Gastric Cancer Quotes

It’s unnecessary and undesirable to limit our readings to medically related texts (she notes that when reading Ivan Ilyich doctors get bogged down arguing about whether the title character of Tolstoy’s novella had gastric cancer or pancreatic cancer, missing the point entirely); that literature helps dismantle the “hidden curriculum,” the teaching that our patients are somehow fundamentally different from us and we from them; that immersing ourselves in imaginary worlds populated by imaginary people and investing emotionally in their problems is excellent training for empathy.

One of the four genes used by Yamanaka to reverse cellular fate is called c-myc. Myc, the rejuvenating factor, is no ordinary gene: it is one of the most forceful regulators of cell growth and metabolism known in biology. Activated abnormally, it can certainly coax an adult cell back into an embryo-like state, thereby enabling Yamanaka's cell-fate reversal experiment (this function requires the collaboration of the three other genes found by Yamanaka). But myc is also one of the most potent cancer-causing genes known in biology; it is also activated in leukemias and lymphomas, and in pancreatic, gastric, and uterine cancer. As in some ancient moral fable, the quest for eternal youthfulness appears to come at a terrifying collateral cost. The very genes that enable a cell to peel away mortality and age can also tip its fate toward malignant immortality, perpetual growth, and agelessness-the hallmarks of cancer.

When people make judgments, they argued, they compare whatever they are judging to some model in their minds. How much do those clouds resemble my mental model of an approaching storm? How closely does this ulcer resemble my mental model of a malignant cancer? Does Jeremy Lin match my mental picture of a future NBA player? Does that belligerent German political leader resemble my idea of a man capable of orchestrating genocide? The world’s not just a stage. It’s a casino, and our lives are games of chance. And when people calculate the odds in any life situation, they are often making judgments about similarity—or (strange new word!) representativeness. You have some notion of a parent population: “storm clouds” or “gastric ulcers” or “genocidal dictators” or “NBA players.” You compare the specific case to the parent population.

But myc is also one of the most potent cancer-causing genes known in biology; it is also activated in leukemias and lymphomas, and in pancreatic, gastric, and uterine cancer.

Every decade has a unique hematological riddle, and for Minot's era, that riddle was pernicious anemia. Anemia is the deficiency of red blood cells-and its most common form arises from a lack of iron, a crucial nutrient used to build red blood cells. But pernicious anemia, the rare variant that Minot studied, was not caused by iron deficiency (indeed, its name derives from its intransigence to the standard treatment of anemia with iron). By feeding patients increasingly macabre concoctions-half a pound of chicken liver, half-cooked hamburgers, raw hog stomach, and even once the regurgitated gastric juices of one of his students (spiced up with butter, lemon, and parsley)-Minot and his team of researchers conclusively demonstrated in 1926 that pernicious anemia was caused by the lack of a critical micronutrient, a single molecule later identified as vitamin b13. In 1934, Minot and two of his colleagues won the Nobel Prize for this pathbreaking work. Minot had shown that replacing a single molecule could restore the normalcy of blood in this complex hematological disease. Blood was an organ whose activity could be turned on and off by molecular switches.