THE OTHER FACE OF CANCER

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THE TRUTH ABOUT CANCER (An Update in 2001)

A search for truth has been considered a noble pursuit. Gandhiji titled his autobiography, My Experiments With Truth. But truth is difficult to define. Just before his crucifixion, Jesus Christ declared, "Truth shall prevail." Pontius Pilate, the Roman Governor in charge of his crucifixion, mocked Christ and asked, "What is truth?" And, as history records, he did not care to wait for an answer.

Truth or satya is rooted in satatya, or existence, or an unchanging "isness". The truth that we gleaned about cancer was put before the world in 1973. 6 Thereafter over 10 million (at least) "scientific" articles and books on cancer have been published. And not one of them has forced any change on the abridged version of our findings which we published 20 years ago. It is possible that what we said has emerged as the essential truth about cancer. The saving grace is that the same truth is comprehensible by the lay and practicable by the learned.

Our justified emphasis on the fact of cancer being a biological phenomenon, well beyond the domain of modern medicine with all its glittering gadgetry, demolished the wall that separated the "ignorant" cancer patient and the "learned"*cancer-specialist. We further stressed that since the cancer patient has had the actual experience of the problem and the cancer-specialist only studied or attempted to treat it, the patient was any day superior to the doctor in epistemological terms. 338 " 339 We have had no occasion to regret this one-upping of the cancer-patient over the cancer-doctor.

We ventured to declare that cancer per se can never be treated: only its manifestations can be. We also showed that cancer cannot, be researched upon. Yet the cancer establishment is busy working nationally and internationally. It has not stopped its periodic "positive" pronouncements. It continues to promise breakthroughs. We need to place all this drama in a larger perspective.

One of us was in the U.S. in Oct-Nov 1977, and had a long discussion with the then Director of the famed Sloan Kettering Institute (SKI), New York, where all the bigwigs of the world get treated. The Director, Dr. Lewis Thomas, basically a profound biophilosopher, said: "You are largely right about cancer. But we are so politically committed to the cure of cancer, that we have no courage to tell the truth to the public."

The above discussion was followed by a meeting with Joseph Hixson, a cancer-journalist, and author of the book, Patchwork Mouse. 8 The whole expos è contained in the book was about a great scientific scandal that occurred at the SKI. When asked what he was doing prior to taking up journalism, Hixson said that he had been the PRO at the SKI for 19 months. When asked why he gave up such a cushy job, his reply was terse: "I got tired of telling lies to the public." Hixson's resentment was an uncommon reaction against what the subtitle of a tome called Medicine on Trial describes as The Appalling Story of Medical Ineptitude and the Arrogance That Overlooks It. 340

We have often been told that we ought to have worked for decades in a cancer hospital before lifting our pens. But it is forgotten that our working in any 5-star cancer centre would have gifted us with all the prejudices and traditions of members of the 5-star set-up, who willy- nilly have to keep pace with world trends. Ernst Boris Chain, co- discoverer of penicillin and Nobel laureate, had prophesied in 1966: "But do not let us fall victims of the naive illusion that problems such as cancer.. .can be solved by bulldozer organisational methods, such as were used in the Manhattan project.. .No one can tell in which section of the biologic sciences they will appear: in all probability in one of the least fashionable ones." 341

We now have over 30 years of close contact with cancer patients of all types and we dare say that what we perceived as a theoretical truth has turned out to be a practicable discipline.

There are a few issues related to the myths and realities of cancer that can be enumerated, now that we are past a highly scientific millennium. The new millennium promises to be a push-button one. You press a switch and the world literature on cancer, or the latest developments on coronary artery disease, will be on your laptop. A scholarly volume titled The Greatest Benefit to Mankind: A Medical History of Humanity ends on a pessimistic note vis-à-vis the might of modern medicine. 342 With such a perspective in mind, we present below a survey of the current cancer scene, detailing what mankind can hope to achieve and what it never can.

1. Painlessness of Cancer

The evolution of cancer in the human body, from inception to manifestation, is recognisably a silent process. And thereafter too, cancer is not synonymous with pain. It is highly likely that Nature has endowed cancer cells with the special ability to secrete endorphins. Endorphins are opioidal agents that structurally and functionally mimic opium derivatives, especially morphine. Hence the term endorphin, meaning morphine-like pain relieving agents, released from within the human or animal body. Future pharmacological research may reveal that cancerous tissues mimic the brain and spinal cord in releasing endorphins. Nature in its profound wisdom and generosity has allowed cancer to evolve in the human body without the punishment of pain.

