A NEW CANCER HYPOTHESIS

Despite intensive efforts to cure breast cancer, treatment generally f ails, as evidenced by the age-adjusted mortality rate for breast cance r. For 60 years, breast cancer mortality remained virtually constant. As treatment failed to improve the life prospect of the average patien t, it is based on false premises, e.g. Halsted's hypothesis, according to which the tumor is the only threat to the patient. Yet there is mo re to cancer than just the tumor. Two hallmarks of cancer, cachexia, a nd paraneoplasia, are usually ignored, since it is assumed that they a re caused by the tumor. But what if it is the other way round, and can cer is first of all a cachexia accompanied by a tumor? At least this c ould explain why, in most cancers, treatment fails. Cancer is a chroni c systemic disease with local manifestations like arteriosclerosis, wh ich is also systemic and manifested solely by its local manifestations , e.g. stroke and myocardial infarction. In the same way as treatment of an ailing heart does not cure the underlying arteriosclerosis, tumo r removal does not cure cancer, as it is 'metabolically' systemic. It is proposed here that carcinogens deplete a vital substance and induce a metabolic deficiency that ends in cachexia. In order to survive, th e organism grows a protective organ the tumor - that replenishes the m issing substance. During the preclinical phase of cancer, deficiency i s slight and compensated only by a minute tumor. With time, it gets wo rse and the tumor has to grow more and more in order to make up for th e loss, causing pain and secondary damage to vital functions. The pati ent seeks help and the disease starts its clinical course. When defici ency worsens, the patient becomes cachectic and dies. Such a metabolic relationship exists in pernicious anemia, which illustrates how a tum or might be protective. Cancer is viewed here as pernicious cachexia i nduced by the loss of a vital metabolite and compensated by the tumor. Until the discovery of the missing substance, treatment ought to pres erve the tumor and alleviate its secondary manifestations.