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What Caused the Cancer

Posted 5/3/2016

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  Even when we understand that they are ridiculous, most of us have theories about what caused our cancers. Sometimes there is reality: exposure to radioactivity or asbestos, heavy smoking and drinking. More often, however, we are trying to pin the blame on diet or behavior or geography or life style choices, hoping both to understand and then to control. If we knew that X caused the cancer, we could eliminate it from our lives.

  One woman believed that her dog caused breast cancer by stepping on her breast. Many believe it was too much sugar or stress. My personal (and I know this is probably nuts) theory is that my father's job of supervising the construction of the army's first nuclear reactor, coming home every evening probably loaded with exposure, was eventually the culprit for his cancer death (that part probably is true) and my mother's and my breast cancers.

  The truth is that, except in a few cases (think BRCA mutations), no one really knows what causes cancer. There has to be a perfect storm of mistakes in our cells to cancer to begin.

  Here is a nice essay from The New York Times about all of this:

Wondering What Caused the Cancer
By Mikkael Sekeres, M.D.

“But what caused it?” my patient asked, referring to the failure of her bone marrow to make the blood cells
the rest of her organs craved. She was profoundly anemic and seemed to tire from even asking the question.
Dozens of my patients have asked the same thing. Even a dozen dozen.
I think the question reflects a human desire to revisit events that occurred over a lifetime, and speculate
whether a change in course could have avoided an untoward outcome.
In truth, though, except in very rare cases, it is almost impossible to say that a specific environmental
exposure triggered a given person’s cancer. The majority of cancers arise randomly, as if thumbing their nose at our collective need to find a cause.
But that doesn’t stop me from trying, during the part of the clinic visit when it’s my turn to ask the questions.
And sometimes, I even convince myself that I have uncovered that nugget of truth that explains disease.
One patient, a man in his 70s, told me he served in the military.
“Which branch?” I inquired.
“Navy,” he said proudly.
“Did you see any action?” I asked.
He glanced at his wife briefly, as if checking in with her that it was all right to tell this story she had probably
heard hundreds of times before. She nodded slightly, giving her permission.
“I was on one of the ships that was active during the Cuban Missile Crisis,” he said.
“Wow!” I said, incredulous. “What was that like?” 

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