Featured Image: Stanford University School of Medicine, Striking Commemorative Fountain reminding all who view it, of the unprecedented contributions to humanity, which were underway at the time in 2001.
What is Cancer
Gregor Mendel discovered the way by which father and mother genes are distributed when they get together to form a new person. Mendel proved this with beans in his famous experiments—intriguing and clever. Though farmers had known for centuries that crossbreeding of animals and plants could favor certain desirable traits, Mendel’s pea plant experiments conducted between 1856 and 1863 established many of the rules of heredity, now referred to as the laws of Mendelian inheritance. To say the least, everybody who learns basic genetics has learned it from the marvelous knowledge contributed by Mendel. In fact it has become an inherent part of our basic education in “life.” “Stem cells” refers to the newly formed cells which are the direct descendants of the two cells which joined to form one single cell, which is a new person. The one cell is a new entity, with a dignity, a personality, and a way of life. New and independent. However, it is derived from components, not only of the parents but the grandparents and from the culture from which it sprung, and from their epigenetics, the genetic material which is to be altered and affected by environment.
In the discipline of child development, the concept is that, environment allows release of all these factors in the new person little by little. What is just mentioned is that there are genes and also epigenetic changes.
What is most intriguing is that DNA with its genes has supervisory control as this new person matures in its own independence. The stem cells are the cells descendent from the single one cell. Note, by the way, that every one of the trillion cells in a person’s body, in the new body which is forming, has the same DNA code in each of the cells. These newer cells, however, have the ability to differentiate, generation by generation, into different cells: brain, heart, gastrointestinal, muscle, toenails, rectum—and once these new lines are solidly formed they no longer differentiate but replicate more of that new line as needed, without very much change except when the process of mutation occurs.
Mutations result from errors during DNA replication or other types of damage to DNA. Mutation is somewhat usual in the course of nature and somewhat under the influence of free radicals. Mutations may also result from insertion or deletion of segments of DNA, as in genetic modification by Monsanto. Mutations play a part in both normal and abnormal biological processes including: evolution, cancer, and the development of the immune system.
In my case, and please listen up here, my DNA code had differentiated for many generations and had long since been supervised into brain cells, etc., and these had replicated themselves quite a bit over the years with the natural occurrence of apoptosis (cell death). When cells dropped by the wayside they were replaced by other identical cells from the same line. This is more possible in a skink that can replace the entire tail organ, whereas we are better at replacing wounded or injured tissue.
When cells are replicated they are subject to change and mutate, with imperfections sometimes escaping central control. This is the short way of explaining how cancer forms. The cancer process is not entirely unlike people who have overthrown the government in politics, and not unlike changing from a socialistic programming (acting for the good of the whole body) to more of a republican or capitalistic point of view, operating in a self-centric manner. In a way these cells turn from socialistic to capitalistic, not concerned with the needs of the entire organism. The cancer cells corral nutrients to themselves of many sorts and they are able to feed themselves from bodily reserves, to the detriment of the other cells. They disobey mother control, which is our DNA. This is cancer.
But if these original cells, which are descendent from the brand new one, do not differentiate, they retain the potential to change and they have the ability to change into whatever is needed in the body in case of injury or deficiency or other necessity. As far as blood is concerned, only more or less one percent of blood cells remain undifferentiated. These are the mystical stem cells, the progenitors, we know who they are and where they are.
Stem cells are able to be gathered, and they can be asked to replace or repair injured tissue, which they seem to be attracted to by the chemicals of the injury.
After the birth of a new person, an arm must stay “an arm”. An arm when severed (cut off) cannot re-form another arm. But if the arm is damaged, or formed improperly, stem cells have the ability to make a repair. Similarly, the stem cells are at a stage of development just prior to becoming differentiated and have not yet lost the magic ability to do general formation of any and all organs, but they have the ability to perform regeneration of injury or abnormality.
So stem cells are able to perform regeneration of injury to organs and to do general repair where needed. We harvest them when they are still multi-potential, and able to know what and where repair help is needed for the good of the organism. Like plastic surgeons, they have great ability both in general practice and in specialization. This process is not yet refined enough to be clinically applicable.
When stem cells are harvested from bone marrow, this type of stem cell has the ability to form almost all of the various blood cells. For example, new lymphocytes have the ability to know what the bigger organism requires, or so it seems.
