Of undetermined causes

March 18 2017

“Can you please be more quiet? Your mom is sick,” my grandmother tells my younger brother and me while we are playing on the carpet of the living room.

I am 9 years old and to me being sick means having a cold. But my mom is spending long hours laying in a comfortable chair in her room. She goes to the hospital for several weeks in a row and sometimes more. My dad goes with her while my grandmother is taking care of my little brother, my older sister and me. Something serious is happening. I am trying to listen to adult conversations to pick up some clues, but they carefully avoid certain topics in my presence. The other day, my mom gave me one of her own jewel: a black and golden butterfly. Nobody is talking about it, but I just know it: my mom is going to die.

I wake up one morning, a few days before Christmas, as I had not seen my mom for several weeks. My grandmother does not reply to me when I say hi to her. She is sitting on her bed with her head down. This is strange; she would always greet me back. My dad is back at home today, preparing breakfast.

“Your mom is in heaven,” he tells my brother and me. The sound of this information is so casual that everybody keeps behaving apparently normally around the table, although we are not very talkative. I am wondering if my little brother has understood what it means and I later join him in his room to explain him. My sister keeps herself locked in her room the whole day. I then go to mine to hide under the desk and cry.

I did not go to the funeral. Instead, I was sent to one of my friend’s family. I guess the adults thought it would be easier that way. Truth is, it has been 30 years now and the pain is still as sharp as if it had been yesterday. Why did my mom disappear? Why did she leave without saying bye?

I did not know it was cancer, a pretty nasty colorectal cancer that had taken away my 43-year-old mom in a little more than a year. This is probably why I went to study molecular biology years later. My first internship was on a very interesting topic: the research team at the Curie Institute in Paris was trying to determine if cancers caused by radiations harbor specific genetic mutations. This could allow the attribution of certain cancers to determined causes. However, holding those plastic tubes containing tumor samples from patients in my hand felt a bit too heavy somehow. I decided to go for basic research and to study molecular stress responses and chaperone proteins in a microscopic worm: C. elegans. This has been fascinating. Chaperone proteins are safeguard proteins induced upon any stress that can potentially harm the shape of our proteins (heat, heavy metals, oxidative stress…) and cause protein aggregation and cell death. Chaperone proteins are crucial to maintain protein homeostasis and therefore are conserved in every living organism. They are involved in ageing and many diseases: Alzheimer, Parkinson, and…cancer, where they are hijacked by tumor cells at their own benefit. This is the way I have found to study the monster from not too close.

Last week I was reading an article entitled “the fake war against cancer”. Among the points of the author: cancer is over-diagnosed nowadays, prevention costs a fortune, large amounts of public money are invested into cancer research and seem wasted, as there is no significant progress, despite a few milestones, and big pharmaceutical companies make tons of money over cancer patients. The end of the article was all about how you could prevent cancer including diet advices, avoiding stress, because “unsolved conflicts favor cancer”. Reading this makes me sad, cause the reason why we treat cancer better and cure more patients is prevention. Yes, we have not found the cure against cancer yet, because there are multiple cancers, probably as many as cancer patients. One of many progresses of these last years is that we are able to treat different genetic types of cancer with appropriate treatments. Another recent breakthrough that looks so promising to me is single-cell sequencing. Tumors are very heterogeneous, and this might allow us to identify driver cancer cells within tumors, have a more precise diagnostic by analyzing circulating tumor cells, and see with much better resolution the effects of treatments. Cancer comprises a cascade of genetic mutations and it is hard to identify the causal mutation(s). As far as I know, there is no proven link between psychological stress and cancer. How unfair to the patient is this statement that maybe he or she had cancer because of an unresolved conflict? This is only going to make them feel guilty. If this is mind breaking not to be able to narrow down the ultimate cause(s) of the disease, we should probably not make up some.

Thanks for reading this, and sorry that it was so long.

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