When people begin to look at ways they may have participated in their development of cancer, it is a good idea to seek the aid and support of a trained counselor or therapist. Many times, just asking for help is the first step in breaking a “rule” one learned in early childhood and establishing a more healthy way of responding to stress. Unfortunately, many of us grew up with a culturally induced reluctance to seek help for emotional problems. Yet if we are diagnosed with a severe illness, we do not feel embarrassed or ashamed to seek the help of a physician who has spent many years learning about the body. Neither should we feel embarrassed about enlisting the help of a professional to learn the ways in which stress has played a role in our illness.Most of our patients who go through this process of self-examination see important links between their emotional states and the onset of their disease, as well as the ways they participated in these emotional states. But, having seen how their beliefs and behaviors in response to stress may have contributed, some begin to feel guilty about their actions in the past. You may have similar feelings, so we would like to give you the same advice we give our patients.First, it is not our intent, nor is it desirable, for you to feel guilty for having recognized that you’ve participated in your disease. There is a difference between being “to blame” for something and having “participated” in it. It makes no sense to blame persons living in this society for becoming ill in light of the rules they were taught for dealing with their emotions and feelings. (Few individuals in our culture have been taught how to deal with emotions and feelings appropriately.) Further, blame suggests a person consciously knew better and yet decided to respond or act in a self-damaging way. That is certainly not true of people who respond to stress by developing a physical illness. Like most people in our culture, you were probably not even aware of a link between emotional states and illness. Thus, the ways in which you did participate are almost certain to have been a result of unconscious beliefs and habitual behavior.It is a particularly sad course of events, that many times those people who most steadfastly and responsibly attempt to live up to cultural rules develop the most serious illnesses. The literature describing the emotional aspects of cancer is replete with examples characterizing cancer patients in general as “too good to be true”—people who are kind, considerate, unselfish, and pleasant in the face of all adversity.Individuals who begin to accept responsibility for influencing the state of their health deserve the greatest of congratulations. Not only are they willing to begin the process of exploring their own attitudes, emotions, and feelings—and the ways these contribute to their response to stressful situations—but they are also finding the courage to stand up to the cultural rules they were taught and to reject those that are not conducive to health.The real point of a self-examination is to turn up clues on how you can participate in health through a process of recognizing and changing self-destructive beliefs. If you have participated in the onset of the disease, you also have the power to participate in your recovery.*35\347\2*
It is clear that a number of crucial control elements called genes within the cell have to be altered before it becomes cancerous. What we have not yet said is how these alterations that produce the malfunctioning genes actually occur. A few of the processes that damage the genetic material are well understood, but most can only be described in very general terms. A small number of well-understood examples comes from the study of rare inherited cancers like retinoblastoma. Here it is easy to understand how the inheritance of an abnormal gene from parents can put the child at risk of developing a cancer. There are other examples of inherited cancer patterns. Perhaps the most closely studied is a condition (called familial polyposis coli) in which multiple growths occur in the bowel, many of them turning into cancers. Here again, the inheritance of an abnormal gene from parents puts the patient at risk of developing a cancer. However, we have already said that cancers that clearly run in families represent a small minority. Studying them has given important insights into how cancers develop but cannot tell us what happens for most common cancers where no clear family pattern exists. For these cancers it is likely that the oncogenes and tumour suppressor genes are damaged by factors present in the environment. There are very many chemicals which are known to damage DNA, our genetic material.
Such substances are usually referred to as mutagens (that is mutation-generating) and when they are capable of causing cancer they are called carcinogens (that is cancer-generating). We believe that exposure of normal cells to damaging substances in the environment produces the changes in oncogenes and tumour suppressor genes that lead on to the development of a cancer. We know that many of the environmental factors which appear to be associated with the development of cancers, each of which will be discussed in some detail in subsequent chapters, are capable of damaging DNA. We do not yet know which environmental factors cause consistent damage to particular oncogenes or whether the damage can (often) occur in many different oncogenes. Perhaps, when we do have this knowledge, the process of preventing cancer will become much simpler to plan and explain. For the time being, the new biology has provided us with an understanding of how cancers grow and what the essential targets for carcinogens are. It has not yet filled in all the gaps to explain step by step the link between cancer-causing substances in the environment and the development of the cancer in the patient.