The Magic of Stem Cells
In this way, stem cell magic is a bit similar to the physiologic principles of human reproduction. Coincidentally principles of plastic and reconstructive surgery are similar also. The ability of cells to know what is asked with the organism, to know what to do about it, the power to diagnose and to fix it back as it should be, is a plastic and reconstructive surgery talent that is interestingly built into our DNA instructions. Stem cell magic, mammalian reproduction, and plastic and reconstructive surgery have goals with some similarity. In the case of conception, the new hybrid cell, i.e., part mother, part father, replicates quickly. These new cells soon begin to replicate rapidly, but then turn to the function of specialization in order to form our abilities—thinking, seeing, moving, interacting with others, etc. Brain, eyes, limbs, personality, immunity.
The stem cells in the case of stem cell transfers are early blood marrow cells ready to turn themselves into such special types of blood cells as lymphocytes (immunology), granulocytes (infection), red cells (for oxygen), monocytes (hand-to-hand warriors), eosinophils, and basophils.
Stem cells are multi-potential enough to help damaged tissue; for example, damaged brain in Parkinson’s. They have great future in the field of commercial retail medicine if we allow such to happen. Good luck to our ethics experts.
A word about cloning: certainly the apple tree has been cloned for years. That is, the disease-resistant rootstock sexually reproduced but is non-sexually grafted to an apple branch. This is a clone and it possesses tremendous productive capacity, because it was the best branch of a tree selected over the years, so there really is one-in-a-million selection leverage. This is the apple we are enjoying—a clone that seems to imply a type of perfection.
The wonderful apple clone is bound to be imperfect, susceptible to one bacteria or fungus or virus enemy which will be resistant to all the pesticides in the world. Chemicals won’t be able to cure it without paying the price of injury to humans and others, including the apple tree and all of its clones subsequently produced. Nature tends to be difficult to conquer, or even to control for long. Nature ups the ante until it doesn’t pay to stay in the game. The point is that we are tempted to take one stem cell from the most perfect human and produce another perfect human, or perhaps a million perfect humans. But the “perfect” ones will have an Achilles heel which when detected will cause the millions all to be in jeopardy unless we devise a greater and greater amount of complexity in protection. And then the process will escalate—more complicated protection, more complicated attacks, and so forth. It seems to be in our nature to try to control nature, but in the end nature prefers not to be completely controlled.
These new friends of ours, the stem cells, are actually able to form an entirely new person, an exact replica of the donor of the stem cells, although under very special conditions—in the future. Our stem cells can be found in a special group of cells which we harvest daily in plastic surgery “liposuction aspirate,” fat. It will be hard to resist the temptation to commercially exploit these stem cells.
I have personal experience in large-cell, or B-cell lymphoma (non Hodgkin’s lymphoma). I experienced a relentless and not-so-slow-growing condition of these lymphocytes of marrow in December 2001. Blood cells became maverick and were not working for the common interest of the organism, but rather for their own delights—they no longer obeyed headquarters’ central command.
The site of my particular tumor was inside the brain itself and, more than that, inside the blood vessels of the brain. The tumor had begun to grow through the vessels a little bit, in effect shutting off blood supply. This shutting off of blood supply created confusion in the original diagnosis because the net effect was similar to that of stroke: small places with no blood supply. There was no evidence of a cancer mass to be seen grossly on the MRI, only on the brain biopsy.
When cancer is part of the blood itself, or puts up shop in the blood vessels, we the medical profession call into play the “scorched earth policy” which is to wipe all those cells which aren’t working for the common good. Many non-cancerous cells are damaged. This is the collateral damage.
Cells in general are either socialists or capitalists. The large cell aggressive lymphocytes (my cancer cells) are not very good “socialist,” but rather “abusive capitalists”. Some helpful cells are also destroyed in the process.
The clever strategy developed to wipe out a cancer (in this case a lymphoma consisting of an uncontrolled and aberrant growth of lymphocytes of blood origin) is to utilize stem cells for just this job description, multiplication and specialized repair and reconstruction.
Drugs are administered by the agents of the aggressive oncologist, Aggressive with a capital “A”, because they seem to be more aggressive than the surgeons. At one time I had twelve IV bottles up on my IV stand, one with 2075 grams of a certain chemical, one of the highest doses of anything in my experience.
