There’s a nice laymen’s explanation for how most types of diseases work. Viruses, for example, are little pods that inject DNA or RNA into your cells, thus replicating themselves. (Here’s an awesome video by Robert Krulwich and David Bolinsky illustrating how a flu virus works.) Similarly, bacteria, fungi, and various other parasites are independent organisms–made of cells just like us–and its their process of going about their lives inside of us–eating various things (sometimes parts of us), excreting, releasing various chemicals, etc–that makes us sick (or gives us rashes or helps us digest food or boosts our immune system, etc). These various pathogens have evolved to kill. Autoimmune diseases are incredibly complicated (and often poorly understood), but the rough idea is clear: We have cells in our body that are designed to kill off viruses, bacteria, fungi, etc., and sometimes they screw up and kill the good guys instead of the bad guys.
All of those simplified descriptions make perfect sense, and as I’ve become more of a medical nerd, they’ve essentially held up to scrutiny. In other words, they’re good models.
However, the pop-culture description(s) of cancer never really satisfied me. In fact, I would argue that most descriptions of cancer actually ignore the basic question of what the hell this thing is and why it exists. Even my beloved Wikipedia neglects to just come out and say what the damn thing is in its main article about it, though its article on carcinogenesis is pretty good. That type of thing gets on my nerves–I don’t really understand how people can be comfortable talking about something without knowing what it is.
So, until recently, I knew embarrassingly little about cancer. Obviously, I understood that cells mutated and divided rapidly to form cancer, but what made them do that? And why are such a huge variety of things implicated in causing cancer? Radiation, cigarette smoke, HPV, and asbestos are very different things, so how can they all cause the same type of disease? What makes these evil mutant cells so damn deadly? What the hell is metastasis, and why does it happen? I did a decent amount of research and learned some stuff, but I still didn’t really understand what cancer actually is.
That changed thanks to the awesome NPR radio show/podcast Radiolab (which you should absolutely check out if you haven’t already–especially the archives). Their episode on cancer, “Famous Tumors,”finally provided me with a description of cancer that made any sense. It’s still the only decent layman’s explanation of what cancer actually is that I’ve been able to find (and I did a lot of searching while I was writing this blog post up). Once I understood the basics, I found that my other research on the subject actually made sense–even though almost all of it neglected to define the concept in question.
Anyway, you should probably just listen to “Famous Tumors” right now. Seriously. The part that led to my epiphany is a very brief segment that starts around minute eleven or so, and (as is Radiolab’s style), it’s described quite beautifully.
However, for those of you who’d rather read my ramblings, I’ll provide my own description below. In keeping with my tradition of verbosity, this post will take a while to actually mention cancer directly, but I swear the whole thing’s about cancer. Bear with me.
The story starts with a description of what we are:
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