Why haven’t scientists worked it out yet?
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Imagine that every cell in your body is a little house party. Your body keeps a lid on these parties by a cool feature whereby everyone is periodically opening the front door and looking for a sign that they should *continue their party*. The default position is to stop partying, if the “Party” signal disappears, you stop. If a “stop partying” message appears, you stop. The party people in your body are VERY well behaved, if they get a shutdown message they shut it down, pronto.
Parties which have been going for ages are a liability, so your body prunes them off. You’ve only got room for a certain amount of partying so there are physical limits too.
After millions and millions of parties starting and stopping, it’s possible you get a rogue party. The “party” signal disappears and they say – fuck it, we keep partying! Or, a “stop partying” signal appears and they ignore it. In the early days this doesn’t look very weird – they’re just doing what everyone else is doing, and what they’ve been doing all along. By the time you get symptoms what you have got is a MASSIVE party. Unless the party is in the skull, one giant party kicking off and outgrowing the space is not often life threatening. And so we go in and hack that party out with some surgery or whatever.
Two things can happen though which are very bad:
1) the inhabitants of the party start to look fucking strange. All this partying causes damage to the way cells copy themselves, and you get a positive feedback loop where cells just get weirder and weirder in there, they go from being kidney cells to partying specialists – all they’re good at is partying! The function of the organ is in jeopardy.
2) (related to 1) Some rogue partygoers run out the front door and start parties in other suburbs. At this point, what you’ve got is a group of cells that don’t give a shit about you. They just want to party (divide), and partying made them weird. They don’t respond to any of the normal signals, they wiggle into the bloodstream and establish their own massive party somewhere else in the body. This is metastasis – the “secondary” cancers which are very often fatal. Once a partygoer has the capacity to literally wiggle out of their organ and *set up their own party*, you are so far from normal cell function that we have no emergency break to pull.
So far, almost the only thing that works is a nuclear weapon which stops all parties (even the good parties). This is chemotherapy. In the early stages, the rogue parties are not doing anything unusual, they’re just doing it HARD. This makes them very very difficult to detect and selectively damp down amongst millions of (necessary) parties. We don’t understand exactly how/why some rogue parties develop the ability to set up shop elsewhere in the body. This is the zillion dollar question. By the time it has happened, it is often untreatable, because the amount of anti-party weapon required to shut this down will be fatal to the patient.
Finally – every organ has its own unique kind of rogue party – sometimes multiple kinds of rogue party. Cancer is a GROUP of diseases not one disease, so research into lung cancer doesn’t necessarily transfer across to ovarian cancer.
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