Download 2016-01-01 Cancer and Terrorism

Preventive Medicine Column
January 1, 2016
Cancer and Terrorism
Terrorism is commonly, and aptly, I think, compared to cancer. I recognize that neither cancer nor
terrorism may seem opportune grist for the New Year mill- unless fervent wishes to see a lot less of both in
2016 qualify. But I believe that where the resemblances of the two commingle, there is indeed an uplifting
message, and lessons for more enlightened action across the full expanse from war, to love. Suspend disbelief
accordingly if amenable, and stick with me.
Cancer is to some extent a native disposition of cells in their multitudes, subject to mutation at
varying rates. This notion was rather exaggerated at us a year ago, when headlines told of the primacy of
random factors. This year, we received the corrective, opposing reaction, in a study asserting the importance
of factors we ostensibly control. We are left knowing what we have long known, that we and our
circumstances have considerable influence over our oncological destiny, but never perfect control.
Terrorism, too, is to some extent a native disposition of people in their multitudes, subject to
radicalism at varying rates, prone to primal impulses of tribalism, xenophobia, and territoriality.
In both cases, that native rate is deterred or accelerated by the balance of exposures, salutary or
seditious. In the case of cells, the salutary exposures are products of lifestyle and environment: diet, sleep,
and exercise; air, water, and shelter. The noxious exposures are toxins, from tobacco to pathogens to
pollution, degraded environments, all manner of duress, and the many adulterations of diet. In the case of
people, radicalism is fomented by destitution, privation, hopelessness, helplessness, and the insularity of echo
chambers. Such forces are opposed by opportunity, self-actualization, kindness, security, equity, education,
and the unimpeded flow of competing ideas.
Cancer, of course, invades our bodies; terrorism, the body politic. But for the divergence of this
provenance, the analogy is remarkably robust. It cannot be invoked so blithely, without respect for its
implications. Those implications point both ways, to the limits of love and war. They argue for restraint and
cautious respect for the costs of collateral damage. But they argue as well for sufficient force to do the
essential.
There is a spectrum of appropriate responses to cancer. Active surveillance, in the form of cancer
screening, is a first defense, allowing at times for prevention. When cancer is established, but isolated and
prone to indolence- we may merely monitor it closely. Cancer has taught us to be wary of unnecessary
“cures,” worse than the natural history of the untreated disease.
When injurious to surrounding tissue, and threatening more of the same, however, cancer demands a
harsh, if localized reprisal. If resurgent thereafter, invading locally, or propagating distally, it requires a
commensurate, systemic remedy. Across this expanse, there is established benefit in nurturing the vitality,
resilience, and resistance of the body in which a cancer has gained purchase.
Science argues decidedly for care of the whole person, not just their pathology. Effective attention to
the whole person can foster recovery, reduce the risk of recurrence, and favorably alter the propensity for
future mutations at their origins. The same is true, presumably, of terrorism.
When cancer is localized and limited, targeted therapies are preferred and may suffice. Surgery, at
times, is curative. Radiation, regionally channeled, can be as well. Cancers of notorious virulence, however,
or those already seen to have spread, demand systemic treatment, chemotherapy the most familiar. At times,
good tissue is willfully sacrificed to banish the bad, as when bone marrow is ablated and replaced.
The intensive care of a person, as seen in ICUs, requires rather complete medical governance. For the
sake of potential, eventual recovery, the individual, in extremis, must at times surrender all control. Does the
terrorism analogy extend this far?
The iron fist demagogues wave in our faces and use to pound the table could be put to far better use.
That hand should wield the requisite armaments with all due force, but with the best approximations of
surgical precision. It should be bold, but not brutal. It should incline toward tenderness for the common
humanity, most vulnerable to mutating radicalisms when preferable alternatives are most elusive. It should
proffer just such alternatives at every opportunity. It should, whenever possible, be a gentle hand; a
comforting hand; a guiding hand.
It should, indeed, when necessary, be an iron fist- but even then, it should wear the oft-forgotten
velvet - or perhaps surgical - glove.
-fin
Dr. David L. Katz;www.davidkatzmd.com; author, Disease Proof; founder, True Health Initiative