I recently read a fascinating book, How Life Works by Philip Ball. It expands on the simplistic view of genetics that is taught in school (all the way from elementary school to medical school, in my experience). Genes and the proteins they encode are not the master switch for how the body functions. Instead, tissues and cells behave in a certain way due to the signals in their environment and from other cells. An analogy the author uses is that we would not expect to understand literature by taking apart a typewriter to see how it works. Examining the minutiae of how a cell makes proteins is the equivalent of doing that. The molecules that DNA makes are tools, not determinants for our lives.

    However, I do not recommend that everyone read this book. The author tried hard to make the material accessible to a layperson, but a layperson would have to be quite dedicated to get through it. An article by Bell in Quanta Magazine, titled “Biologists Rethink the Logic Behind Cells’ Molecular Signals,” gives a taste of what the book is like.

    While I read the book, I was struck by the remarkable number of ways cells have to get things done. As a result, cancer cells are quite good at figuring out ways to get around any effort to control them by tinkering with individual genes in their makeup. Treatments based on genetic markers and manipulations can be tremendously helpful in the short run, helping patients who are desperately ill at diagnosis to function. But they are rarely a curative option for metastatic disease. To quote the book:

Given the well-established link between cancer and genetic mutation, the disease has come to be seen as an aberration that is best understood and mitigated by seeking its genetic origins and developing treatments to suppress them. But decades of effort based on this picture have yielded little in the way of treatments.

    The author then examines the concept of “cancer as demented development,” not a disease of individual cells but of tissue organization. The author references some of the same articles I reviewed in a previous newsletter.

    The concepts described here bear much resemblance to the work of John Beard, more than a century ago. He too described cancer as a disease of aberrant development, a problem at the tissue level. And based on the body’s mechanism to control another tissue in early development, the trophoblast, he also came up with a solution — pancreatic enzymes.

    Reading this book was both encouraging and frustrating; encouraging because eventually the medical world may see the value in what Beard theorized, frustrating because it has taken so long. I wish Dr. Gonzalez, Dr. Kelley, Dr. Shively, or for that matter Dr. Beard himself were still alive to see it.