There are three important unknowns about cancer:
1. What drives cancer?
2. Cancer prognosis.
3. Cause of death.

1. What drives cancer?

Inflammatory cancers

There are three kinds of  carcinogen: physical,  like x-rays, chemical, and biological. Apparently most human cancers are driven by biological carcinogens which are manifested by an inflammation. Many cancers start as chronic inflammations which end as cancers. Some, like hepatoma are driven by a virus, Hepatoma  starts  as a chronic liver disease, proceeds into a cirrhosis, and ends as  a cancer. Sometimes the biological agent driving the disease is unknown, nevertheless the cancer is preceded by a chronic inflammation.. Like Hodgkin’s disease which ends as Hodgkin’s lymphoma. Chronic ulcerative colitis which ends as colon cancer. Or seminoma and childhood lymphatic leukemia.

While not all chronic inflammations end in cancers most cancers are preceded by a  chronic inflammation. Breast cancer is preceded by a chronic cystic mastopathy,  which led the great pathologist Rudolph Virchow (1821-1902) to propose that cancers are caused by a chronic irritation which is manifested by a chronic inflammation. Chronic bronchitis precedes bronchial carcinoma. It is generally assumed that chemicals inhaled during smoking cause the cancer. Yet long before its appearance these chemicals induce a chronic bronchitis which is perpetuated by viruses and bacteria,  and may end as cancer.

Additional reading: Cancer and metaphysics

It is proposed here that most human cancers are driven by biological agents and may be prevented by eliminating them. Chemical and physical carcinogens contribute only marginally to cancer progression  even in cancers like skin melanoma, which is attributed to UV radiation.   UV radiation damages the skin initiating  an acute inflammation which ends when returning from the sunny beach. However when it continues to smolder it may end as a melanoma. The same applies to xeroderma pigmentosusm which is regarded as a disease of gene repair. Yet initially faulty repair initiates a chronic inflammation which is followed by a cancer..

Further reading Inflammatory cancers.

Cosmic rays

Cosmic rays are extremely energetic particles, primarily protons, which originate in the sun, and other stars.   The cosmic ray particles interact with the upper atmosphere of the earth and produce showers of lower energy particles. Many of these lower energy particles are absorbed by the earths' atmosphere as they travel down to the surface the rest may cause cancer. A similar radiation causes cancer in laboratory animals.

Cosmic rays  may drive also  many human cancers. They have accompanied life on our planet from its very beginning. While microbes resist their mutagenic effect, mammals may succumb to it. Throughout its evolution life was exposed to cosmic rays, and may have developed protective mechanisms against their hazard. “Survival of the fittest” means that we are better equipped  to handle cosmic rays than our predecessors. It is proposed here that the tumor protects us against the damage of cosmic rays. Stem cells produce a vital substance which is damaged by cosmic rays causing a metabolic deficiency. In response, the organism grows a tumor  which replenishes the vital substance.

Additional reading: Pernicious Cachexia

2. Cancer prognosis

Two women undertake mammography which reveals in them a 0.5 cm tumor. Both are of the same age and habitus and get the same treatment. Nevertheless one will die in old age and the other will succumb to cancer. Why the survival difference?  Let’s augment this example somewhat more. After some time their disease flares up. They return to the same clinic where they will get the same treatment. Nevertheless one will die in old age and the other will succumb to cancer. Why the survival difference?

Equilibrium

Medicine covers its ignorance by blaming the patient: ”You came to late, you smoked, you neglected yourself, and so on”. In reality medicine ignores an important cancer dimension without which it is impossible to asses its  course. All along disease progression cancer and the body (WOB) maintain a balance. Cancer progresses either because the tumor is more aggressive, or the host is weakened. Medicine does not attribute any role to the host whom it regards as helpless. It rejects the notion of an equilibrium between host and cancer. Yet by ignoring the role of the host in a disease, medicine fails to  explain the survival difference in the two women. The fortunate one succeeded living with cancer since mobilizing more resources for this purpose, than the other one did..

The equilibrium concept has important therapeutic implications. When the tumor has spread into other organs, there is little hope to cure it. However its progression may be slowed down. Either by weakening the tumor, which medicine does, or by strengthening the host, which medicine ignores.  This site highlites the role of the host in cancer and guides the patient how to live with cancer and even control its progression.

Additional reading Medicine reached a conceptual impasse

3. Cause of death

What kills the cancer patient? In most diseases the patient dies because of a failure of an organ..  But what fails in cancer? The patient simply fades away known as cachexia. Medicine blames the tumor which supposedly produces toxic substances poisoning the patient. However many patients may fade away even with a minute tumor. Following an aggressive treatment of leukemia a patient may die without leaving any trace of his leukemic cells, which was documented by experienced pathologists. Cancer is viewed here as a cachexia accompanied by a tumor. It is a progressive  deficiency of a vital substance, which  when fully depleted  kills the patient.  Consequently, cancer is called here  Pernicious cachexia