Then why so much noise about cancer pain? So much of worry about painful death from cancer? We have, over the years, and in innumerable patients, found that untreated cancer does not cause pain. Even when it does, it does not have the burning, unbearable quality of the pain that follows therapy of cancer.

Surgery, unless grossly mutilative, leaves no pain behind. Chemotherapy, which is inimical to almost every tissue of the body, can generate a very vicious mucositis: inflammation and reddening of the inner linings of the body. The mouth burns, the stomach and intestine may pain, and the urogenital and rectal mucosa may get inflamed. The skin may also excoriate. With remarkable resilience, these tissues are capable of recovery to relieve the person of pain. Radiation, while trying to kill the cancerous tissues, can hurt the blood vessels going to the nerves around the irradiated area. At times the arteries to the nerves get so badly blocked that the nerves literally cry for mercy. Post-radiation neuralgia is one of the most bothersome problems. Irradiation to the pelvic region can leave behind indolent cystitis and proctitis. Oral mucosa can also become irritated and cause pain following irradiation to the head and neck area.

The WHO has taken upon itself the task of providing pain relief. One glaring truth it needs to emphasise is that cancer per se is painless; cancer-treatment is painful. Untreated cancer does not lead to a painful death. Treated cancer and painful death tend to go together.

The day science discovers that cancer by itself, when undisturbed by therapy, produces endorphins, a great intellectual battle will have been won. Cancerologists and their patients will have to respect the innate wisdom, the innate kindness of cancer.

2. CHARAKA, CHRIST, KRISHNA

While contributing a chapter on cancer pain to an American text, 343 we happened to read slokas (stanzas) by the sage Charaka, written 500 years before the Christian era: 2500 years ago. They reveal wisdom that has remained unchanged. Charaka classified arbuda or tumor into saumya or benign and ghataka or malignant. He further advised that the doctor better keep his hands off the ghataka variety lest the patient curses him thereafter. What Charaka advised was once again echoed in 1966 AD by Dr. Borges a few months prior to his death. 334 Charaka's clarity on the issue reveals that modern medicine has not travelled even an inch in the last 2500 years in terms of understanding or treating cancer. Maybe it is so because cancer is a biological issue and not at all a medical one. It turns into a medical issue, for man, alone amongst all the animals, fights what is otherwise inevitable and natural.

In summing up all forms of cancer therapy, we initially created the acronym CHRIST to read Chemotherapy, Hormonotherapy, Radiotherapy, Immunotherapy, Surgery, and Theotherapy (theos = god, hence theotherapy involves prayers, puja etc). Later we enlarged the acronym to KRISHNA, where K reads as Kemotherapy, R, I, S, and H as in the foregoing, N as Naturopathy, and A as Alternative therapies such as Homoeopathy, Ayurveda, Unani, Reiki, Acupuncture, Acupressure, Magnetotherapy, Faith-healing, and Auto- Urine Therapy. Both CHRIST and KRISHNA demonstrate that mankind has left no stone unturned in its search for the ever-elusive goal of cancer cure.

No matter what the sophistry and what the gadgetry, no matter which big name is treating the patient, CHRIST and KRISHNA have refused to oblige mankind. The untreated have longer and better coexistence with cancer as compared to the treated. Why?

In advanced cytological thinking, the cancer cell is no longer seen as an abnormal cell, but only as a variant of normality. 344 All attempts at creating a divide between "cancer" cells and "normal" cells have failed. If the lordly CHRIST and KRISHNA reside in normal cells to run the show of life, they must reside in cancer cells as well, integral as they are to life. A cell, as a distinct entity, evolved about 4 billion years ago. It is heartening and chastening to realise that the cell of today refuses to differ from the pioneer grandparent cell. All theories of mutation of cells to form cancer, of cancerogens causing cancer, turn out to be figments of human imagination.

