This is among the most frequent questions asked when someone gets a diagnostic of cancer. You try to find a reason why you have this cancer. You try to see how you could have avoided it. Since medicine at present can only rarely identify the exact cause for a cancer, you are tempted to seek reasons elsewhere.
The multiple risk factors of cancer
Cancer is a disease that can be influenced by multiple factors. These factors can increase the risk of cancer without being identified as a clear reason. Scientific research is continuously trying to better understand patterns and links between risk factors and cancer.
Cancer is not a punishment
Many authors have written about the “Why me?” question. Sometimes through a spiritual process or by trying to establish a link between emotions and cancer.
An answer to “Why me?” would mean that you did something wrong. That you could have had better life habits, better relationships with others, that you could have controlled things better to avoid getting a cancer. Just like if cancer was a punishment.
Cancer is a matter of cells
In reality, the cancerous cells don’t really bother about the body they live in (yours in this case). To understand better how cells “think”, we will look closer at the biological mechanism behind life as we understand it today: evolution.
The Evolution of life
Evolution is a theory that explains life and its history. Charles Darwin explained the basics in the book The Origin of Species in 1859. Since then, the “ theory of evolution” has profoundly influenced life sciences and humanities. We will shortly see how it concerns your cancer.*
Evolution: to survive and to reproduce
The core of the theory of evolution is
Survival and reproduction allow your genes to pass to your children.
Sometimes, genetic mutations will happen (for better or worse)
Small mutations will change the genetic material that is transferred to your children. Those genetic mutations can be visible or invisible.
Evolution is for cells too
Evolution applies also for cells. They also undergo mutations to survive better, and one of the side effects is that some cells survive so well that they don’t stop growing, ….and become a cancer.
Cancer in action, evolution included
Cells lineages develop more quickly than a new species. A new species can take millions of years to evolve, whereas a cancer cell lineage, in comparison, takes a few months up to a few years.
Let’s have an example to make it clearer. A DNA mutation in a cell in a vital organ like the liver can give a proliferation advantage to a cell that grows quickly. That cell will reproduce quicker than its neighboring liver cells and, become more and more numerous, and, eventually, simply viewed,the vital organ will have a cancer.
You can wonder what benefit there is for a cell lineage to do harm to its living host, such as the cancer in the liver in the example above. Well, we could simplify evolution to the individual cell that behaves like an individual and acts for its own growth. The cancerous cells act for their own survival and to reproduce themselves even if they hurt the individual they live in. In other words, the cell “enjoys” growing fast and does not bother about hurting its host.
Less “why me?” more “what now?”
Talking about cancer in terms of biology and evolution shows that people have very little to do with the development of a cancer. It is a blind process that does not distinguish “good” people from “bad” people. It can be enabled or not by one or many risk factors.
The cells that help keep you alive and those that harm you don’t see the bigger picture, and only think about surviving and reproducing themselves, a little like single celled humans.
Even if the desire to explain your disease is strong, it is better to put aside those questions because they will remain unanswered. Because they may make you feel bad about yourself whereas you should not feel that way.
What is important is to focus on how to best deal with those cells that have become intruders and to figure out the best way to maintain the big you by eliminating the selfish cancer cells trying to grow over you.
- Linda Lei, previous medical librarian at JGH Gynecologic Oncology
- Walter Gotlieb, MD, PhD, Medical Director of the Gynecologic Oncology Team
* Please note that the explanation of the theory of evolution is described here in a very simplified way. If you are interested to know more about it more in-depth, you can find numerous books, documentaries, websites, etc. for every type of public online or at your local library.
** Book suggestion: Faire face au cancer avec la pensée réaliste par Josée Savard (2010, Flammarion)
- Understanding Evolution : Another Perspective on Cancer : Evolution Within (page consulted January 20, 2014)
- Casás-Selves, Matias and DeGregori, James. How cancer shapes evolution, and how evolution shapes cancer, in Evolution (N Y). 2011 December; 4(4): 624–634. (page consulted January 20, 2014)
- Howard Hughes Medical Institute. Biointeractive. The Evolution of Cancer. (page consulted January 20, 2014)