Undressing the Matryoshka Doll

Or... Down the Rabbit hole in Cancer


Charmed magic encasements, opening on the foam of perilous seas, in faery lands forlorn. ~John Keats

The tautological descent into evidence is like an onion peel, each layer brings out another and another. The Matryoska Dolls open and reveal a tinier version within until the infant appears as a single last piece. From Nuclear Physics and the discovery of Atom, which was once considered indivisible now come Leptons, Muons, Quarks and Neutrinos, all arising from ever enlarging circumferences of the Particle Accelerators. The knowledge today is undergoing constant evolution as revolutions of thought and study continue to evolve. We reach the infant in side the Matryoshka Doll and find that it is not! While curiosity uncloaks the strange, imagination delves deeper into the shape of the peculiar.

Those damn fluorescent tube lights kept flickering. It was the 27 year-old young man who solved the problem. He was not an electrician although many had been paid handsomely to fix the problem several times. This youth with a cheerful face, easy demeanor, a shock of dark brown hair, thick eyebrows that were overshadowed by a smile that would not quit, an athletic body and a fecund mind that would run circles around any subject or field of endeavor was a gem. Yup, that just about describes him to a tee.

“So what do you think?” He asked with his open-faced hands on his knees and with a slight knit to the eyebrows. The inquiry required an intelligent response.

“It is a cancer of the testicles.” The words tumbled out from my mouth. “It is called a seminoma.”

‘How’d I get it?” That hundred-and-twenty-four-thousand-dollar-question.

“Its difficult to say.”

“Come on doc. There is always a cause and effect. Right?” His eyes curious and now his hands were in play as he let them wave with emotive expression.

“You are right.” I said. “We don’t really know the proximate cause for each cancer. But we have some clues.”

“Ok. Try me.”

“We know that when it is hereditary or familial then a mutated gene may be the culprit.”

“So any family with that gene would be decimated right.” He inquired.

“Well not exactly.” I replied. Now we were walking down a pathway that forked and each pathway divided like a ancient deciduous oak tree.

“So then something else is at play. Right?”

The screws of this conversation had a long way to drive to reach sufficient understanding. Only the superficial drywall of this invisible frontier had been pierced.

Open the Sarafin dressed Orange colored Doll ~ The First Undress

“Yes.” I said. I thought for a moment and tried to ascertain how far down the rabbit hole to go with him. “For instance in some diseases a bad gene may exist only on one arm of the chromosome and the other happy fully functional gene may forestall and prevent the cancer from ever forming.”

“So in other words, that would work for instance with smokers, if they happen to have a bad gene then smoking can kill the other side and they develop cancer. For I know everyone who smokes does not get it. My uncle died at age 96 and he was a chain smoker.” He interjected.

Wow he was a smart one. His eyes were lit up from this discovery and the shadow of his own disease encased by an invisible wall not allowed to venture into his mind just yet.

“Right.”

“So how exactly would that happen in my case, since smoking is not a cause from what I have read?” Uh oh, here we go, I thought. Down we go the rabbit hole for that pitcher of the special elixir.

“In Seminoma there is a genetic predilection with a mutated gene, but it is not a 100%.” I looked at him and decided to ask a question before proceeding, “You read about chromosomes, right?”

“Yup.”

“Well there are studies that show anomalies on the short arm of Chromosome 12 or 12p as it is called. Additionally there are some mutations noted in the c-kit gene, which also may have a promoter effect leading to spread. Not everyone has it, but not everyone has been tested. So to speak.” I looked at him and he sat there without any quizzical look about him as though the flood of understanding was washing on his shores. “There is a possibility that since your right testicle was in your belly till after puberty when they hooked it down.”

“Orchipexy, you mean?” Medical terms and all, this young man was beginning to impress me big time.

“Yes and that delay might have increased the risk of testicular cancer.”

“Ok so supposing there is no genetic basis and the testicles in the belly did not influence this, what else could cause it?”