The 20 th century has been the century of experts. While experts do achieve in their own specialized fields, their ignorance on other essential aspects of life, their lack of any perspective can be appalling. An expert has been defined as one who knowing more and more about less and less, ends up knowing everything about nothing. Way back in 1932, Jose Ortega y Gasset, the noted Spanish thinker, philosopher, reformer and writer, warned of the dangers of expertism in The Barbarism of Specialization: "For it is necessary to insist upon this extraordinary but undesirable fact: experimental science has progressed thanks in great part to the work of men astoundingly mediocre, and even less than mediocre.. .This is no mere wild statement. Anyone who wishes can observe the stupidity of thought, judgement and action shown today in politics, art, religion and general problems of life and the world by 'men of science', and of course, behind them, the doctors, engineers, financiers, teachers, and so on." 345 This was echoed a little more bluntly by Eysenck a noted British psychologist, who, in 1957, said : "Scientists, especially when they leave the particular field in which they have specialised, are just as ordinary, pig-headed and unreasonable as anybody else, and their unusually high intelligence only makes their prejudices all the more dangerous." 346 The British radio-oncologist David Smithers 71 and the Australian Nobel laureate Macfarlane Burnet 5 have lamented that cancerologists tend to be very poor in biological scholarship.

A Niagara of printed words continues to wash our ignorance on cancer. But this is the Niagara of untruth. The result is that today's oncologist knows more and more untruth about less and less truth till he knows all the untruth about a vanished truth. Till cancerologists come to accept that we all basically know nothing about cancer, the torrent of spoken, printed, and internetted verbiage will continue unabated.

3. Yet, Cancer can be, must be, Treated

We as authors have been blessed with the notoriety of being against cancer treatment. Why should we be against anything that eases dis- eased mankind?

The key-word in the above is dis-ease. For a long time, cancer in an animal or human body causes no dis-ease and demands no eas-ing measures. As and when it does cause dis-ease, an appropriate measure to ease the dis-ease is warranted. Put in simpler terms, it means: Do not trouble your trouble unless it troubles you. And trouble your trouble only to the extent that it troubles you.

Let us once again emphasize a self-evident truth: cancer is a part and parcel of yourself, your prakriti, your tissues, your own flesh and blood. You just can't afford to quarrel with it. Just as you have a right to be around, so does your cancer and it can't be done away with. Whatever dis-ease it occasions, an appropriate measure can be taken, knowing fully well that only a particular symptom or sign is being tackled, not the cancer itself.

Set below is brief data on some cases that we have had to tackle recently, apart from those alluded to earlier . The nature of the problems and the measures taken to ameliorate them convey a comprehensive message to the lay and the learned alike.

i. Mr. B. At 85, diagnosed to have cancer somewhere, as evident from erosion of a rib, and fluid in pleural cavity. There was severe infection of the chest. A course of antibiotics cleared the chest symptoms. The erosion of the rib and the cancer that allegedly caused it were ignored. It is 10 years since then and Mr.B. is hale and hearty.

ii. Mrs.D. At 63, detected to have a large cancer of the uterus. The complaint was occasional bleeding. For 7 years, Mrs.D lived with her endometrial cancer, and her occasional bleeding. She passed away with cardiac failure.

iii. Mr.M. At 80, diagnosed to have a rapidly growing blood cancer called Acute Lymphoblastic Leukemia (ALL). For 11 months he lived well On three occasions, his hemoglobin touched very low levels, so he was propped with transfusion of packed cells. Exit was peaceful.

iv. Mrs.A. At 75, diagnosed to have cancer of the cervix. Left alone. 6 months later, she complained of foul discharge per vaginum. Advised douches. After a few days, the discharge disappeared. After 3½ years, in April 1999, she came with painful (R) heel. MRI (Magnetic Resonance Imaging - a form of scanning) showed that there was a metastasis. FNAC (Fine Needle Aspiration Cytology - a simpler way of doing a biopsy of a tumor) confirmed the suspicion of the cervical cancer having moved to the (R) calcaneum. Without tackling the primary at all, she was given a course of irradiation which reduced the pain that accompanied weight bearing. Orthopedic advice to amputate her foot was not accepted. She continued moving around, assisted by a walker, and was then confined to bed for a few months before her death in mid-2000.

v. Mr.N.At 70, had enlargement of abdomen due to ascites. Diagnosed as abdominal cancer, operated for removal of colonic cancer and cancerous masses in abdomen. All right for a while. Ascites returned. No treatment. For 3 months he was bedridden, with no pain. Only increasing ascites. Passed away peacefully, laughingly.

