Part 1: The political figures
“In God we trust. All others [must] have data. - Bernard Fisher”
Bernard Fisher was an eminent breast cancer surgeon and researcher who pioneered many innovative techniques in breast cancer.
The latter half of the last century has seen an unprecedented success of cancer treatment – thanks to extensive and innovative biomedical research! We have come a long way since radiation therapy almost a century ago – 1950s saw the first approved chemo regimen - this was followed by a boom in research bucks for expansive cancer research – 1990s actually witnessed a decline in cancer deaths for the first time in history – then at the turn of century we have biologics for cancer therapy that had almost changed the new landscape of cancer treatment. This has been made possible thanks to years and years of dedicated team of scientists and clinicians – nurses and caregivers – patients and advocates who had patiently and painstakingly churned out heaps and heaps of research and data – striving to end the elusive and dreaded plague called cancer – and how!
But one thought that has remained pervasive is that Cancer is non-selective – no on escapes from the unpredictable chaos of randomness called cancer! Sure one might possess a unique disposition (read genetic or even epigenetic susceptibility that we are beginning to appreciate) but having susceptibility is not enough! It can also be considered a disease of the “aging” due to the accumulation of mutations in the genome due to internal aberrations or environmental triggers – but not every aging is tagged with cancer. When it comes to cancer –even the rich and the famous and the celebrated – the celebrity gets afflicted too!
You type “celebrity cancer” in the Google search bar and what you get are countless number of pages chronicling cancer celebrity survivors! The list is page 3 material and pretty versatile spanning celebrities from different spheres of celebritydom: entertainment, sports and politics!
They are rich – they are famous – AND most importantly they are brave – brave enough to fight and slay the “cancer” demon!
In today’s issue, we will start with politics: Below we list some of the note-worthy battles of eminent political figures along with their nemesis – the respective cancers that were ailing them.
Politicians, statesman and other dignitaries
When it comes to politics, you think about complexity and challenges! When you think about cancer, you also think about complexity and challenges! Despite the complex challenges – there are glorious survivors who have won both political duels and cancer!
Here is a select list of glorious soldiers who has battled not just political duels but cancer as well – our true heroes!
1) Former U.S. Supreme Court Chief Justice Rehnquist suffered from thyroid cancer. He worked full time even after being diagnosed with thyroid cancer and while being treated with chemotherapy and radiation.
Incidence: The American Cancer Society’s most recent estimates for thyroid cancer in the United States for 2019 are: about 52,070 new cases of thyroid cancer (14,260 in men and 37,810 in women) and about 2,170 deaths from thyroid cancer (1,020 men and 1,150 women). The chances of dying from this cancer are relatively low compared to other cancers. Interestingly, women are more prone to this cancer than men.
Molecular genetics: Malignant transformation of thyroid cells occurs through multiple genetic events encompassing both oncogenic activation (Ras, ret/ptc, braf, akt1) and tumor suppressor inactivation (p53, PTEN).
2) US senator William R. Haine was suffering from multiple myeloma – a relatively rare cancer indication. He actually good-humoredly joked about his hair after losing it to extensive chemotherapy for the relatively rare indication multiple myeloma. He said “I looked like Yule Brenner last year and then I developed into Bruce Willis and now I'm back into an aging Buddy Holly. If the winds blowing, it's Jerry Lee Lewis!” (See ref. below).It appears that he had gotten exposure to Agent Orange during the Vietnam War!
|Multiple myeloma (blood cancer)
Incidence: Multiple myeloma is a relatively uncommon cancer. In the United States, the lifetime risk of getting multiple myeloma is 1 in 132 (0.76%). The American Cancer Society’s estimates for multiple myeloma in the United States for 2019 are: About 32,110 new cases will be diagnosed (18,130 in men and 13,980 in women). About 12,960 deaths are expected to occur (6,990 in men and 5,970 in women).
Molecular genetics: This deadly disease is a result of many different steps leading to accumulation of genetic abnormalities that in turn leads to dysregulation in different pathways. The plasma cells accompanied by the bone marrow microenvironment are responsible for clinical manifestations. It arises mainly by either chromosomal translocations or fusions (trisomies of multiple chromosomes). A unified feature is the dysregulated expression/activity of cyclin D gene. Secondary genetic events include multiple aberrations like affecting Ras, Myc or even sustained activaton of pro-inflammatory NFKbeta.
3) Rosa L. DeLauro – Congresswoman and US House of Representatives battled a long and tenacious ovarian cancer and was a constant champion for biomedical research.
Incidence: The American Cancer Society estimates for ovarian cancer in the United States for 2019 are: About 22,530 women will receive a new diagnosis of ovarian cancer. About 13,980 women will die from ovarian cancer. Ovarian cancer ranks fifth in cancer deaths among women. A woman's risk of getting ovarian cancer during her lifetime is about 1 in 78 and the lifetime chance of dying from ovarian cancer is about 1 in 108.
Molecular Genetics: Oncogenic activation of erb-1, erb-2, k-ras, beta-catenin while inhibition of tumor suppressors like p53, PTEN, brca1, brca2 are the genes implicated in ovarian cancer.
On the Indian turf, notable politicians who braved the cancer demon:
4) Sharad Pawar – thrice the Chief Minister of Indian state and held important central Government portfolios battled a bitter struggle with oral cancer.
Incidence: The American Cancer Society’s most recent estimates for oral cavity and oropharyngeal cancers for 2019 are 53,000 people will get oral cavity or oropharyngeal cancer while an estimated 10,860 people will die of these cancers. Especially it is prevalent in the Indian subcontinent, - among the top 3 of the cancers. This could be attributed to socio-economic risk factors such as tobacco chewing and lack of awareness to screening.
Oral and oropharyngeal cancers occur most often in the following sites: the tongue, the tonsils and oropharynx and the gums, floor of the mouth, and other parts of the mouth.
Molecular Genetics: Multi-pronged genetic processes cause an increase in growth factor TGF-alpha, TGF-beta, PDGF or cell surface receptors like EGFR, GPCR-eventually leading to enhanced intracellular messenger signaling or enhanced transcription factors (ras, c-myc). Several oncogenes and tumor suppressor genes like cyclin, ras, CDKI, p53 and RB1 might be involved in the etiology. Sometimes viral infections with human papilloma virus subtype and Epstein-Barr virus have cancerous effect on oral epithelia.
5) Yashwant Sinha – another erstwhile politician and Central Government Minister of Finance – contracted lymphoid cancer but completely got cured as detected early on.
Incidence: The American Cancer Society’s most recent estimates for non-Hodgkin’s lymphoma are for 2019. About 74,200 people (41,090 males and 33,110 females) will be diagnosed with NHL. About 19,970 people will die from this cancer (11,510 males and 8,460 females). Overall, the chance that a man will develop NHL in his lifetime is about 1 in 42; for a woman, the risk is about 1 in 54. But each person’s risk can be affected by a number of risk factors.
Molecular Diagnostics: Depends on the type of lymphoma (there are many types and subtypes of lymphoma) and is genetically complex including single gene anomalies and cytogenetic aberrations.
- American Cancer Society- cancer statistics (incidence part)- https://www.cancer.org/