactly what William Stephenson and Captain Levitt found among the Inuit peoples. They didn’t find agriculture because you can’t grow corn while crossing a frozen land bridge from Siberia to Alaska over the course of dozens of generations. There were no fields of wheat, or barley, no amber waves of grain or corn to feed the tribes of Eskimo. It was fish and fat, as well as fasting, day in and day out, for weeks, and months, and years.

In part 2, we’ll take a little peak at biochemistry, standards of care for cancer, and return to “public health” interventions.