vi. Mrs. K. At 75, she had a cricket-ball sized cancer of (R) breast. Left alone. 14 months later, she died following a stroke. A lady of her age and with similar cancer, was treated at a leading hospital with chemotherapy. On the 4 th day, she had vomiting and diarrhea because of the therapy. One large vomit entered her lungs. A lady who came walking to the hospital went out through the backdoor as a mere corpse.

vii. Mr.S. 75. Diagnosed as pancreatic cancer through MRI. Only complaint was pain because of the pressure of the lump on nearby nerves. A nerve block relieved the pain. For 2 months thereafter, he participated fully in family life. Passed away comfortably talking to near and dear ones, joking with them, smiling at them. Till the last day, could enjoy a bit of food and drink.

viii. Mrs.K. 82. Diagnosed as breast cancer. Advised to do nothing. The cancer "burst", revealing an abscess that healed on its own. She lived for 5 years thereafter and died of old age.

ix. Mr.M. 60. Diagnosed as prostatic cancer. Advised only TUR (Trans Urethral Resection - a technique whereby prostate can be cored out through the urinary passage) to remove blockage to the urine flow. Thereafter for a year, the pain from metastasis was relieved by analgesics. He lived well, and died comfortably.

x. Mr.N. andDr.B. (not handled directly by us) 60+. Both operated upon for cancer of the stomach. Opened and closed because the cancer was far too advanced to be operable. It is about 10 years since then and both are busy enjoying life and working. CANCER DOES NOT KILL.

It should be seen from the above that there was no attempt to treat the cancer per se. Whatever little that could be done against the dis- ease was done. And that remains the sheet-anchor of cancer management. We are often asked: "How long will I live?" And no matter how advanced the problem, each of us sincerely submits: "Well, you are fit enough to attend my funeral." "How come doctor, you are looking OK!" "Disease and Death are not related. Disease is a function of the body. Death is a function of time. Life is so strong that it loftily disregards any number of diseases. Death is so precisely timed that it can't afford to pay heed to health. With each breath, I first inspire. Then I expire. Just see, in your presence I expired. If my breath-quota is not over, I inspire again." The healthy should be humble that death is yours at each breath. The diseased should be courageous that disease and death are not related.

The principle of easing only the dis-ease is applicable to heart disease, hypertension, diabetes, arthritis, and so on, not excluding the much trumpeted AIDS. And above all, it must be emphasized that no treatment also constitutes a form of treatment.

4. Oncogenes and Gene Therapy

"How far is your home from mine?" "Simple. It is as far as my home is from yours." "What is the difference between capitalism and communism?" "In capitalism, man exploits man. In communism, it is just the reverse."

The above questions and answers illustrate circular reasoning: apparently convincing, but basically senseless. Koestler found that the Darwinian dogma of "survival of the fittest" was pregnant with circular reasoning: "Who are fittest?" "Those who survive." "Who survive?" "Those who are fittest."

Because of the pivotal role of tumor suppressors in the prevention of tumor formation, their study is of considerable medical significance. By understanding how cancer is naturally suppressed by the body, we can ultimately develop more effective medical therapies for tumor prevention and treatment.

A second specific class of genes that can cause cancer is termed oncogenes (i.e. cancer genes). Most oncogenes originate from proto- oncogenes, which are genes that are involved in the four basic mechanisms of cell growth regulation mentioned above (i.e. growth factors and their receptors, signal transduction molecules, and nuclear transcription factors). When a mutation occurs in a proto-oncogene, it can become an oncogene, a gene whose product can upset normal cell growth and differentiation.

Jorde, Carey, and, White, Medical Genetics 347

The whole concept of oncogenes rests on circular reasoning: A cancer (onco = cancer) must be dependent on genes that can thus be called oncogenes. Oncogenes work by secreting oncoproteins. Oncogenes can be countered by anti-cancer-genes or anti-oncogenes, thus providing you with the concept of gene-therapy of cancer. It is significant to note that science as of now can define neither cancer nor gene, and yet can talk of and work upon cancer-genes or oncogenes. One of us in 1976 went to the famed McGill University in Montreal. Professor Willis, of the Department of Immunology, was busy preparing for a grant for "tumor immunity". He confessed: "I neither know what is tumor (cancer) nor do I know what is immunity, but I am expected to research on tumor-immunity." It is humbling to note that there is no change in the ignorance-status on the once much-prized and investigated tumor-immunity.

