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Writer's picturelouiscatania

Blog #27: Cancer, Part 1: Immunology’s cruelest enemy and greatest challenge (Lay Version)

Updated: Jul 8, 2023

(Selected Tables and Figures referenced, but not present in this blog

can be found in their corresponding Science Version blogs)


You have probably seen this popular sign by now with a red slash through the word "Cancer":

​You’ve just gotta love it. I doubt there are many words in the human vocabulary that engender more anxiety, uneasiness, and fear than the word “cancer.” It’s so near and painful to almost all of us with either an unfortunate direct, personal experience with the disease or agonizing over a loved one, family member, or friend suffering through a cancer diagnosis. So, kudos to MD Anderson (or whoever created their signage) for “crossing it out” as is everyone’s hope. Thank you. To understand cancer, one must not think of it as a noun, but rather as a verb. The rate of acquired mutations in the human genome with about 37 trillion cells in our bodies is in the trillions.” Only an infinitesimal amount of them (less than 60 per gene), override the suppression of these mutations, called “apoptosis,” to produce genetic disorders and disease.” Nonetheless, those mutations are continually occurring, and virtually all mutations have the potential to become irregular, accumulate, or mutate into cancer. Thus, if you follow the mathematical law of large numbers, it follows that “If you live long enough, or your luck runs out earlier, you will get cancer.” Thus, throughout our lives, we are all “cancering."


TABLE 6.1


There are over 185 types of cancers, according to the National Cancer Institute (Table 6.1), and leading the list of the top 10 cancers in America (Table 6.2) is skin cancer, followed by lung cancer which is the leading cause of cancer deaths and the second leading cause of all deaths in America. According to the Centers for Disease Control, cancers are the second leading cause of death in America, second only to cardiovascular deaths. Tragically, in 2020 COVID-19 became the leading cause of death in the U.S. just behind heart disease and cancer. Indeed, with cancer, we are dealing with a devastating disease that is being better understood with an expanding commitment to immunologic, genetic, and cancer research. A 26-year decline in cancer mortality is driven primarily by a long-term decrease in death rates for the four major cancers; lung, colorectal, breast, and prostate. The drops we are seeing are likely due, at least in part, to the early and improved diagnosis and management of the common cancer types as well as more public health education and messaging about cancer prevention (e.g., smoking cessation advertising). Also, immunotherapy has had a profound effect on our ability to better treat and control cancers.


Sadly, data since 2020 has indicated a resurgence in the rates of cancer development and mortality by as much as 26%. Contributing to and exacerbating this distressing trend are the direct and indirect effects of COVID-19 over the past 3 years. The virus has been identified as a significant risk factor in multiple ways. The immunocompromised and immunosuppressed cancer patient becomes more vulnerable to SARS-CoV-2 infection and a resultant increased mortality risk. Epidemiologically, the pandemic has decreased access and caused delays in early cancer diagnosis and care due to the increased inaccessibility of hospital and medical care secondary to the overburdened healthcare system from COVID-19 patients.

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