More on the Debate on Cancer

Oncologists Lament!

Abhijit Mukherjee

Your blog had highlighted through couple of posts, the report of Science on this New Year’s Day which took the cancer establishments by surprise that “Most cancers are caused by bad luck not genes or lifestyle”. Your bloggers also added a similar thought process was pioneered by two Indian doctors in 1969 viz. Dr. Manu Kothari and Dr. Lopa Mehta. Such revelations by Science was bound to create great amount of anxiety for the cancer establishments, as for decades they had tried to assign a cause to the causeless-ness of the cancer and continued to witch-hunt it. So we are not at all surprised when we saw in Times of India (1/2/2015) a report by Malathy Iyer “Not bad luck, pollutants & lifestyle cause most cancers”. However, if one starts reading between the lines one notices dilemma and sweeping remarks like “Tobacco is the cause for 40% to 50% of cancers in India as it increases the risk of cancers of the oral cavity, lungs, gastrointestinal tract and urinary bladder” (Dr. S D Banavali head of medicinal Oncology TMCH). Now if it is the cause for 40% to 50% of cancer of lungs or oral cavity, then why for the balance 50% it remains just a “risk factor”? On what basis this 50% figure is arrived at - no one knows. However Dr. Badwe the director of TMCH says “Every smoker doesn't get cancer, but there is a matter of luck in who among the smokers will get cancer” and the report laments “There seems to be no common thread linking all cancers”.  Dr. Manu Kothari and Dr. Lopa Mehta explained about this 'Common Thread' in their Nature of Cancer “The  enormous  hue  and  cry  over  the production  of  cancerogens  by  industrial growth,  and  such magisterial  statements that  ‘cancer  is a  disease  of  civilization’  do  not  take  into  account  the  fact that Cancer  is  an integral factor  in  the  evolutionary  process  and  has  a  history  as  long as  the  type  of  life  it  affects.” As a matter of fact representatives of cancer establishment like Siddhartha Mukherjee concedes “Nineteenth-century doctors often linked cancer to civilization:....The link was correct but causality was not: civilization did not cause cancer, but by extending human life spans - civilization unveiled it."[The Emperor of All Maladies] It appears that the medicos of TMCH continue to coincide correlation with causation.

I was so delighted to see a fantastic piece in the Bengali Daily – Ei Samay - by Dr. Sthabir Dasgupta on 31/1/2015। I wondered what the super-specialists of TMCH would have had to say if they read that piece because with his sharp reasoning Dr. Dasgupta floored the theories of environment and genes. However, a sense of melancholy prevailed in my mind after I concluded reading the article of Dr. Dasgupta as I recollected his superb obituary on Dr. Manu Kothari in EPW (8/11/2014) where he wrote, “We are more amused to see that the so-called Indian experts are still keeping themselves ignorant with contemptuous silence. However, we also know that they are destined to accept him, in time, because for them whatever emanates from the West is the best.”, the Ei Samay article was indeed an opportune space for Dr. Dasgupta to break the silence of 'Indian Experts'.