The polar opposite of oncogenes is the concept of oncosuppressor- genes which supposedly prevent cells turning cancerous. When the suppressor-genes get mutated (read changed), they lose their control and cancer results. The suppressor-gene concept is another variant of circular reasoning: if there are genes that cause cancer, there must be those that suppress/prevent its occurrence.

The utter failure of conventional and unconventional cancer therapies - CHRIST and KRISHNA - has now prompted the researchers to promise salvation through oncogenes and gene-therapy. In 1979, at the 66 th Ciba Foundation Symposium among 26 world-class scientists and clinicians, some of them Nobel laureates, they discussed the

Possibilities and Realities of Human Genetics. The closing remarks of Brenner, the Chairman, are worthy of note: "Scientists should not promise society too much. In the past, we have been overenthusiastic in making promises because of the special social contract we have with society.. .Our promises have been made too easily...It is a lesson of the past that we are nearly always wrong about the time they will take." The Chairman's final lines, with which the whole symposium ends, are very telling: "We have had a very exciting meeting and our symposium will be a landmark even if it only records our confused perception of the future of genetics and human biology." 348

Let us move from 1979 to 1997. The epilogue to a 1000-page tome Genes VI (sixth edition) talks only of "romantic pessimism". 349 It was in 1995 that Kenneth Culver, Professor of Gene Therapy at the Iowa University, USA, talked at the G.S. Medical College and K.E.M. Hospital, to a packed crowd on his favorite topic of how, under gene therapy, "tumors" in the rat brain regressed. At the end, there was pindrop silence. "Any questions?" Culver asked. One of us got up: "I have no questions. But I do not want the house to go home with wrong ideas. The rat model that Dr. Culver has used was out-dated over 20 years ago. He is drawing right conclusions from a wrong experiment." Prof. Culver's one-line defense was that "this was the only available model to work upon."

A great paradox of "Human Gene Mapping and Cancer Therapy" is that it uses viruses to carry into the cancer cells the right message that they better turn wise. 350 This is a classic example of set a thief to catch a thief. That has been the history cancer therapy: what causes cancer - hormones, rays, chemicals, viruses - is mooted as curative. "The technological basis of gene therapy is the gene delivery systems. An ideal system should have the following characteristics: (1) protect and deliver DNA into cells efficiently, preferably to a specific cell type;

(2) be non-toxic and non-immunogenic; and, (3) be easily produced in large quantities. No existing system meets all of the requirements." 351 The foregoing is a classic, unending combination of promisism and tentativism.

5. Tumor Angiogenesis Factors (TAF)

As things stand now, modern medicine is clearly schizophrenic over the blood-vessel issue. It is desperately seeking "new-blood-vessels- for aging-heart". So it literally "bores" holes in the living human heart with the assumption that the blood vessels that sprout to heal the hole, will end up feeding the heart. On the other hand, having failed against cancer itself, it wants to attack and abolish the blood vessels going to a cancer. Unable to attack the blood vessels of a cancer directly, it wants to attack some basic factor that helps blood vessels to grow in a cancer. Researchers have chosen to call such agents as the Tumor Angiogenesis Factors or TAF. A carrot of promise is dangling before hopeful mankind. You suppress TAF and you will cure your cancer.

Here is a big-lettered announcement in the Newsweek of May 1998: "ONE MAN'S QUEST TO CURE CANCER : For years, researcher Judah Folkman was scorned by peers. Last week he became famous: for a break-through that may, or may not, help conquer our most- feared killer." 352 Dr. Moses Judah Folkman, working on TAF since 1960, featured in the front-page story of the New York Times in early May 1998. Folkman and his colleague, Dr. Michael O'Reilly have zeroed in on natural factors, endostatin and angiostatins, that suppress TAF, to inhibit or destroy a cancer's lifeline.

