The complexities of disease
Posted on May 27th, 2007
by 
spiral5
spiral5
Today a press release from Forbes (http://www.forbes.com/forbeslife/health/feeds/hscout/2007/05/27/hscout604980.html) summarized new findings in breast cancer research. The new research is being hailed as the biggest breakthrough since the discovery of two important predictive genes for breast cancer, BRCA 1 and BRCA 2, in 1994. When an individual has these genes they are at very high risk for breast and ovarian cancer. Fortunately these genes are rare and are present in only 5% of those with the disease. The other 95% are in the dark regarding why they have succumbed to the disease.
Today’s announcements herald the identification of four more genes associated with breast cancer-FGFR2, TNRC9, MAP3K1 and LSP1, from results out of three independent labs. The FGFR2 gene appears to be present in 60% of American women. Genes come in pairs, and for women with one copy the risk appeared to be 20% jumping to 60% in those who have two copies of the gene. The data are interesting to be sure, but we must take care not to rush to conclusions about what they might mean.
Genes never act alone and it is rare for a disease to be linked back to just one gene. Cancer in particular is usually a multi-factorial disease with many interacting genes and other physiological influences that have to combine under favorable conditions for the disease to manifest itself. Some cancer are even caused by viruses such as HPV.
All of us have known someone with breast cancer or had it ourselves. One in three women who are diagnosed with cancer will have cancer of the breast. If it is found before it has spread (in situ), the success rate of treatment is remarkably high. Some oncologists regard cancer in situ as not really cancer at all, rather a precursor to the spreadable kind that kills. I lost two friends to the disease last year. We say people die of breast cancer, but technically no-one does. While the cancer may start in the breast tissue, the disease only turns into a deadly killer when it has migrated, often to the liver or to the bone which, contrary to breasts, are essential for life.
When we get news of exciting discoveries such as those published today, we become very hopeful that a cure may not be far behind. Unfortunately, today’s findings, while highly significant, are just more noise in an already very loud room. This is not to diminish the findings, nor the sincere efforts of the smart scientists behind them. These scientific steps are necessary to further our understanding about cancer. However, in this data-rich room, a conductor is required to single out the gems and understand how harmony can be found amongst the seeming chaos. One question that requires a great deal of attention is whether the presence of a gene in an individual with cancer an indication that the gene was a risk factor for the disease, or merely a gene that happens to be present and is not causative.
Many scientist have turned to systems biology to make sense of the growing complexity in our understanding of disease. Systems biology attempts to put all the pieces together, but often this is a ground-up process which is a bit like trying to put Humpty Dumpty together again when you didn’t see him before he fell off the wall. I believe integral science may be able to help. The newer intelligence tools (www.biowisdom.com as an example) could, along with some questions from diverse fields around the periphery of traditional science, provide a more holistic perspective than has been typical in the past. The answers to why some folks get cancer and some do not, and why some folks who get cancer survive and others don’t, will come from looking at the whole picture—lifestyle, genes, diet, medication history, environmental influences etc. Even the level of the spiral, or our Myers-Briggs type could be included. We are all unique, and it will be difficult to take medicine to the next level that fully recognizes this. Ontological systems that can record our ‘is-ness’ will be vital to understanding why we succumb or why we do not, as well as point us in the direction of more effective prevention and individualized cures.
Today’s announcements herald the identification of four more genes associated with breast cancer-FGFR2, TNRC9, MAP3K1 and LSP1, from results out of three independent labs. The FGFR2 gene appears to be present in 60% of American women. Genes come in pairs, and for women with one copy the risk appeared to be 20% jumping to 60% in those who have two copies of the gene. The data are interesting to be sure, but we must take care not to rush to conclusions about what they might mean.
Genes never act alone and it is rare for a disease to be linked back to just one gene. Cancer in particular is usually a multi-factorial disease with many interacting genes and other physiological influences that have to combine under favorable conditions for the disease to manifest itself. Some cancer are even caused by viruses such as HPV.
All of us have known someone with breast cancer or had it ourselves. One in three women who are diagnosed with cancer will have cancer of the breast. If it is found before it has spread (in situ), the success rate of treatment is remarkably high. Some oncologists regard cancer in situ as not really cancer at all, rather a precursor to the spreadable kind that kills. I lost two friends to the disease last year. We say people die of breast cancer, but technically no-one does. While the cancer may start in the breast tissue, the disease only turns into a deadly killer when it has migrated, often to the liver or to the bone which, contrary to breasts, are essential for life.
When we get news of exciting discoveries such as those published today, we become very hopeful that a cure may not be far behind. Unfortunately, today’s findings, while highly significant, are just more noise in an already very loud room. This is not to diminish the findings, nor the sincere efforts of the smart scientists behind them. These scientific steps are necessary to further our understanding about cancer. However, in this data-rich room, a conductor is required to single out the gems and understand how harmony can be found amongst the seeming chaos. One question that requires a great deal of attention is whether the presence of a gene in an individual with cancer an indication that the gene was a risk factor for the disease, or merely a gene that happens to be present and is not causative.
Many scientist have turned to systems biology to make sense of the growing complexity in our understanding of disease. Systems biology attempts to put all the pieces together, but often this is a ground-up process which is a bit like trying to put Humpty Dumpty together again when you didn’t see him before he fell off the wall. I believe integral science may be able to help. The newer intelligence tools (www.biowisdom.com as an example) could, along with some questions from diverse fields around the periphery of traditional science, provide a more holistic perspective than has been typical in the past. The answers to why some folks get cancer and some do not, and why some folks who get cancer survive and others don’t, will come from looking at the whole picture—lifestyle, genes, diet, medication history, environmental influences etc. Even the level of the spiral, or our Myers-Briggs type could be included. We are all unique, and it will be difficult to take medicine to the next level that fully recognizes this. Ontological systems that can record our ‘is-ness’ will be vital to understanding why we succumb or why we do not, as well as point us in the direction of more effective prevention and individualized cures.
Access: Public
breast cancer
May 2008 