Published on July 24, 2024 12:25 AM GMT
Book review: The Cancer Resolution?: Cancer reinterpreted throughanother lens, by Mark Lintern.
In the grand tradition of outsiders overturning scientific paradigms,this book proposes a bold new theory: cancer isn't a cellularmalfunction, but a fungal invasion.
Lintern spends too many pages railing against the medical establishment,which feels more like ax-grinding than science. I mostly agreed with hisconclusions here, but mostly for somewhat different reasons than theones he provides.
If you can push through this preamble, you'll find a treasure trove ofscientific intrigue.
Lintern's central claim is that fungal infections, not geneticmutations, are the primary cause of cancer. He dubs this the "CellSuppression theory," painting a picture of fungi as cellular puppetmasters, manipulating our cells for their own nefarious ends. This partsounds much more like classical science, backed by hundreds of quotesfrom peer-reviewed literature.
Those quotes provide extensive evidence that Lintern's theory predictsdozens of cancer features better than do the established theories.
Older Theories
The DNA Theory (aka Somatic Mutation Theory): The reigningheavyweight, this theory posits that cancer results from an accumulationof genetic mutations in critical genes that control cell growth,division, and death.
Another old theory that still has advocates is the Metabolic Theory.This theory suggests that cancer is primarily a metabolic disease,characterized by impaired cellular energy production (the Warburgeffect). It proposesthat damage to mitochondria is a key factor in cancer development. Iwrote a mixedreviewof a book about it.
Lintern points out evidence that mitochondria are turned off bysignals,not damaged. He also notes that tumors with malfunctioning mitochondriaare relativelybenign.
Evidence Discrediting the DNA Theory
The standard version of the DNA Theory predicts that all cancer cellswill have mutations that affect replication, apoptosis, etc.
Around 2008 to 2013, substantial genetic data became available forcancer cells. Lintern wants us to believe that this evidence fullydiscredits the DNA Theory.
The actual evidence seems more complex than Lintern indicates.
The strongest evidence is that they found cancers that seem to have nomutations.
Almost as important is that the mutations that are found seem morerandomly distributed than would be expected if they caused consistenttypes of malfunctions.
Lintern's theory seems to explain all of the Hallmarks ofCancer,as well as a few dozen other features that seem to occur in all cancers.
He argues that the DNA Theory does a poor job of explaining thehallmarks. DNA Theorists likely reject that characterization. Theyappear to have thought their theory explained the hallmarks back beforethe genetic data became available (mostly just positing mutations foreach hallmark?). My guess is that they are busy adding epicycles totheir theory, but the situation is complex enough that I'm havingtrouble evaluating it.
He also points out that the DNA Theory struggles with Peto'sParadox (why don'tlarger animals get more cancer?), while his theory neatly sidesteps thisissue.
Additionally, mouse embryos formed from cancer cells showed no signs ofcancer.
Evidence of Fungi
A key game-changer is the growing evidence of fungi in tumors. Until2017, tumors were thought to be microbe-free. Now? We're finding fungiin all types ofcancer,with tumor-specific fungal profiles.
There's even talk of using fungal DNA signatures to distinguish cancerpatients from healthyindividuals.
It's not a slam dunk for Lintern's theory, but it shifts the oddssignificantly.
Medical Establishment Inertia
It looks like people in the medical mainstream respond respectfully tothe ideas in the book, when they react at all. Yet the DNA Theory seemsto remain the prevailing dogma. The shortage of reactions to Lintern isdisappointing.
My impression is that researchers are hedging their bets when they canconveniently do so, but many of them have built careers that depend onthe DNA Theory.
It's possible that some important parts of the establishment arepivoting their research in the directions that Lintern suggests, and arebeing quiet until they have something worth publishing.
It seems likely that some parts of the establishment are treating theDNA Theory as a religion rather than a theory. I can't tell howwidespread that problem is.
Possibly some apathy toward fungal infections is because solutions aresomewhat less likely to involve patentable treatments. But there'sstill some room for patenting new anti-fungals, so I doubt that this isthe primary obstacle to accepting Lintern's theory.
Paul Ewald's book PlagueTimeanticipated some of Lintern's claims, arguing that pathogens are theroot cause of many chronic diseases. It was published in 2000, andoverlooks fungi (little of Lintern's evidence was available then).Ewald's reasoning is more theoretical than Lintern's.
My limited attempt to spread Ewald's theory stopped when someonepointed to evidence that mice raised in a sterile environment developedmost of the same chronic diseases. Lintern counters that there are manymicrobes that aren't detected by the tests that supposedly confirmedthat the mice were microbe-free, so we should wonder whether theexperiments demonstrated much. I feel foolish for not wondering aboutthat 20+ years ago.
This reminds me of how long it took to refute the theory of spontaneousgeneration, due to mistakenbeliefsabout what it took to create a sterile environment.