The endostatin-angiostatin promise of the 90s has only one snag. It may go the same way as 3 earlier promises: interferon of the 60s, monoclonal antibodies of the 70s, and interleukin-2 of the 80s. And the journalistic summing up of the current state of the current promise begs to be read between the lines: ".. .And it should work without poisoning the patient. Though traditional chemotherapy quickly loses its effect on cancer cells, it continues to kill healthy ones. People relying on angiogenesis inhibitors could face serious side effects: including Thalidomide-style birth defects and an inability to heal common wounds. But as University of Toronto cancer-biologist Robert Kerbel observes, disrupting angiogenesis is rarely dangerous, for blood vessels rarely have a good excuse to proliferate. 'We used to hope that the drugs we developed would kill more tumor cells than normal cells/ he says. 'Now we can hope for something better.' Unfortunately, it's still too soon to bank on it." 353

6. An Immortalizing Enzyme could be Cancerogenic and hence Suppressible

In the section on oncogenes, we saw UK molecular biologist Brenner complaining of the hurried promises that researchers give to the expectant world. 348 Researchers have repeatedly found that the terminal portions of human chromosomes, rightly called the telomeres, are concerned with regulating the lifetime of cells. A cell's division is accompanied by the unwinding of its telomeric clock. After the cell has divided a certain number of times, the telomeres have attrited enough so as to no longer sustain the cell, and the cell dies. An enzyme, telomerase, discovered in 1984, can repair and reset the damaged telomeres to grant the cell a longer lease on life, bordering on immortality, which is another name for cancer. So telomerase-therapy's side-effect could be cancerogenesis.

But science being science reasons the other way: If telomerase can immortalize a cell, an anti-telomerase can snub that telomerase to snub a cancer. So, the Time magazine report ends on the following hopeful note: "Even if the fountain-of-youth business doesn't pan out, however, knowing how to activate telomerase may help Geron discover how to deactivate the compound in cancer cells. That could lead to an effective anti-cancer drug. It wouldn'tbe the key to eternal life, but it might be a valuable weapon against one of life's worst scourges." 354

7. The Vaccine Promise

A report from The Independent of London featured in The Times of India of 30 th July 1998, under the very encouraging title: "Cancer vaccine may end chemotherapy." The report is so succinct, that it merits verbatim reproduction here, whereafter we can read it between the lines.

CANCER VACCINE MAY END CHEMOTHERAPY

A new era in cancer therapy could be opened later this year with the launch of a vaccine which tackles the disease in a new way and could spell the end of chemotherapy.

Melacine is the first cancer vaccine which has been developed as a treatment for advanced melanoma, the most aggressive form of skin cancer which claims 2,000 lives a year in the UK. The drug is expected to win approval from the US Food and Drugs Administration within the next six months after trials in patients showed 'promising' results.

A further five or six cancer vaccines are in the pipeline and are expected to be launched within the next two years. Some experts predict that they could spell the end of chemotherapy: treatment with large doses of toxic drugs whose effects can be worse than the disease: and usher in kinder therapies for people with cancer. Cancer vaccines are so called because they work by harnessing the body's immune system to fight the disease.. They differ from conventional vaccines because they are given as a treatment rather than to prevent disease. They are the first new class of drugs for cancer in a decade since the taxanes were developed in the late 1980s. These include the drugs Taxol, for advanced ovarian cancer, which is derived from the bark of the Pacific yew tree and Taxotere, for advanced breast cancer. Melanoma is the first cancer for which researchers have identified antigenic molecules on the surface of the cancer cells which act as a trigger for the immune system. Melacine, made by the US biotechnology company Ribi Immunochem, is one of a number of vaccines being developed for melanoma which primes the immune system to recognise the molecules and boosts the immune response to destroy cancer cells.

Professor Angus Dalgliesh, Director of the Gordon Cancer Vaccine Laboratory at St George's Hospital, London, said: "Cancer vaccines may well take over from chemotherapy. They will probably knock out chemotherapy." He said: "Where cancer vaccines are going to work is in cases where a solid tumour is removed and there is a high chance of the cancer coming back. They are the people who will get the vaccine to kick start the immune system. In most cases it will only delay the inevitable but if you can do that with a non-toxic treatment that will be a valuable advance."

Reading Between the Lines

The above report makes two things clear: (a) The cancer world is tired of chemotherapy, and, (b) Vaccines may replace chemotherapy as a curative measure. This will be for the first time that a vaccine will be used not as a preventive measure, but as a curative one.

The only snag about the vaccine promise is that it is unlikely to work for 2 reasons: (a) No two cancers, even in the same individual, have ever been alike. Which means you must have a specific vaccine against a specific cancer. Which means you allow a cancer to develop fully, then set about making a vaccine, and then administer it to now kill the cancer. But any given cancer has multiple clones. If the vaccine misses one, then by natural selection, that clone will exert its might to recreate the original mass of the cancer, (b) Supposing the vaccine is effective against all the possible clones that a cancer exhibits, the 100% cancer kill cannot prevent neocanceration of the next normal cell that is waiting to turn cancerous.

