It is the question most frequently asked of doctors by patients who have just received a diagnosis of cancer, “Why me?” It is usually asked by those who thought they were living a healthy lifestyle and had little expectation of receiving the devastating news. Others may have been aware of near or distant family members who had a form of cancer.
While much progress has been made in the effort to understand multiple forms of cancer and the development of effective treatments, the answer to why some people get the disease and others do not remains predominately an elusive mystery. Cancer is known to be caused by changes, or mutations, to the DNA within cells that can cause the cell to stop its normal function and may allow a cell to become cancerous. Some faulty genes that increase the risk of cancer, known as inherited cancer genes, and genes that increase the risk of cancer called cancer susceptibility genes can be passed on from parent to child. But most of genetic mutations appear to occur after birth and aren’t inherited.
Environmental influences such as smoking, radiation, viruses, persistent exposure to cancer-causing chemicals (carcinogens), obesity, hormones, chronic inflammation and a lack of exercise has been proven to provide a more definitive answer to the “Why Me?”. Even with this accepted knowledge, some people who share one or more of these environment factors appear to avoid a cancer diagnosis altogether.
Why do some cancers spread and kill patients, while many remain docile? Seeking the answer to this question has researchers redirecting their approach for answers from why some get cancer to why so many do not. Ruslan Medzhitov, an Immunobiologist at Yale, says “You can inject the same virus into different hosts and get vastly different responses.”
Diagnosis and treatment becomes art and science. Researchers continue to develop and identify predictive tests based on gene mutations and patterns of gene regulation. These tests assist in targeting the right therapies and treatments for each patient. Research related to the micro-environments in which the cancer lives and spreads will provide beneficial to the prevention and early detection of cancer.
The field of oncology remains focused on a holistic approach factoring in the environment, genetic factors, and physiology, in the hopes of finding a concrete, science based answer to the “Why Me?”