on cancer and other unfiltered thoughts

I’m engrossed with Azra Raza’s new release ‘The First Cell’. For those of you who love Atul Gawande and Paul Kalanithi, Raza writes in a similar style – poetic, beautiful, moving prose but with medical rigorous language as someone who is well-read in the field. She explores both the human and scientific sides of our human battle against cancer and gives refreshing perspective on how our paradigms need to change. I spent the morning reading the first few chapters, and I’m hooked. 

Here are some of my unfiltered thoughts that came after:

I’ve had two dreams so far in which I’ve had brain cancer.

My friend, Chris, tells me it means I’m working too hard. My research is sub-consciously slipping into my dreams.

All I know is that I’ve woken up each time with an intense wave of relief that my body is not racked with glioblastoma (the aggressive type of brain cancer my research is focused on).

But, in a strange way, also curiously mystified to the fact that it isn’t.

According to Raza, 3 copying errors occur with each round of DNA replication. These errors could be due to mistakes in base pairing, induced by DNA polymerase, the enzyme responsible for organizing the whole affair, or even spontaneous DNA damage caused by reactive oxygen species that our body naturally generates from metabolism.

So, simply just by existing, and having cells that replicate, there will be these mutations that occur.

I probably have a few hundred mutated cells circulating around in my body this instant (don’t quote me on this – I did not get this from any scientific paper, again, the unfiltered thoughts of Vivienne Tam).

Of course, on which genes the mutations occur is key.

If they occur on one of the 140 driver genes that determine cellular fate or survival or control the mutation rate of all the other genes (BRCA), the cell is much more likely to turn cancerous and turn into the uncontrollable beast we know very well.

And of course, your body’s environment – whether it has the appropriate inflammatory environment for the cancerous cell to take up residence – will determine if it has the chance to proliferate.

So, yes, being exposed to tobacco, alcohol, UV radiation (too much sun) and even pathogens could provide that kind of environment.

On a side note, I was carrying out a reaction in my fume hood two weeks ago with oxalyl chloride, a chemical that releases toxic fumes, when I suddenly realized (when I started feeling a bit light-headed) that the light beside the fume hood was red, instead of green!

Meaning that the toxic fumes were not being removed by the fume hood (!!)

The fume hoods are always something you take for granted – I pay more attention to my reaction than whether my fume hood is working – but warning to all you chemists out there, fume hood lights are important!

I spent the next few hours with a slight headache, wondering if the fumes might have induced some sort of genetic mutation and if so, how much time of of my life it would have taken off.

All that to say – we try our best to limit our exposure to carcinogens, but unexpected things happen and unless you live in a glove box with no interaction with the outside world, mutations are just a part of human life.

Although, still, don’t smoke.

Anyways, when I reflect on how we acquire all these random mutations and exposure to known (and unknown) carcinogens over the course of our life, I’m both grateful and mystified that I don’t have cancer.

When people newly contract cancer, I think the most common question to ask is “Why me? I don’t smoke. I’m healthy.”

But this book, and my research on cancer, is increasingly leading me to think the question, “Why not me? Why am I healthy? Why do my organs continue to function the way they do? Why do my cells continue to divide without me even instructing then to do so?”

These are processes I have absolutely no control over, which both terrifies and humbles me at the same time.

So, this morning, I prayed for my cells – that they would replicate their DNA well.

I prayed for my DNA polymerase – for all the work it does, it probably doesn’t get enough prayer. It only comes to our mind when it makes a mistake, when most of the time, it’s faithfully copying base pair after base pair.

And I thanked God that for all the things that could go wrong and that I have no control over, that at least, I have today to live. And for that I’m very grateful.

P.S. If you would have read “The First Cell” and have any thoughts to share, please shoot me a message! I’m in the middle of reading it and would love to discuss it with people.