8. Preventing Cancer

Mankind's continuing, rather obstinate, refusal to believe that canceration is a normal process has spawned the unending science of prevention. Articles and books thrive on the chronic refrain: 65- 80% of cancers are preventable. All that you have to do is to hate tobacco, love "natural" diet, and have the right thoughts.

The Americans have floated the idea that since 65 years is the average life-expectancy, any disease or death prior to that is unnatural and hence preventable. Such an approach more than proves the charge that doctors and cancer researchers are hopelessly poor in biological scholarship. The Granit- Gompertz rule about ADOHM (Age Dependent Obligatory Herd Mortality) has stood the test of time for over 175 years. The rule only means that diseasing and dying embraces human life predictably from age of 16 to 100, and must occur every year during this period, maybe every day. A recent pronouncement by a Mumbai surgeon that "Heart disease before 80 is not God's will but due to our own faults" 355 is but an example of j'accuse, the doctor telling the patient that your disease and even your death is all your fault.

One great consolation that cancer (and coronary) preventologists can have is that they will never be short either of work or of slogans. They are the Quixotes of medicine, tilting at the biological windmills and promising mankind a cancer-free future. 356-357 Towards this end, science is ready to hold nothing back Thalidomide, the "most-feared drug" that spawned the tragedy of limbless babies is being brought back for its holds the promise to "cure cancer". 353

9. Can Bill Gates and Silicon Valley Help?

As of 2001, Bill Gates is personally worth 100 billion dollars, a figure that is threatening to expand exponentially. Let us imagine a scenario wherein Gates is afflicted with a sense of detachment and philanthropy so as to commit all his current and future wealth to the cure of cancer. Would the big C be licked? What if all other cyber-saints commit their wealth to rid mankind of cancer, once and for all.

Not in the least. In most countries, even in the developing ones, cancer research has not languished for want of money. People and politicians have trusted the scientific vision and kept their purse-strings loose. If at all, the surfeit of money has blinded researchers, doctors and patients to the ordinary realities of cancer. The day they develop a child's candor of declaring that the king is unclothed, cancerologists will stop propitiating Bill Gates and his like.

10. End of Science

It was in 1979 that Gary Zukav ended his Overview of the New Physics with the chapter titled "The End of Science". 358 By this he implied "the coming of western civilization in its own time and in its own way, into the higher dimensions of human experience." One higher dimension is to realise that beyond a point science can be impotent.

Let us read Horgan's book published in 1996 titled: The End of Science - Facing the Limits of Knowledge in the Twilight of the Scientific Age. 359 In a way, even the End of Science is irrelevant vis-a-vis cancer which is both beyond science and beyond technique. There is nothing that mankind has done in the last 3000 years that has furthered our understanding of the cause, the course, and the cure of cancer. Even if cancer research continues unabated for the whole next millennium, someone in 3001 AD may echo the above generalisation

Horgan's 300+ page book deals with a wide range of topics but the refrain is Zukavean - that even the Western world needs to go beyond the immediate goal of attacking this enemy (say, cancer) and subduing that (say, coronary). In the fairly large bibliography, Horgan quotes Feyerabend and his "first and still most influential book" Against Method: "Feyerabend has contended that there is no logic to science. Scientists create and adhere to scientific theories for what are ultimately subjective and even irrational reasons. It cannot be denied that the chief engine of human destructiveness has been the phenomenal progress of science in the 20 th century."

We would like to end this section by first quoting Horgan on Feyerabend: "Feyerabend's Dadaesque rhetoric concealed a deadly serious point: the human compulsion to find absolute truths, however noble, too often culminates in tyranny. Feyerabend attacked science not because he truly believed that it had no more claim to truth than did astrology. Quite the contrary. Feyerabend attacked science because he recognised: and was horrified by its power, its potential to stamp out the diversity of human thought and culture. He objected to scientific certainty for moral and political, rather than for epistemological, reasons." The hegemony that the Western media and world-view exercise over the rest of the world has created the anomaly of the whiteskin being always right, and the non-whiteskin readily imitating the divine leader.

