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DBL%20Hendrix%20small.png College chemistry, 1983

Derek Lowe The 2002 Model

Dbl%20new%20portrait%20B%26W.png After 10 years of blogging. . .

Derek Lowe, an Arkansan by birth, got his BA from Hendrix College and his PhD in organic chemistry from Duke before spending time in Germany on a Humboldt Fellowship on his post-doc. He's worked for several major pharmaceutical companies since 1989 on drug discovery projects against schizophrenia, Alzheimer's, diabetes, osteoporosis and other diseases. To contact Derek email him directly: derekb.lowe@gmail.com Twitter: Dereklowe

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October 20, 2010

Is Cancer A Disease of the Modern World?

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Posted by Derek

This paper in Nature Reviews Cancer is getting more attention in the popular press than most papers in that journal manage. Titled "Cancer: an old disease, a new disease or something in between?", it goes over the archaeological evidence for cancer rates in ancient populations, and goes on to speculate whether the incidence of the disease is higher under modern conditions.

I'd be interested in knowing that, too, but the problem seems to be that there's not much evidence one way or another. The authors concentrate on the evidence that can be found in bone samples, since these are naturally the most numerous, but it seems to be quite hard to get any meaningful histology data from ancient bone tissue. As for other tissue, the Egyptian record is probably the most statistically robust, thanks to deliberate mummification and the desert conditions, but even that isn't too definitive. The Greeks definitely described metastatic tumors, though (and in fact, gave us our name for the disease).

Still, they believe that the archaeological record indicates a smaller incidence of cancer than you'd expect, although given the long list of confounding factors they present, I'm not sure how sturdy that result is. One of the biggest of those is the shorter life expectancies in ancient populations, and it's not easy to get around that one. As the authors themselves point out, working-class ancient Egyptians seem to have mostly died at ages between 25 and 30 (!), and there aren't many forms of cancer that would be expected to show up well under those demographic conditions. (Osteosarcoma is the main tumor type the authors look for as being not so age-dependent).

The paper itself is fairly calm about its conclusions:

Despite the fact that other explanations, such as inadequate techniques of disease diagnosis, cannot be ruled out, the rarity of malignancies in antiquity is strongly suggested by the available palaeopathological and literary evidence. This might be related to the prevalence of carcinogens in modern societies.

But the press reports (based, I think, partly on further statements from the authors) haven't been. "Cancer Is A Modern Disease", "No Cancer In Ancient Times" go the headlines. (Go tell that last one to the ancient Greeks). And it's impossible to deny the environmental causes of some cancers - I'll bet that lung cancer rates prior to the introduction of tobacco into the Old World were pretty low, for example. Repeated exposure to some industrial chemicals (benzene and benzidine, right off the top of my head) are most definitely linked to increased risk of particular tumor types.

So in that way, modern cancer incidence probably is higher, at least for specific forms of the disease. But (as mentioned above) the single biggest factor is surely our longer lives. Eventually, some cells are going to hit on the wrong combination of mutations if you just give them enough time. And the widely reported statement from Professor Davids, one of the paper's authors, that "There is nothing in the natural environment that causes cancer", is flat-out wrong. What about UV light from the sun? Aflatoxins from molds? Phorbol esters in traditional herbal recipes?

That statement strongly suggests a habit of mind that I think has to be guarded against: the "Garden of Eden" effect. That's the belief, widely held in one form or another, that there was a time - long ago - when people were in harmony with nature, ate pure, wholesome natural foods (the kind that we were meant to eat), and didn't have all the horrible problems that we have in these degenerate modern times. (You can see a lot of Rousseau in there, too, what with all that Noble Savage, corrupted-by-modern-society stuff).

This 1990 article (PDF) by Bruce Ames and Lois Gold, "Misconceptions on Pollution and the Causes of Cancer" is a useful corrective to the idea that modern environments cause all cancers. You'll have to guard yourselves, though, against the prelapsarian Golden Age fallacy. It's everywhere.

Comments (31) + TrackBacks (0) | Category: Cancer | General Scientific News


COMMENTS

1. darwin on October 20, 2010 9:38 AM writes...

Mother Nature has no use for the body after reproductive age.

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2. John on October 20, 2010 9:39 AM writes...

According to SEER, the there is about a 30x difference in cancer incidence between 25 year olds and 60 year olds. So one might guess that with a life expectancy of 30 years, the US cancer death rate would fall from about 500K per year to less than 30K.