We lay down the premise and expose the random residues of thought only to find that these are but, the best laid plans, that they are subject to scrutiny, to exposing unintended consequences like swarms of bees flying out of the hive stinging every thing in their path denying accuracy.

The cream colored doll opened. ~ The Second Undress

“There is this Sporadic issue where the researchers feel that a hit on the cell deranges the genetic structure and that propagates the cell growth.” I figured with his intellect, why not give it to him in his lexicon.

“You mean like kick-it-into-action?”

“Something like that.” I replied.

“What’s a hit?”

“You know our bodies are bathed in gamma rays, right?” I replied.

“Yeah. I read that in physics.”

“You also know that there is radio-active Radon gas that is the radioactive decay product from Uranium and Thorium, which are resident in the earth and this Radon gas permeates through the ground, right?” I looked at him. He was, all ears, focused. “And you also may have heard that Radon exposure is linked to Lung cancer. Right?”

“Uh huh!” His eyes bubbled over, wide as saucers, I had ventured into his territory somewhere.

“Ok. Well there is a belief that our DNA gets about 10,000 hits every day on every cell.”

GRB (Gamma Ray Burst)

“Wow!” he paused, “Go on doc.”

“Most of those hits are repaired by the evolutionary survival kit we all have called, DNA Mismatch Repair mechanism. This weeds out the cells that have taken a hit, by fixing them or throwing them into the junk pile for recirculation of the material contained within.”

“And if the cell is not repaired…?”

Now the generalizations were generating new and complex responses that might create an embargo on optimism. Confidence seems concerned as it stands at the threshold of a vast open space.

The pink colored doll opened. ~ The Third Undress 

Mismatch Repair Concept

“The cell still has other mechanisms that can prevent it from becoming cancer.” I replied.

“What’s that?”

“It’s called the p53 gene and protein product, which prevents bad cells from multiplying and termed the “Guardian of the Genome.”

“So then I might have taken multiple hits from the gamma rays, My DNA mismatch went out to lunch and the p53 was sleeping?”

“Maybe. This is all conjecture, based on known science. None of this, some of this or all of this could be the case, we can never know, only postulate.”

“What other reason could there be?”

Speculations grow, through division without reference to rule. Only the well-devised and validated experiment could be grasped in the simple fractal that makes the whole mosaic of this complex field of cancer seem elusive.

The dark maroon doll opened. ~ The Fourth Undress

“There are these “jumping genes” and micro-RNA that have unfolded a whole new molecular aspect of science that can be the causative agents. For instance the Transposons or "jumping genes” as they are called, jump indiscriminately around the DNA linking with other genes that they can in turn, enhance or promote like for instance the cancer producing gene, or suppresses the activity of a tumor suppressor gene both events can lead to unmitigated cell growth.” It was interesting to see his eyes reach out into the far reaches of his mind. He would look upwards and to the right when dealt with an onslaught of new information.

“What is the function of these jumping genes?” He asked quizzically, transformed into a student eager to learn, absorb and digest.

“Evolution.” I replied.

“How so?”

The theoretical nuance that underlies each current of thought ebbs and flows to the very premise of unity, the singularity where all dimensions coalesce. Can we then reach the promise land of all singular truth?

The blue colored doll opened. ~ The Fifth Undress

Senescence has no function--it is the subversion of function. ~ Alex Comfort.

“The evolutionary function is to keep modifying the genome to transform and protect the individual carrier (person) from maladies.”

“Oh the Soma Theory.” He said quietly.

“You know about that?” He nodded. “Something like that, only in Soma Theory the premise of Weissman and Kirkwood was that constant repair to protect and promote health leads to the disposability of the living body via senescence, but for our discussion, the purpose is that the DNA is a built in laboratory that experiments on a steady basis. It keeps trying through generations to come up with protective barriers against invading agents like viruses, for instance some African Americans are born with a disease called Sickle Cell Disease,” He nodded with knowledge, “That was a DNA mutation to stave off the attack from Malaria.”

“I read about Sickle cell disease and Malaria in biology, but didn’t know the connection. Wow!”

