Smoking

soccerfreaks said:

Thanks for the effort!
I found several articles online, RF, perhaps the most concise of them an abstract published by American Association for Cancer Research in 2003. Here is its text:

[The concept of "field cancerization" was first introduced by Slaughter et al. [D. P, Slaughter et al., Cancer (Phila.), 6: 963–968, 1953] in 1953 when studying the presence of histologically abnormal tissue surrounding oral squamous cell carcinoma. It was proposed to explain the development of multiple primary tumors and locally recurrent cancer. Organ systems in which field cancerization has been described since then are: head and neck (oral cavity, oropharynx, and larynx), lung, vulva, esophagus, cervix, breast, skin, colon, and bladder. Recent molecular findings support the carcinogenesis model in which the development of a field with genetically altered cells plays a central role. In the initial phase, a stem cell acquires genetic alterations and forms a "patch," a clonal unit of altered daughter cells. These patches can be recognized on the basis of mutations in TP53, and have been reported for head and neck, lung, skin, and breast cancer. The conversion of a patch into an expanding field is the next logical and critical step in epithelial carcinogenesis. Additional genetic alterations are required for this step, and by virtue of its growth advantage, a proliferating field gradually displaces the normal mucosa. In the mucosa of the head and neck, as well as the esophagus, such fields have been detected with dimensions of >7 cm in diameter, whereas they are usually not detected by routine diagnostic techniques. Ultimately, clonal divergence leads to the development of one or more tumors within a contiguous field of preneoplastic cells. An important clinical implication is that fields often remain after surgery of the primary tumor and may lead to new cancers, designated presently by clinicians as "a second primary tumor" or "local recurrence," depending on the exact site and time interval. In conclusion, the development of an expanding preneoplastic field appears to be a critical step in epithelial carcinogenesis with important clinical consequences. Diagnosis and treatment of epithelial cancers should not only be focused on the tumor but also on the field from which it developed.]

It is likely that such thinking, promulgated nearly 60 years ago, has some role in the thining of our doctors, those who insist that we give up smoking and drinking upon discovery of cancer (I would hope that if they are any good, they are suggesting such long before cancer is discovered, even if we choose to ignore them).

More recent research tends to give more weight to genetics and epigenetics (fascinating if only for the potential therein with respect to ALTERING our makeup to the degree that vaccines or at least cures might be available sooner than we think, to say nothing of the interesting parallel 'field theory' that is at the center of what is happening with epigenetics).

In any event, I suppose that this is why my doctors insisted that I stay on Nexium when my insurer was trying to get me to switch to an OTC. People have told me that Nexium coats the throat and my doctors agree (someone once posted in this board that Nexium coated the throat to such an extent that it would hide cancer, so I asked my ENT about it at our next appt and he dismissed that notion out of hand, which led me to realize just how much I was leaving my brain at home when it came to cancer-related advice).

As for the 22% you mention, RF, I think we should keep in mind that those odds, based on what I read of the theory, predict a one-in-five chance (roughly) of a LOCAL recurrence. The difference between a local recurrence and metastasis to other parts of the body may be the difference between life and death, as I know first hand, so it is an important distinction.

I am not giving shortshrift to that percentage, RF: it IS 'staggering' in a sense. Perhaps I am somewhat insulated due to the fact I may be one of those 22% (no conclusions about metastasis were available when the SCC was removed from my lung) and am still kicking and all of that, thus the distinction I note above.

Regardless of my own thinking on the subject, it is evident that we should ALWAYS do whatever we can to get rid of the stuff in the hope that it will be permanently removed. I would say that we should also stay vigilant for its return, but we, regrettably do too much of that without any help from one another.

Survival rates for SCC in the head/neck ARE much better than those for many other cancers and for SCC in other areas of the body, after all.

Interesting stuff. I should probably quit drinking or start taking my Nexium, or both .

Take care,

Joe