Cancers, Viruses, and the Evolution of Fear – Renal and Urology News

In The Emperor of All Maladies: A Biographic of Cancer, the oncologist Siddhartha Mukherjee, MD, intuits, Down to their innate molecular core, cancer cells are hyperactive, survival-endowed, scrappy, fecund, inventive copies of ourselves.1 Replace cancer cells with viruses and the quote holds equally true.

Darwinian perpetrators of genomic dysregulation, many viruseshave integrated foundationally into the human genome. Indeed, nearly 8% of ourgenome is believed to consist of inactive viral sequences, an ancient graveyardof disabled invaders that attacked our ancestors eons ago now lying asremnants of past infections.2

Overbillions of years of evolution, the complex genomic battle between virus andcellular host has varied from symbiosis, to detente, to revolution. In its mostrapid, extreme, and antagonistic form, infection results in exuberant viralreplication, uncontrolled inflammatory responses, communicable dissemination,and swift death of individuals or species by pandemic. In a slower butinvariably malignant process, viral mediated cellular transformation leads touncontrolled host cell proliferation and cancer death. For his discovery ofhepatitis B virus and connecting the concepts of viral genomic integration andcertain cancer risks along with the development of a vaccine and prevention ofliver cancer by this mechanism, Barry Blumberg, MD, of Fox Chase Cancer Centerin Philadelphia, won the Nobel Prize in Medicine some 40 years ago.

Viralinfections and cancers share more than just their desire for nucleic control.While the spectrum of these disease states are equally broad, ranging fromindolent to virulent, perhaps the greatest and most universal human emotionstoked by both invasive ailments is fear. This is partly because of theiruniversality, our personal histories, and their cryptic inevitability. It hasbeen said that what the mind does not understand, it fears.

Asthe world negotiates its first global pandemic in over a century, the lessonslearned from our human responses to COVID-19 can teach us a great deal aboutour visceral response to cancer. As Neil Shubin put it in a Wall StreetJournal article, both literally and figuratively, Each of us is part virus(and part cancer), in ways that affect who we are and what we do.2

Robert G. Uzzo, MD, MBA, FACS

G. Willing Wing Pepper Chair in Cancer Research

Professor and Chairman, Department of Surgery

Fox Chase Cancer Center, Temple University

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Cancers, Viruses, and the Evolution of Fear - Renal and Urology News