Throughout most of prehistory, we spent half the year trying to stay warm by building wood fires in enclosed spaces, thus inhaling smoke continuously. I'd guess my carcinogen exposure is considerably less than the average North American or Northern European hunter gatherer.

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3. Al on October 20, 2010 9:57 AM writes...

A couple of other examples from antiquity: In the first century AD, Pliny the Elder documented an account of lead refiners who strapped pig bladders over their faces to protect against lead fumes, and also about how asbestos damaged the lungs of miners, causing them to "die young."

No OSHA back then!

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4. barry on October 20, 2010 10:04 AM writes...

the epidemiology is pretty solid on the decrease in stomach cancers across Europe in step with the spread of refrigeration technology. The exact causal link (eating less spoiled food? Eating less nitrite? less smoked foods? less salted foods?..) is still debated, I think

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5. banumath on October 20, 2010 10:06 AM writes...

Just two days before , I have seen an article saying that 'cancer is a man made disease"

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6. InfMP on October 20, 2010 10:09 AM writes...

Another embarrassment to the direct arylation field in JACS today...10.1021/ja1080822
Refering back to the discussion here on radical arylation of benzene with tert-butoxide and/or ligand, this is the third paper in the series (after charette's spectator iron catalysis).

They got scooped by Kwong/Lei 10.1021/ja103050x but it still got in! surprising.


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7. skatesailor on October 20, 2010 10:11 AM writes...

The poison, toxin, and mutagen that occur in the wholesome, natural foods carrots, raspberries, and parsley feature in Angew. Chem., Int. Ed., 39, 1724-1744 (2000). Never fond of carrots or parsley, I am disappointed by raspberries.

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8. banumath on October 20, 2010 10:12 AM writes...

Just two days before , I have seen an article in "in.news.yahoo.com" saying that 'cancer is a man made disease"

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9. Andrew on October 20, 2010 10:13 AM writes...

Try reading "land of the spotted eagle" if you want a glimpse into that garden-of-eden period. I think it's more true than you realize, although certainly still romanticized.

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10. Andrew on October 20, 2010 10:14 AM writes...

Try reading "land of the spotted eagle" if you want a glimpse into that garden-of-eden period. I think it's more true than you realize, although certainly still romanticized.

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11. MoMo on October 20, 2010 10:18 AM writes...

Show this article by Bruce Ames at your next vegetarian gathering.

Ames, Bruce N.. Dietary carcinogens and anticarcinogens. Oxygen radicals and degenerative diseases. Science (Washington, DC, United States) (1983), 221(4617), 1256-64.

Foods and spices are some of the most potent toxins known to man, and with 490 references Ames knows all.

All Hail Bruce Ames! A voice of reason in the Wilderness!

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12. Karen on October 20, 2010 11:01 AM writes...

I don't have access to the full article, but when the paper refers to "life expectancy" are they looking at average life expectancy? Average life expectancy in the past is skewed by high infant mortality. An average life expectancy of 25-30 may include a population where half of the children die before age 5 and then a group of adults where many people live to age 50. Some measurements of life expectancy take this account and some don't.

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14. seb on October 20, 2010 3:14 PM writes...

Proper respect to Sam for pointing out this very good article.

The two key statements are: "Age is the major risk factor for cancer" (some might argue it is _a_ and not _the_ major risk factor) and "There are many natural causes of cancer".

Being a chemical engineer very close to my diploma, it's no wonder to me that cancer has been becoming much more frequent ever since the industrial age began - exhaust gases loaded with nanoparticles, new materials never tested for their carcinogenity (asbestos springs to mind)... I remember we were once told that they used to make butter more yellow by adding 'Buttergelb' (literally butter yellow in german) to it, which was found out to be carcinogenic later on.

I'd expect cancer cases to show a peak somewhere in the late 1980ies and then a decline since then with awareness growing and enhanced efforts to ban carcinogenic compounds.

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15. mad on October 20, 2010 3:32 PM writes...

The probably you will die from a form of cancer which is essential the malfunction/mutation of our cell division sysetems vastly increses as you start curing or managing all the other disseases the in the past killed people first.

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16. John Thacker on October 20, 2010 3:59 PM writes...

seb:

I find it confusing that you would refer to asbestos as a "new material never tested for [its] carcinogenity." Asbestos was used (indeed, named by) the Ancient Greeks and used by the Romans, and known to be dangerous.

It did start becoming a lot more common in the mid to late 19th century, to be sure, but its more widespread use was almost immediately associated with discovery of its dangers. (Though there do appear to have been attempts by governments and others to suppress such information.)