In Farewell to Reason, Feyerabend describes the true nature of modern science:

It shows itself in the killing of nature and of "primitive" cultures with never a thought spent on those thus deprived of meaning for their lives; in the colossal conceit of our intellectuals, their belief that they know precisely what humanity needs and their relentless efforts to recreate people in their own sorry image; in the infantile megalomania of some of our physicians who blackmail their patients with fear, mutilate them and then persecute them with large bills; in the lack of feeling of many so-called searchers for truth who systematically torture animals, study their discomfort and receive prizes for their cruelty. As far as I am concerned there exists no difference between the henchmen of Auschwitz and these "benefactors of mankind".

We must allude to the holocaust that pure science has brought upon unsuspecting mankind. The relentless scientific slaughter of monkeys from the jungles of Africa, India and the Philippines has reduced the primate population to one-tenth of the original. Some viruses - Ebola Zaire, Ebola Sudan, Reston, HIV - that were peaceful symbionts of the monkeys, are now forced to find a new home. And for that they have chosen an animal, called "the degenerate ape" by the illustrious Huxley. No wonder, viral infections are on the upswing in humans. Preston, who wrote the above real story in The Hot Zone, is of the opinion that Nature by a whack of its left hand may eliminate the most dangerous parasite on Earth, namely, man. 360

Prince Charles of England, more known to us for Diana and Dodi, is a man of culture, of learning, of the love of Nature. At a medical meeting in London, he remarked that "The whole imposing edifice of modern medicine, for all its breathtaking success is, like the celebrated Tower of Pisa, slightly off balance." 361

The New England Journal of Medicine, from the US, in terms of impeccability and respectability, is what the Lancet and the British Medical Journal are on the other side of the Atlantic. Two surveys in it, one in 1986, and the other by the same investigator in 1997, speak volumes for the glorious unproductivity of cancer research and treatment. The 1986 survey concludes that "we are losing the war against cancer." 362 The later survey is titled "Cancer Undefeated", and declares that "The effects of new treatments for cancer on mortality has been largely disappointing." 363 Typical of the West, and now the East, both surveys posit unabashed hope in prevention. One could generalize: The greater the therapeutic bankruptcy, the greater the preventive crusade. Cushing, the pioneer neurosurgeon of the US, said that "prevention can be very much overworked." That was 70 years ago. Modern cancerology is yet to take the hint.

Medicine's Promisism and Pollyannaism

Sir MacFarlane Burnet, the Nobel laureate in Medicine, in his thoughtful summing up titled Genes, Dreams and Realities ends his penultimate chapter "Aims and Limitations of Therapy" on a realistic note: "The great pharmaceutical houses of the mid twentieth century may come to feature in history as examples both of the productivity of science as applied to industry and of the evils inherent in the technological momentum of a competitive industrial society." 15 The triumph of profit over principles is best gleaned from a learned tome from the Rockefeller Foundation, New York, titled Doing Better and Feeling Worse: Health in the United States. 3<A The burden of the anthology is to show that whereas the medical establishment is Doing Better, the patient-world is Feeling Worse. In the 60s, USA spent about 8 billion dollars in a year on health; today it is 1.25 billion dollars a day. There has been no change in who are doing better and who are doing worse. The escalating spiral of expenses has been in direct proportion to the exasperating spiral of expectations that the lay are taught to posit in the learned. The Human Genome Project is a case in point. Medicalase and journalase are replete with forecasts of not only the management of maladies by micromanipulations, but of a superior species made to order. The pollyannaistic promisers have not read Burnet, whose book (see above) scholastically shows that genes are inscrutable, dreams unending, and realities harsh.

The 2000 AD edition of the Concise Oxford Textbook of Medicine carries a foreword by Sir David Weatherall, who warns: "As we move into the new millennium, medical practice is going through an uneasy time. None of the Western societies have come to grips with how to cope up with the increasing expectations of medical care and the spiralling costs. Hospital-based practice has become increasingly compartmentalized and specialized. This has resulted in an increasing dearth of teachers who can provide students and young trainees with the kind of balanced picture of medical practice that they require." The summary failure of modern medicine vis-a-vis every aspect of cancer should drive home the worth of the heretic tenth chapter of this book, namely, that "Cancer is untreatable" in terms of gaining ground with respect to the cause, the course or the cure of cancer. If modern medicine is not worried about the three Cs in the foregoing, it could as well continue to research and promise on cancer till eternity.

March, 2001Manu Kothari
Lopa Mehta
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