Here is part two of our series covering Howard Straus’ incredibly enlightening lecture that was originally delivered at the Cancer Control Society in Japan in July 2009. If you missed part one, you can find it here.
It is generally accepted that the number of individual cells in the human body is some large fraction or small multiple of 100 trillion (1014) cells, so just for the sake of simplicity, we shall use 1014 as a round number. The count does not need to be precise for the purpose of this discussion, as the arguments hold true for numbers plus or minus an order or two of magnitude. It is also widely accepted that virtually every cell in the body is replaced at least once every year and a half. Many structures, such as the liver or the lining of the intestines, are replaced far more quickly, in the order of days or weeks. When the organs are replaced, they are replaced with healthy, new cells.
The numbers that this implies are staggering. A year and a half is approximately 550 days (1.5 x 365 days). Since there are about 1014 (about 100 trillion) cells to be replaced in 550 days, an average of 1014 / 5.5 x 102, or approximately 1.8 x 1011 cells are replaced each day. That means 180 billion cells per day must be generated, and another 180 billion cells that have died must be digested and quickly and efficiently removed from the system. This would be an impossible task if the cells were managed from a central control point. The only way that it is possible is if each cell, when generated, knows what to do on its own, and comes into existence in a medium conducive to its birth, development, growth, life cycle and eventual disposal.
A question that sprang to mind immediately upon looking at the above numbers for daily cell creation, was, “Where do these cells come from?”
It is our belief that each cell develops from an adult stem cell, of which we must have, or can create, almost as many as we have cells themselves. In addition, the cells that die must be replaced by new cells at a rate that is virtually indistinguishable from unity (1:1). The very mathematics of compounding show that if the replacement rate were so much as one percent higher than unity, or 1.01:1, then an organ that was replaced every six weeks, like the liver, for instance, over the course of a mature human lifespan would end up over 90 times larger at the end of life than at the beginning. Conversely, if the replacement rate were one percent lower than unity, or 0.99:1, the organ would end up just over one percent of its original size at the end of a normal 75-year lifespan.
Since neither is true, we may assume that the replacement rate is indistinguishable from unity. How this rate is regulated is a mystery: either an electrical or chemical signal is sent out when a cell dies, or, perhaps, a biological or other signal that we do not yet have the means to detect. When this signal is sent, a stem cell is either activated, or duplicated, then activated to begin the growth and replacement process.
THE SEEDS OF LIFE
Stem cells are defined by two properties: they can replicate themselves indefinitely, and they can develop into mature, differentiated cells1. There are at least two critical factors in the development of a stem cell into a mature, differentiated, functional cell. One factor is the internal mechanism inherent in the cell’s DNA that gives it a blueprint to follow in its development. The other factor is the environment into which it is born, and must develop.
Assuming that a stem cell starts development with intact DNA, it must be the environmental variables that modulate and direct its growth for better or for worse. The body is responsible for the global variables rather than the individual development of each cell, and is very good at what it does. Oxygen and pH are maintained at precise levels, proteolytic enzyme concentrations are maintained at optimum levels, nutrients are provided, and each new cell develops in a nutrient and oxygen-rich environment, with genes expressing themselves at designed-in times to effect the proper development of a functioning cell.
The fact that this process occurs hundreds of billions of times per day, and that we humans survive so long in all manner of environments, climates and situations shows how incredibly resilient the process is. But it also calls into question why stem cell research is so important. We each have, or can create, as many stem cells as we need for a lifetime, probably almost as many as we have cells.
Stem cells can remain dormant, they can split into two stem cells, they can develop normally into a functioning, differentiated cell, or they can develop into a trophoblast, all determined by external signals received from their environment. All outcomes but the last are normal processes, and the last is a normal process for a fertilized egg in the uterus. If this last process occurs anywhere else, or under any other circumstances, it is the beginning of cancer.
ACIDITY, OXYGEN AND CANCER
We know that one of the vital responsibilities of the blood stream is to transport life-sustaining oxygen to each cell in the body, 24 hours a day. It does this through the medium of red blood cells (RBCs), which float in the blood stream, each separate from the others, carrying oxygen on their surfaces. If they collide in the presence of atomized fat, the RBCs stick together, rather like rolls of coins, and remain stuck until the fat in the blood is metabolized and removed. As long as they are stuck together, their surfaces of the RBCs are inaccessible to oxygen adsorption, plus these rouleaux (as the clumps of cells are called) can no longer pass through the smallest capillaries like the tiny, flexible individual RBCs can. The blood stream thus loses a significant proportion of its oxygen- carrying capacity, plus the ability to supply the furthest reaches of the capillary system, and important organs and structures begin to be oxygen-starved.
The danger of this situation is highlighted by many experiments done in the first half of the 20th century by Nobel Laureate Otto Warburg, who noted that when he deprived tissue of oxygen, it turned cancerous, and the cancer could not be reversed simply by restoring oxygen availability to the tissue.
We now believe that what Warburg was witnessing was not normal cells turning cancerous, but normal cells dying from lack of oxygen, and new cells being born into an environment where a normal oxygen supply was lacking. Without an adequate supply of oxygen, most such nascent cells would die, but some, even just a few, might figure out how to survive by using fermentation instead of the much more efficient process of oxidation as an energy source. Because of its low energy efficiency, fermentation does not supply cells with enough energy to develop normally or to perform normal functions; all they can do is to grow and split indefinitely. This is cancer.
If it is so desperately important for RBCs to keep from colliding, there must be a powerful mechanism that normally keeps them separated. In fact, we see in photomicrographs of normal blood a field filled with little circles that are unusually evenly spaced in the view. How do they maintain this uncannily regular separation in the presence of millions of other RBCs?
It turns out that healthy RBCs carry millions of electrons on their surfaces, enough to give them a net negative charge. When two RBCs come into each other’s vicinity, they repel each other due to their similar electrostatic charges, and the closer they get, the more strongly they repel each other8. In theory, they should never collide. This process should protect us, and normally does, but when the blood’s normal, slightly alkaline pH (7.35-7.36) goes acidic, the critically important electrons are stripped from the RBCs, allowing them to collide and stick together, forming rouleaux, or “clumps” that do not carry oxygen efficiently, and cannot pass easily through the smallest passages of the capillary system.
Here the macro factor of pH operates at a micro level (individual RBCs), maintaining an environment that is conducive to oxygen transport. Disturb that pH balance, and suddenly the blood can’t carry oxygen as efficiently as it needs to, and organs and tissue are in jeopardy of developing cancer.
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