The government provides excellent cancer incidence statistics. The decline in lung cancer from the decrease in smoking tends to overwhelm everything else.

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17. befuddled on October 20, 2010 4:22 PM writes...

I find reading Ames' articles on cancer to be useful, but a bit tiresome. There are clearly synthetic chemicals which are potent causes of cancer. Without regulation, we would be exposed to much more of them. If we were exposed to much more of them, then the man-made contribution to the overall cancer burden would be greater.

In other words, the plausibility of Ames' argument is due in part to regulations that Ames opposes.

That said, the rodent models used for carcinogenesis testing are indeed poor ones, as are the rodent models used for cancer therapeutics. Despite curing cancer being such a hard problem in principle, I'm convinced we'd be *much* further along if the models were better.

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18. befuddled on October 20, 2010 4:24 PM writes...

I don't have access to the paper, but is doesn't sound like something worthy of a slot in a Nature journal...

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19. John on October 20, 2010 4:30 PM writes...

Hard to find US info going back pre-1975, but in England and Wales the cancer death rate has been remarkably constant since 1950, in spite of greatly improved occupational exposure standards.

http://www.statistics.gov.uk/downloads/theme_health/cancertrends_5099.pdf

This and the data from the 1970s Royal Society of Chemistry study of cancer in chemists, which found overall rates lower than those of the general population, appear to support the hypothesis that most carcinogen exposure is from the diet and from free radicals that are normal byproducts of metabolism.

(The RSC study noted that chemists are above average in income, and that income is a strong predictor of cancer rates. Chemists had very slightly elevated leukemia and pancreatic cancer rates compared to other professionals).

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20. Cynthia on October 20, 2010 5:12 PM writes...

In Bruce Hollick's lecture (on youtube) about vitamin D, he points out that vitamin D is important in reducing metastasis and proliferation of cancer cells. The cancer is still there but doesn't proliferate and kill when vitamin D levels are high. Perhaps ancient man spent more time exposed to the sun (not wearing sunscreen) or eating vitamin D containing foods. And don't get me started about high blood sugar and the M2 form of pyruvate kinase in cancers and our overfed/high carb diets in modern societies. It's possible to have cancer but not die from it if its proliferation and growth can be controlled.

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21. AlchemX on October 20, 2010 6:37 PM writes...

@MoMo

I'm still confused about alcohol. Does it actually cause cancer? A study showed that heavy drinkers still outlived complete non-drinkers. It's hard to connect diet and disease beyond incredibly obvious examples.

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22. Jose on October 20, 2010 7:52 PM writes...

AlechmX- the best evidence for EtoH and disease shows an U- shaped curve, with little/no intake and very high intake correlated with some cancers (esophagus, stomach), and a protective effect in the middle. The problem is the bounds of that middle zone (and any specific "vehicle" effects) are very poorly understood. Too many conflicting studies.

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23. Anon on October 20, 2010 8:56 PM writes...

That statement strongly suggests a habit of mind that I think has to be guarded against: the "Garden of Eden" effect. That's the belief, widely held in one form or another, that there was a time - long ago - when people were in harmony with nature

Ummm...held by whom, exactly? Leftist blowhards?

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24. PTM on October 21, 2010 4:52 AM writes...

Unless it happens before 30 cancer should not really be seen as a disease, it's simply a result of running past the expiration date so to speak. We are engineered for a certain lifespan - long enough to produce plenty of offspring and educate them about their environment but otherwise as short as possible to take full advantage of the benefits of evolution.

Any trade-offs that improve life for the young at the cost of making it harder for the old were beneficiary for the species and have been implemented.

We are extremely complex parallel systems of trillions of cells which have been heavily optimized by evolution for a certain narrow range of parameters, but when we get old we are running out of that optimized range and into an uncharted territory and things start to go wrong. Unfortunately for us this is working as intended.

This is why a "cure for cancer" is such a tall order, as opposed to a regular diseases where we are looking for a solution to a single relatively well defined problem, with cancer what we are looking for is really a case of life extension and to achieve it we need to take over from evolution and literally re-engineer our own biology for this purpose.

It won't happen anytime soon as considering our technology it's like trying to re-engineer a microprocessor with stone age tools.

There is also a (likely imho) possibility that cancer is not just a system running out of it's optimized parameter range but rather a deliberate mechanism whose purpose is to ensure that we die when we should. There are some benefits to keeping older individuals past their reproductive age around - they pass the knowledge to next generations for example, but the resources they consume eventually outweigh any such benefits and so there is an evolutionary advantage in putting them to death in a timely manner.