“Good for you.”

The panorama that unfolds is but the childish dream of idylls. We venture, we express, we learn and yet even with all the approximations of our accuracy we remain innocent of the real truth.

The little grey doll opened. ~ The Sixth Undress

“This is good doc. Can I ask you just a few more questions?” The nurse peeked in the door, placing her index finger on her wrist where her watch should have been, informing me about delays for the other patients, who were waiting.

“Sure.” I said, this was fun for the both of us and waved off the nurse with a acquiescing nod.

“What,” he asked and then held his words in that silent pregnant momentary pause of thought, “makes it spread, as in my case, to the abdomen? There is no direct connection?”

“In your case via the lymphatics. These are…”

“I know those channels that drain lymph. Yes I read that.” He paused again, “Aren’t there mechanisms that prevent that?

“Actually there are. The cancer cell to spread has to go through a lot of hoops to get there/”

“Like what?”

We live on an orb yet we approximate everything in triangles, rectangles, squares and cubes. We devise mechanisms to study the orb yet always seem to add more digits to the pi in a never ceasing battle to conquer- 3.141 goes on for trillions of units towards infinity, wherever that is. Knowledge never ends, understanding does.

The littler green doll opened. ~ The Seventh Undress

Cancer Cell

“Like, the cancer cell has to spread towards a lymphatic channel or a blood vessel. And to do that it needs nutrition. So it throws out chemicals that make the blood vessels come to it. Then it has to circumvent the local machinery of tissue cells and turn them into “turn-coats” using a mechanism of EMT (a phase-transition) that leads to liberation of more chemicals from these “turn-coat cells”. These chemicals poke a hole into the network of normal tissue cells, breach the wall of the blood vessels and the cancer cell motors through.”

Cancer cell acquiring blood via VEGFs

“So then it can go any where and set up shop. Right?”

“Pretty much, but here’s the caveat. It isn’t that easy. The cell has to find a safe harbor. It has to attach itself to the inside wall of the vessel and then poke a hole there to get out and start the process anew. There are many chemicals that come into play secreted by many different cells under command by the cancer cells.” I stopped to find a metaphor. “Did you see Die Hard part 4?”

“Yeah. I loved it.”

“The bad guys taking over the command center to do their mischief. Same story here.”

“I got it.” His awareness was self-evident.
"But the good guys are ever vigilant!" I finished, leaving a trail of scent for him to sniff.
"Who are the good guys?"
"The Immune cells. These are the bread and butter of our defenses after the genetic machinery has failed. We are endowed with the liberty to enhance our own immunity with exercising good health or conversely diminishing it with confrontations like; stress, smoking, drinking, obesity and other chronic diseases. The choice is always ours to fight the good fight with the best of defense."
"I get the message doc!"

We both sat in silence for a while. I knew his mental gears and levers were clanking away in full fury. His eyes were frozen in thought momentarily. He looked up, smiled and then asked, “What’s my future?”

With the sails filling with the sudden breeze, the great ark of understanding rocks and is in motion.

The infant appearing doll revealed itself. ~ The Eight Undress

“Excellent! You have a 98-99% chance of living to a ripe old age.”

“Really!” Ever seen a 27 year-old transform into a 15 year-old? I did, with delight.

“Yes.”

He got up and gave me a hug. A tear bubbled up in his right eye teetering on the edge of his youthful embarrassment but his inner discipline held firm.

He is, happily married with three of his own children, a philanthropist, by desire and wealthy by trade.

The life-journeys that we take or are forced to take build our innate character. They make us stronger. Give us discipline. Free us from smaller irritants in life and make for a joyous living.

Live long my dear young man and enjoy the fruits of your labor, your children and theirs.

But this is human life:  the war, the deeds,


The disappointment, the anxiety,


Imagination's struggles, far and nigh,


All human; bearing in themselves this good,


That they are still the air, the subtle food,


To make us feel existence, and to shew


How quiet death is.


John Keats, Endymion, Book II, l.153-159.