In February of 1981, I sat in a farmhouse in Alberta. It was -35 outside, and my brother and I had finished busting the hay bales open to feed the cattle for our evening chores. My mother and I were in the living room, each reading while the dark and the wind swirled outside the windows. I was dissolved into the Lord of the Rings. An unknown group, the hobbits, struggled to overcome an enemy that moved over the land like lava oozing out of a volcano. They had no swords, though swords played a central role in the story. They had no status, though the prestige of kings swung nations from one direction to another. They had no armies, though the rumble of hoofbeats and march of boots on the ground shaped events in dramatic ways. They had no wealth, yet who does not love a chest full of gold? They did not even have magic, though enchantments opened doors and split mountains into avalanches. Yet this overlooked band of friends were critical in the world-wide combat against an uncaring foe that corrupted and killed.
Sam was encouraging Frodo to keep pushing through his exhaustion when my mother’s voice tugged me back into our living room. “Eric”, she said. I looked up. “What?” I responded. “I love you” she said. “I love you too.” We smiled at each other and slipped back into our books. It was such a cozy evening as she pronounced her blessing. I had no idea that two years later, my father would use another short sentence to announce a curse in my world. “Your mother has cancer.” The relentless enemy had come back. She had battled breast cancer before and been declared free of it. But the tumours were now in her bones. I was a 16 year old farm boy who loved reading, and I had no idea how to oppose the chaos that twisted her cells. By June of 1983, she died.
I did not know what to do with the stone of grief that sat in my chest, or how to defeat the enemy that put it there, so I pushed on with my life. After finishing my Ph.D. in psychology, I entered private practice. Years later, through a very curvy path, I wound up listening to a webinar put on by the Evolution Working Group of the American Association of Cancer Researchers. I wondered if I had anything to contribute or not. One brilliant researcher said cancer was the result of the breakdown in communication between cells that enables them to join into networks that work towards large-scale goals for the tissue or organ. If communication collapsed, a cell would focus on more primitive objectives.[i] Another scientist said that excessive stress could disrupt the environment in the tissue. For a cell, the surroundings had become unstable. This would activate ancient programs in the cell, from the time when it was unicellular, causing it to mutate to try to adapt to the now-dangerous surroundings. This mutation and genetic instability could result in cancer.[ii] All this talk of stress revved up my brain. I was reminded of people I treated who had PTSD. They were flooded with stress, and would pull back from engaging with the group. They no longer worked with the group, they just focused on their own survival. I did not know the details of the biology, but I certainly knew about how highly stressed individuals reacted.
On another webinar, Dr. Heng discussed that once cancer occurred, new problems arose when oncologists tried to treat it. Drugs often resulted in the cancer coming back, in a far more aggressive fashion. A tumour that may have taken three years to grow to the size of a golf-ball, and was hit with chemotherapy to poison it, might shrink, and then balloon to the size of a grapefruit in 4 months. It would then go on to quickly kill the patient. Dr. Heng argued that the chemo drugs were causing extreme stress on the cells.[iii] This stress would trigger the formation of giant cancer cells. These giant cells would then put their genome into a state of chaos, even making many new nuclei. This chaotic process would quickly produce many new genetic combinations in an effort to find a mutated cell that would survive in this poisonous environment. One or more of these combinations would take hold, and the cancer would come roaring back, immune to the drug that had shrunk it before.
During the discussion of surviving, someone mentioned that being married had a larger positive impact on survival, than the survival benefit of chemotherapy.[iv] This fact stuck in my brain like a fish-hook. Being married was better for your survival than taking chemo? This is a stunning finding. Vast amounts of resources are spent on finding new drugs to treat cancer, but the nature of your relationships has a bigger impact on survival? Why is this not a huge focus of research? Should this not be a major path of intervention, of learning how to beat cancer? Now I was sure that I had something to contribute.
As I nerded out on the research, I was blown away. Psychology had more to contribute to the fight against cancer than I imagined. It was a weapon to use against this disease that no one knew about. For example, women diagnosed with breast cancer who are in a lousy marriage are 4 times more likely to have a recurrence of cancer, or to die, over a 10 year follow-up, than women in a good marriage. [v] The implications are obvious. Every woman with breast cancer should have the quality of her marriage assessed. If it is mediocre, she should be offered marriage therapy. That would quadruple her odds of survival. If there was a pill that had such a positive impact, it would be all over the news. There would be ads for the pill in every magazine for women. Any oncologist who did not prescribe it would be sued for malpractice.
Yet nobody knows about this. I spoke to a professor of oncology at an Ivy League school, who had written one of the top science books on Amazon in the last 5 years, who had dozens of publications in all the top scientific journals. They had never heard of this. They had not learned how serious psychological injuries doubled or tripled the risk of getting cancer. I have met other cancer researchers at top universities, who did not know either. These are all very smart people, yet the information has not reached them, and it has not reached you. You do not know the science on how serious emotional wounds cause cancer. You were not aware of the relational factors, such as being single, or in a lousy marriage, and how they have a profound impact on the trajectory of cancer, or your odds of recurrence. Just like these brilliant oncologists, the power of psychological and relational factors in overcoming cancer is unknown to you.
We need all the weapons and allies we can find in this colossal war. The oncologists have to use the sophisticated weapons in their arsenal, such as transcriptome analysis. Other than donating to them (that is where the subscription money goes) there is little that ordinary citizens can do on that front. But there is a weapon you can pick up and use yourself in the struggle against cancer. I will teach you all the things I wish I could have taught my mother. I will share all the psychological knowledge I have, things that very few oncologists or psychologists either know or do, to help you and your family members in your battle against this disease. I will back up everything I can by research, so that you know these are not just guesses. Follow along, and I will give you a new weapon to oppose this foe.
[i] Levin M. (2021). Bioelectrical approaches to cancer as a problem of the scaling of the cellular self. Prog Biophys Mol Biol. Oct;165:102-113. doi: 10.1016/j.pbiomolbio.2021.04.007. PMID: 33961843
[ii] Cisneros L, Bussey KJ, Orr AJ, Miočević M, Lineweaver CH, Davies P (2017) Ancient genes establish stress-induced mutation as a hallmark of cancer. PLoS ONE 12(4): e0176258. https://doi.org/10.1371/journal.pone.0176258
[iii] Ye JC, Horne S, Zhang JZ, Jackson L, Heng HH. (2021). Therapy induced genome chaos: A novel mechanism of rapid cancer drug resistance Front Cell Dev Biol. Jun 10;9:676344. doi: 10.3389/fcell.2021.676344. PMID: 34195196
[iv] Aizer AA, Chen MH, McCarthy EP, Mendu ML, Koo S, Wilhite TJ, Graham PL, Choueiri TK, Hoffman KE, Martin NE, Hu JC, Nguyen PL. (2013). Marital status and survival in patients with cancer. J Clin Oncol. Nov 1;31(31):3869-76. doi: 10.1200/JCO.2013.49.6489. PMID: 24062405
[v] Yuan L, Cai H, An W, Yuan W, Toloza EM, Song Y, An J. (2023). Associations between marital quality and the prognosis of breast cancer in young Chinese women: 10.3-year median follow-up. Chin Clin Oncol. Oct;12(5):51. doi: 10.21037/cco-23-63. PMID: 37872116.
Dr. Eric Kuelker
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