The three steps to cancer: A new concept of cancerigenesis

A new theory of carcinogenesis is presented. It is based on the premise that the initial step in the development of cancer is injury by a carcinogen of the coding units in the specialized cells which direct or control the elaboration of a specific “product” or “function”. Carcinogens are varied and number in the thousands, yet the end result, following exposure to them by target stem cells, is always the same, i.e. unbridled cell multiplication with invasion and metastasis. There must be one common denominator which, as stated, is the injury of the coding units of the specialist cells. This is the first step toward cancer; the carcinogen need no longer be present. The second is the uninhibited activity by a pertinent stimulator on functionally deficient cells which remain refractory to the demands for the differentiated “product” or “function”. However, the cells do remain responsive to the second aspect of the dual-roled stimulator, namely, the stimulus to divide. This results in hyperplasia and neoplasia. The events characterizing the third step are coincidental or accidental. There is cellular overcrowding, but the neovasculature is often initially or eventually inadequate. As a result, foci deficient in nutrients form, some cells die, and others become detached and thrive in the culture medium provided by the host through the rupture of capillaries, venules and/or arterioles, forming an area of hemorrhage and necrosis. Surviving cells become autonomous, anaplastic, cataplastic, cannibalistic, invasive and metastatic, i.e. cancer (Fig. 4). Since cancer is only possible in multicellular organisms, the author traces evolution of multicells from unicells. The latter are autonomous and cancer among them is a nonentity. The multicellular organism, on the other hand, is composed of inter-dependent organs, whose component cells are specialists by virtue of contained specific coding apparatuses. Concomitant with this development, an exquisitely sensitive “checks and balances” system of Inductors, Differentiators, Stimulators and Inhibitors, involving Neuroendocrine, Immune and other humeral factors evolved whereby harmonious orchestration of functions was attained and chaos avoided. The article includes clinical and experimental evidence in support of the thesis that the defective stem cell represents the initial step in the development of cancer. A discussion of the characteristics of the cancer cell follows, and an evaluation of the present modalities of treatment. Some of the shortcomings and failures are reviewed and suggestions for a completely different approach to therapy is presented. The essence of new therapy is the realization that cancer is not an infection, is not caused by foreign predators, but is the manifestation of the response of the body to its own, i.e. idiosomatic, predators. The cancer cell mass is not a cause but an effect, and its total eradication or destruction following spread is not feasible. The future may lie in measures which “reform”, rehabilitate and differentiate the anaplastic cell.