Lintern reports that fungal infections have also been implicated inParkinson'sdisease andmultiple sclerosis, yetmany sources still say we don't know the causes of those diseases. Isthere a pattern here?
I often say to myself that much of the medical establishment acts as ifthey believe our bodies are the result of semi-intelligent design ratherthan evolution. E.g. their disinterest in a paleo diet. This bookreinforced that impression.
Experimental History has some relevantcommentsabout the state of cancer research.
Many Cancers?
Maybe parts of the medical establishment have rejected the whole idea ofa theory of cancer.
Researchers who try to take the DNA Theory seriously end up confused bythe variety of different mutations that they end up studying. This focusmakes it hard to see the similarities between tumors.
I've seen many denials that cancer is a single disease. I see a gooddeal of tension between those denials and the DNA Theory. And don't theHallmarks of Cancer point to it being a single disease?
Ironically, Lintern advocates a single-disease model, even though histheory implies that a wide range of different fungi are responsible.Presumably many different anti-fungals are needed for the differenttypes of fungi. So in some sense the many-cancers view is likely to bepartly correct.
Implications for Treatment
Lintern doesn't offer much hope for reliable cures. He offers manysomewhat new ideas for treatments that will sometimes work. The mostobvious ones are anti-fungal drugs.
Progress at treating diseases that are known to be fungal infections maybe a bit better than progress at curing cancer, but deaths from fungalinfections have still been increasing.
Much of Lintern's advice for people who have cancer now consists ofstandard recommendations to adopt a healthy lifestyle. That shouldn'tbe surprising: if most chronic diseases are due to pathogens, there willbe plenty of overlap in strategies for fighting them.
That includes a long section on the benefits of organic food. I wasunimpressed by how it started, with a correlational study that likelyhad confounders that couldn't reasonably be controlled for. But he madeup for that by explaining several causal models that I hadn'tpreviously considered.
E.g. fungicides. Indiscriminate use of fungicides on non-organic cropsmeans that there are fewer beneficial fungi which provide nutrients tothe plant, leading the plant to have less nutritional value. Moreimportantly, plants defend themselves against fungi, similar to thefungi that endanger us, by generating anti-fungal compounds that arewell targeted against those fungi. Organic foods have more of thoseanti-fungals, because they're produced in reaction to fungal attacks.Those anti-fungals sometimes work in our bodies when we eat them.
I ended up deciding to give slightly higher priority to buying organicfood.
Lintern suggests that chemotherapy is generally a bad idea. One clearreason is that it damages the immune system, and the immune system isthe main defense against additional cancers. But he still supports it incases where it shrinks the tumor enough to enable surgery. I continue tobe concerned about how hard it would be to evaluate a doctor'srecommendation to get chemotherapy.
What does Lintern's theory mean for Aubrey de Grey's proposed cure forcancer (WILT)? That looks much less promising now. WILT no longer lookslike it addresses the root cause of cancer. Even if Lintern's theory issomewhat wrong, cancer stem cells now seem much more important thanregular cancer cells as a source of excessive cell replication. Cancerstem cells don't depend on telomerase in the way that other cells do.It looks like Aubrey has a new version WILT 2.0 which does something toaddress cancer stem cells. What little I understand of it leaves meskeptical.
The good news is that cancer rates can likely be reduced to roughly therates seen in young adults if other parts of Aubrey's plan work,particularly the parts that affect the immune system.
Concluding Thoughts
There's actually an important similarity between the DNA Theory andLintern's theory. In both, eukaryotic cells have evolved to serve theirown interests, in ways that conflict with the host's interests. The keydifference is when that evolution started: years before the cancer wasdetected, or millions of years?
Evolutionary theory should create a moderate presumption that hostileorganisms do more harm to our bodies than do mistakes.
Lintern's theory seems to have more explanatory power than any othertheory.
Whether or not Lintern is entirely correct, his work highlights twocrucial points:
We shouldn't demand that all proposed cancer treatments conform tothe DNA Theory.
We need to rethink how we evaluate the effectiveness of cancertreatments. There's large room for improvement in the choice ofcriteria without adopting a strong opinion on which theory of cancer iscorrect. The evidence concerning cancer stem cells seems like a strongargument against relying on tumor shrinkage as evidence of success.
At one level, scientists have failed badly at explaining cancer, and itseems like only an outsider was able to point out that the emperor hasno clothes.
But that's at the level of broad theory. At the level of smallexperiments, the medical establishment has been diligently uncoveringplenty of evidence to reject the DNA Theory and to focus some attentionon pathogens.
The book isn't as professionally written as I'd like. E.g. hesometimes cites news stories instead of the peer-reviewed papers onwhich the stories are based.
Parts of the book are difficult to read. Most people should feel free toskip parts of the book, mainly after page 250.
H/T Dave Asprey.
Discuss