All bad cells are destroyed and many good ones are killed or damaged as in the “collateral damage” principle. It works like this: in five cycles of chemo. All of my marrow was discouraged from reproducing itself, so a white blood cell colony stimulating hormone is given. My white blood cell count went from 7500 (normal) to only 100. I had no white cells to defend myself from infection at that time. Under the influence of a white cell stimulating hormone, my white cells jumped from 300 to 61,000, and quite quickly. A triple-lumen catheter is placed in the jugular vein of the neck, and the blood is removed and centrifuged to separate out the puffy coat (white cells). The minimum requirement called for five million cells please, needing 15 million total, some for back up for later re-population if needed. I was proud I gave them more than expected,24 million, which were then stored at minus 300 degrees.
After harvest, more chemotherapy was given in the scorched earth way- all cells of blood and blood origin were asked to leave, or were wiped out. Several days later, five million stem cells were returned from the refrigerator. A bright and happy nurse popped in the doorway to the room with a 60cc syringe and asked me to roll up my sleeve in a matter of fact way, without fanfare. She found one of the last veins left from chemo and injected the stem cells, which in effect saved my life in that 5 minute period. It was a routine injection for her and the start of a new life for me.
A period of engraftment, two to three weeks, is needed for the cells to find their old home in the marrow once again and to start a factory to produce the blood cells, a sort of re-education camp. Recovery is two to four months. Return to normal activity level may require six months. Stem cells for example are able to replace the entire bone marrow, red cells, white cells, and platelets, which have been killed chemically by chemotherapy. (They obviously don’t replace the tumor cells, even if the tumor cells are blood cells themselves). Chemotherapy indeed treats the entire body, and there is a lot of collateral damage from the chemicals, even though they are smart bombs, even though not exactly smart. Perhaps a few stray tumor cells had not been destroyed with the chemo.
Whether the mystical stem cells will repair the brain, I can’t promise. I’ll learn many parts of immunity a second time because parts of the immune system have taken casualties. I have to learn how to defend once more.
My Cancer Reflection
In my case, D. Laub, in my youth I received trauma to the brain five times through concussion. Possibly this damaged some cells I had inherited which had a weaker defensive ability. Besides concussion, I used DDT derived herbicide in the kiwi fruit orchard, known to be harmful, on many occasions. I also received huge doses of UV radiation during six or more summers when I was working on construction without wearing a hat or shirt. In my case the damage in the cells mutated from intravascular large-cell aggressive lymphocyte cells. I calculated that it was perhaps one year and six months from the inception of the damage to a change in only a few cancer cells which then replicated themselves to the point where symptoms were reproduced in the overall body.
My first symptom was “Something isn’t right, here in my brain,” pointing to my head. The next was “I don’t remember how to drive home from a truck trip to the California Propane Company in San Jose. “ I couldn’t find my way back to our Los Altos Hills paradise. Finally, I found it difficult to walk down a hallway without bumping into either wall.
My own diagnosis by a skilled personal internist was “Depression, Don. I know it. All busy guys like you get it when you retire.” That was in 1998-99. Another diagnosis was “A stroke. Many small cardiovascular events. Many spots show here on the CAT scan, a few more than usual for a 68-year-old guy, some in the gray matter and some in the white matter as well.” A neurologist who has known me for twenty years, said, “I don’t know what to do about it.” But according to research by Julie and Judy, the best places for this kind of problem are Mayo Clinic, Scottsdale, and University of California at San Francisco Medical School (UCSF Medical).
My entire chart in hand, Judy dropped me off on Parnassus Avenue at UC Medical Center. Around me at UCSF Medical were many people walking fast, members of the community carrying briefcases, medical professionals, hospital employees. My x-rays were under my arm with my personal medical files. A janitor, who happened to be taking a break, was on the sidewalk with his robot cleaning machine. He saw the bewildered me and asked, “How can I help you?” I said, “Thanks. I’m looking for the MRI facility in the basement of this place.” He said, “I’ll take you there,” and he immediately abandoned his machine. He gave me more A1 top-notch level personal medical care right then than I had seen for quite a while before or after. I was thrilled.
 Prof. Patricia Hall, 16 October 2016, professor of child development, Cañada College, Redwood City, California.