Sunday, August 26, 2012

Alcohol & Cancer - Are there reasons to be alarmed?

Several news outlets in Brazil shared a piece of news that might sound like hope - "The Link Between Alcohol Consumption and Cancer". Below are a few news stories on the topic:

Daily News (UK) - http://www.dailymail.co.uk/health/article-2192611/How-alcohol-causes-cancer--particularly-lethal-Asian-descent.html?ito=feeds-newsxml
Science Daily: http://www.sciencedaily.com/releases/2012/08/120822124714.htm
O Globo: http://oglobo.globo.com/saude/descoberto-um-novo-elo-entre-alcool-o-cancer-5867676
O Povo: http://www.opovo.com.br/app/maisnoticias/saude/2012/08/23/noticiasaude,2905373/consumo-de-alcool-esta-ligado-ao-desenvolvimento-de-cancer.shtml

The author of the study - Dr. Silvia Balbo from the University of Minnesota - points out that Asians should avoid alcohol consumption because they lack a dehydrogenase gene that helps metabolize alcohol. This is how the Daily News (UK) reported her discoveries:
Balbo pointed out that people have a highly effective natural repair mechanism for correcting the damage from DNA adducts. Most people thus are unlikely to develop cancer from social drinking, although alcohol is associated with a risk of other health problems and accidents. In addition, most people have an enzyme called alcohol dehydrogenase, which quickly converts acetaldehyde to acetate, a relatively harmless substance.
However, about 30 percent of people of Asian descent ― almost 1.6 billion people ― have a variant of the alcohol dehydrogenase gene and are unable to metabolize alcohol to acetate. That genetic variant results in an elevated risk of esophageal cancer from alcohol drinking. Native Americans and native Alaskans have a deficiency in the production of that same enzyme.
"We now have the first evidence from living human volunteers that acetaldehyde formed after alcohol consumption damages DNA dramatically,"
"Acetaldehyde attaches to DNA in humans ― to the genetic material that makes up genes ― in a way that results in the formation of a 'DNA adduct.' It's acetaldehyde that latches onto DNA and interferes with DNA activity in a way linked to an increased risk of cancer."

First of all I want to applaud Dr. Balbo's effort and time invested researching the mechanisms of cancer. Thank you for picking such an honorable profession, cancer research.

Now I want to think and evaluate with data if this makes sense, and this is just my opinion:

1. DNA damage and cancer - I am not a biologist so I cannot comment on the link between DNA damage and cancer, but cancer is by definition a mutation in DNA that leads cells to reproduce uncontrollably. DNA damage does not necessarily mean cancer. In fact strenuous exercising severely damages DNA, activating Heat Shock Proteins that help rebuild DNA and protect the body. If DNA damage was per se a cause of cancer all professional athletes would be toast, and the evidence is quite the opposite - high performance athletes have a significantly lower chance of developing cancer.

2. People with Asian descent have an increased risk of esophageal cancer from alcohol drinking - First of all what is the definition of Asian descent? - I researched brain and nervous system cancer incidence per country relative to alcohol consumption per capita. While flawed in method as I am not using a control population test, the general correlation between recorded alcohol consumption per capita and nervous system cancer incidence dropped from 60% to 35% when I picked "Asians", quite a surprise given her conclusion. BTW I only selected the population qualified as "Asian". While Russians, Indians, Pakistanis and Israelis are all Asians, to name a few, the stereotypical definition of "Asians" in the US mean people with "Asian" eyes. I selected China, Vietnam. Japan, South Korea, Thailand, Mongolia, Philippines, Malaysia, Indonesia and Cambodia.

I might seem a bit radical but what is happening to science? How can a scientist say "people of Asian descent"? I am reading Burrhus Skinner's book on Behaviorism and in his first pages he compares science to other areas of knowledge. Science is by definition cumulative, reproducible and well defined. This sound-bite comment sounds more like a news selling tagline than science. Dr. Balbo, please accept my apologies if journalists are butchering your comments to sell the news, but the news reported your quoted words. If journalists used your words out of context I totally understand.

Cancer is serious business, millions of people live with hope of being saved by new discoveries. My mother sent me multiple links to this'"discovery". Scientists and journalists seem to increasingly lack responsibility in their reporting, and the uneducated public can be literally uninformed by pieces of news like this. I don't want to corrupt the first amendment of the US Constitution, people should universally have the right to free speech, and Google is helping the whole world with this process.

To all news outlets, scientists and readers that want to survive in the age of broadcasting freedom, here is my advice:
1. The Truth, The Whole Truth, Nothing But The Truth - focus on the facts and think critically about what you write, read and research, leave the hard selling lines to the tabloids. Always think critically about what you are writing or reading;
2. The Ends do Not Justify the Means - sorry Machiavel, but in the Age of Transparency and Power Universalizing the ends do not justify the means anymore. A scientist might get one grant, a person might get one promotion or be elected for one term, but what matters is consistency. One can only achieve ones long-term goals and life purposes by respecting rule number 1 and having a clear goal, whether you want to find the cure for cancer or sell a news paper.
3. Learn With Others - I am shocked to see how many people reinvent the wheel in cancer and other areas, be it in raising funds (several NGOs raising money globally to combat the same malady, all with their own administrative staff, research grants and efforts) and researching what might have already been researched. On the other hand the one size fits all approach is just as bad in a world that is constantly reshaped by new information. Collaboration is a universal need in every level of society and in the fight against cancer we need more collaboration than ever to eliminate redundancies, from cross-discipline collaboration within universities to cross-university, country and company collaboration.
4. Efficiency and Meritocracy - this simple mantra helped turn struggling companies into global leaders and struggling countries into emerging powers. This mantra must be applied to Cancer Research. Resources are limited and as Governments, NGOs and Universities channel millions to cancer research this money needs to be well managed. There is a reason why health care is so expensive and poorly managed resources are a piece of the problem. Business principles need to be applied to cancer research, always remembering that when companies live for an honorable purpose the money will follow, and not the other way around.

 Long, complex blog but I needed to get this our of my chest. May God, People, Business and Science converge to give the best scientists the will power and resources to tirelessly research cancer until a cure is found.

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