Cancer, in all of its many forms, is a terrible disease, and when you are part of a family where cancer has taken its grim toll you come to dread the very word. It is not surprising that many people — whether cancer sufferers or survivors and their family members, cancer charities, doctors, or researchers — have passionate views about the disease.
This was illustrated earlier this month when Cristian Tomasetti and Bert Vogelstein of Johns Hopkins University published an article in the journal Science that attempted to quantify the role of random chance — what we might call “bad luck” — in the process that causes normal cells to mutate and become deadly agents. They found that while there were clear causes for certain forms of cancer, such as smoking and lung cancer and exposure to sunlight and skin cancer, more than half of many cancers appear to be the product of random mutation.
The notion that random mutation plays a role in the development of cancer is not a new idea; our bodies have 50 trillion individual cells, and in a number that enormous there are bound to be anomalies. Nevertheless, the Science article provoked a huge outcry. Some people accused the researchers of being shills for industry and overlooking or excusing the possibility that foods, chemicals, and other products and substances that we are exposed to are the cause of the cancers. Others depict the article as socially irresponsible, because the quantification of the significant role of simple “bad luck” may cause people to throw up their hands and forsake steps that can reduce the occurrence of cancer. And still others — such as parents of children who have battled cancer — were grateful for the suggestion that the cancers that have affected them and their families wasn’t their fault.
It’s an arbitrary world out there, and bad things happen for reasons, but also for no reason at all. We would like to think that we can control everything that might affect us, but obviously we can’t. When it comes to cancer, that reality doesn’t mean we should rush off to buy a pack of cigarettes, but it does mean that we should accept that bad luck plays a role and not reflexively blame the victim, their lifestyles, and their genes. Avoiding cancer-causing agents remains important — but the unfortunate reality of random mutation and bad luck means that early detection is crucially important, too.