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25. MattF on October 21, 2010 7:00 AM writes...

I wouldn't be surprised if the ancient cancer incidence map was spottier than modern map, but that doesn't mean that the average was smaller.

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26. sgcox on October 21, 2010 12:28 PM writes...

I would like to nominate the authors for the next year Ig Nobel prize in Medicine for the ground breaking discovery that "There is nothing in the natural environment that causes cancer".

If this does not desrve it than what is ?

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27. Smoki on October 21, 2010 5:31 PM writes...

PTM, bravo! Couldn't agree more with what you have written.

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28. Kaleberg on October 24, 2010 9:31 PM writes...

According to the March 1937 issue of Fortune Magazine, cancer then had been known since the time of Hippocrates when it was treated with a mixture of arsenic and acetic acid. Cancer rates in 1934 had nearly doubled for men and risen by 50% for women since 1905.

"In 1910 cancer occupied only tenth place on the mortality list with a total of 63.0 deaths per 100,000 of population. By 1910 it was in seventh place; by 1920 in fifth; by 1922 it was found to be in fourth place, displacing pulmonary tuberculosis; by 1924, in third, displacing nephritis. It reached second place in 1933, with 102.2 deaths per 100,000, and has remained there ever since, its rate of mortality climbing to 106.3 per 100,000 in 1934. It is worth noting that only three other important categories of death show an increasing mortality, namely heart and blood-vessel diseases (the top of the list with 213 per 100,000 in 1934), automobile accidents (28.4 per 100,000), and diabetes (22.1 per 100,000). On the other hand, mortality has decreased sharply in typhoid, pulmonary tuberculosis, pneumonia, scarlet fever, diptheria, and most children's diseases."

They note that average life expectancy had risen from 49 years in 1901 to over 60 years as of 1937, and the birth rate had fallen from 25.1 per 1,000 in 1915 to 16.9 per 1,000 in 1935. This combination meant that there were a lot more old people in 1935 than in 1900.

If you think rising cancer rates are scary now, imagine what it felt like in 1937 with a nearly unknown disease rising so dramatically. On the other hand, so were living standards, life expectancy and the quality of health care. In the light of this, it seem rather obvious that cancer is basically something that is more likely to kill you the longer you live. Of course, one could argue that the rise was a result of vaccine exposure, better diets, urbanization, sanitation, radio, movie theatres, sulfa drugs, pacifism and the like.

Notice the parallel rise of heart disease, as we call it now, and of diabetes as killers. (Since insulin came out in the 1920s, this must mean a rise in the adult onset form.) Life expectancy has continued to rise, though less dramatically, but our modern causes of death seem to have become well established.

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29. Kaleberg on October 24, 2010 9:35 PM writes...

Also, don't discount ancient pollution levels:

http://www.sciencemag.org/cgi/content/abstract/265/5180/1841

Greenland Ice Evidence of Hemispheric Lead Pollution Two Millennia Ago by Greek and Roman Civilizations

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30. David on October 31, 2010 7:10 PM writes...

Even back in the day when people who made it past childhood often died in their 50's or early 60's, which, while cancer can certainly crop up then, the rates increase dramatically later in life.

http://www.nia.nih.gov/ResearchInformation/ConferencesAndMeetings/WorkshopReport/Figure1.htm
#
345.8 per 100,000 in the 45- to 49-year-old population;

# 574.4 per 100,000 in the 50- to 54-year-old population;

# 892.6 per 100,000 in the 55- to 59-year-old population;

# 1,301.6 per 100,000 in the 60- to 64-year-old population;

# 1,773.8 per 100,000 in the 65- to 69-year-old population;

# 2,233.5 per 100,000 in the 70- to 74-year-old population;

# 2,436.2 per 100,000 in the 75- to 79-year old population;

# 2,525.1 per 100,000 in the 80- to 84-year-old population;

So if you're one of my ancestors (I know every one of my direct male ancestor's lifespan and death back to 1512), and died typically between 55 and 65, you probably had a heart attack, infection or maybe cancer (likely stomach as mentioned above). And stomach cancer (Napoleon?) was certainly known in the 'good old days.'

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31. Brett Keys on January 7, 2014 9:55 AM writes...

But nobody famouse ever died from cancer. e.g. kings, queens, inventors or musicians. Jet in the past 20 years, I could name many.

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