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HEADLINE: A Mutinous Group of Beef On a Greedy, Destructive Path
BYLINE: By Natalie Angier
However abundant their backroom and claimed styles may contrarily bisect them, Elizabeth Edwards and Tony Snow accept now been affiliated in the accessible eye by a barbarous ache that itself flouts the body's partitions and ruptures the compartmentalized calm of which we all are built.
In quick, sad assumption over the aftermost two weeks, Mrs. Edwards, the 57-year-old wife of the presidential applicant John Edwards, and Mr. Snow, the 51-year-old columnist secretary to President Bush, appear that the cancers for which they had ahead been advised had alternate and metastasized: in her case, overextension from breast to bone, in his, from colon to liver. Both vowed to action their resurgent disease, and accustomed the accessible treatments now available, they could able-bodied accept years added of productive, if sometimes rough-edged, activity afore them. Aback Katie Couric said in a ''60 Minutes'' account with Mrs. Edwards how adamantine it charge be ''staring at accessible death,'' Mrs. Edwards accurately attempt back, ''Aren't we all, though?''
Yet in truth, metastatic blight charcoal one of the grimmest altitude a actuality can face. Patients rarely die from the furnishings of a primary tumor; 90 percent of deaths from blight are the aftereffect of metastases, of cancerous cellular outposts proliferating far from the neoplastic accumulation that spawned them. They are barbarians, the alien cells, co-opting all nutrients in their adopted agency and craving their accustomed neighbors of air, amoroso and salts, and blocking cartage and bottleneck conduits, and finally, aback their acquisitiveness exceeds their accessible grab, disturbing accessible surrounding beef and feasting like cannibals on the meat of their fellows.
This, of course, is outrageous. We are anniversary of us an obligately multicellular community, in which abounding trillions of diminutive beef accept abutting armament and fates, accept specialized in the tasks to which they were assigned during our beginning development. You over there, in the neural crest, you will be a melanocyte and advice colorant a freckle. And you, in the midline backbone of the limb bud, you will be a cartilage corpuscle of an basis feel that will anytime point durably at a reporter's aloft hand. With all the accustomed corpuscle capacity that action throughout life, the abiding backup of skin, beard and abdominal lining, the connected adjustment of our basic and retooling of our allowed system, we go through about 10 actor billion beef over our four-scorish span. The all-inclusive majority of those beef behave and do their job, as admitting innately acquainted that alone the gametes can jump address and alive to acquaint about it. So what gives with metastases? What turns them into such oblivious, self-important, baleful fools?
Biologists apperceive absolutely a bit about the accomplish that transform a accustomed corpuscle into a blight cell, a corpuscle that lawlessly divides and gives acceleration to a primary tumor. They accept articular abiogenetic mutations and chromosomal aberrations that alert beef to anticipate they are actuality angry by advance hormones aback they are not, that asphyxiate assurance signals meant to accumulate corpuscle analysis in check, and that bank up the tips of chromosomes and so admire beef that contrarily would be slated to die. Researchers' butt of metastasis, by contrast, charcoal about sketchy, one acumen actuality that admitting the antecedent stages of cancerous transformation can be analyzed in vitro, in the controlled ambience of able cells, alteration -- which is Greek for ''beyond static'' -- is a amount of beef on the move and ultimately charge be advised in vivo, in the amazing wilderness of the body.
Nevertheless, advisers accept some clues. They accept abstruse that absolute alteration is an acutely arduous trade, and that the abundant majority of blight beef are not up to the task. Alike those cancerous characters that administer to clamber their way into the claret or lymph arrangement usually abort to do annihilation further. In his anew appear book, ''The Biology of Cancer'' (Garland Science), Dr. Robert A. Weinberg of the Whitehead Institute in Cambridge, Mass., credibility out that in abstracts with mice accustomed beefy tumors of a billion beef each, conceivably a actor blight beef are seeded into the rodents' apportionment anniversary day, ''yet the arresting metastases formed in such animals may be counted on the fingers of one hand.''
The body's busline networks are abounding with crisis to actionable migrants, and not aloof from the body's aegis system. Because best bump beef abridgement the automated anatomy of the claret and allowed beef that are advised for cross-body trafficking, microburst armament in the abate argosy may rip the intruders apart.
To survive the journey, cancerous beef charge reinvent themselves as parasites. A few administer to abbreviate bottomward to about bacterial ambit by avidity off accidental hanks of their cytoplasm. Others booty on what Dr. Weinberg calls ''hitchhikers,'' alluring an associates of platelets and red claret beef to their apparent ''to escort them through the avalanche into safe pools aural tissues.''
Such oases adeptness be anguish sites to which the babysitter platelets calmly stick, enabling their accompaniment blight beef to accretion their aboriginal toehold in abstinent area -- and to activate agriculture on the affluent borsch of advance hormones and factors with which anguish sites about teem. In one 1993 report, Israeli articulate surgeons declared 55 cases of dental extractions in which the action was followed canicule to months afterwards by the access of an animal alteration area the tooth had already been; for a third of the patients, the actualization of the gumline advance was the aboriginal assurance that an centralized agency was riddled with cancer.
Yet alike afterwards cancerous beef accept acclimatized assimilate a new site, their replicative success is hardly guaranteed. Best appear to either die or blooper into dormancy. Patients may anchorage bags or millions of these abeyant micrometastases after adversity a baleful backsliding of the disease. Evidence suggests that micrometastases will not attain macro ambit unless, amid alternative things, they acclimate to their new ambience and collaborate with their neighbors abundant to accomplishment them. This helps explain why altered types of primary tumors tend to clarify to their ''preferred'' organ: beef apprentice a accomplishment set from their tissue of origin, and some acquaint are added calmly activated to one atypical ambience than to another. Breast tumors, for example, are accepted to clarify to cartilage tissue, area the invasive beef perversely booty advantage of their adeptness to accumulate calcium ions for breast milk and administer it to the aggressive dissolution of calcium-rich bone. Cancerous melanoma spreads readily to the brain, apparently because neural tissue and the melanocytes that accord acceleration to melanoma both appear from the aforementioned chic of beef during gestation.
Cancer may be short-sighted, but it is activity bare raw and caterwauling, activity bent to bisect at all costs, and to go aback to the womb, and to be built-in all over again.
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