Issue 90 / November - December 2012
Why Is Cancer a Complex Disease?
The chaos theory, first introduced by Edward Lorentz, offers new horizons for economists, meteorologists, seismologist and scientists studying in other branches regarding the problems they have been studying in recent years. The chaos theory demonstrates a hidden pattern behind seemingly irregular, chaotic physical and sociological events, and suggests that this pattern consists of simple but successive dynamic motifs. Today, these findings that started with the chaos theory have developed the need for a multidisciplinary and interdisciplinary approach towards existence and events called "Complex systems." Many physical, chemical, biological, sociological and medical issues are being reinvestigated from the complex system paradigm perspective.
What are complex systems?
If there are multiple elements (variables/factors) interacting with each other in the creation of an event or a being, this structure is called a "Complex System." For example, in the air system, air and water molecules are a factor. Plants and animals in an ecosystem can also be considered as a factor. These are interconnected to one another in a way hard to imagine and have impacts on each other. Systems with these specifications display complex situations throughout time. For example in the medical field, a disease is described multi-factorial if many factors (causes) take part in its development. However in the past, these laws, specifications, and progress-dependent patterns of the multifactor diseases had to be overlooked due to the lack of a suitable paradigm to study with. But today, with the complex system paradigm, we have a greater access to the inner dynamics of these multi-factor diseases.
Multi-factor systems in terms of structure and function exhibit complex features during the process. Thus, complicated features of a complex system have been found to be dependent on the "Force Law" when investigated with the complex system paradigm. They also establish the basis for principles and laws that are occurring coincidentally. According to the Force Law, in all complex systems, small scale changes occur in greater numbers, and larger scale changes happen less often. This state corresponds to the same direct line, when plotted on the x-y plane logarithmically with scale of changes versus chances of events being created. This indeed results in the stability of the system in the macroscale and yet reveals the variability and instability of the microscale. In other words, the state of the macrosystem is put forth momentarily by selection among many micro incidents, which, for believers, is an indication of an ultimate Divine will in possession of infinite power. The information level, energy and interaction strength of such events or beings plays a great role in the possible selection of micro incidents in the grand scheme of causes.
Complex systems that become visible via space-time river also enters a dynamic cycle which is composed of sub-critical, critical, and super critical states. In this way, events and existence become subjected to newer manifestations or degrees of glory, as for believers, life and existence are artworks of God and His Divine attributes in the visible universe, which resembles a drawing board. Living things display an adaptive and dynamic character along with being a complex system. Healthy processes in the human body display adaptive dynamic complex system properties yet exhibit complex behaviors that bring system down like cancer as well. The medical world in recent years have been referring to cancer more so than before because of undetermined factors in its development, hardships encountered during diagnosis and treatment; as cancer is a multi-factored disease, it is necessary to look at cancer with the complexity lens.
The science of complex systems which studies multidimensional and multifactor relations states that in each complex system there are common features, and that these features can also be observed in cancer just like in all other scientific fields and in all scales. The following will focus on the subject since cancer makes a good metaphor in understanding complex systems of behavior.
In complex systems, a whole system means more than the total value of its factors. This principle emphasizes that properties of events and beings that are the sum of many separate factors do not exist in separate units or tend to disappearas each part is handled more individually. The deduction-reduction examples of a peacock coming out of an egg, a tree growing from a seed, and water that consists of various elements are used as metaphors to explain matters that pertain to belief and bear complex system properties. There are many genetic, epigenetic, metabolic, internal and external factors in ontogeny of cancer, however it only develops with the interaction of these elements and differentiates from regular cells. According to widely accepted views, in order for a cell to become cancerous, it is not enough for it to undergo many genetic mutations on its own. The few mutations that take place in a specific order alongside other epigenetic factors could lead to a tumor and cause a "system death" which means much more than the total value of components. That is why death occurs systematically in humans-cell death, tissue death, organ death, system death (excretion and transport) and death of organism.
All complex systems not only have a specific perimeter but they also remain a part of this boundary. This feature brings attention to the fact that there is even a relation between the Sun and and eye of a mosquito. Cancer starts out with a single cell made up of specific inner parameters, in a particular placement within a tissue. It is not possible for a cancerous cell to proliferate for a long time and cause the death of an individual all by itself. It can cause death as a result of communication with surrounding cells, conversion of these into cancerous types, and dispersion through blood vessels into other organs.
Inhibition or the delay of these stages makes up the most significant strategic approaches of the therapy. Because of this, while a cancerous cell is programmed to change its surrounding it also begins utilizing the nutrient sources of surrounding live cells for itself, as if trying to resolve an optimization problem, and causes disruption in the system by displacing other cells with an uncontrolled proliferation potential. This incident points out that there is no such thing as a "minor" in complex systems.
In complex systems, the more diversity exists within a system, the more powerful the system becomes. This principle brings attention to maintenance contingency and sustainability of the system and the conditions that pertain to it, for the lifespan of complex systems correlates directly with the abundance and diversity encompassed in it. This viewpoint could be observed in the case of a normal cell turning malignant. A mature tumor is a group of differentiated cell types that can provide interaction with neighboring cells through intra- and inter-cellular structures (matrix). That is why one of the characteristics of cancer is progress-dependent heterogenity at a cellular level. Because of this reason, although there is only one cancerous cell at the beginning, it can divide into different populations in time. Each population can be considered as an independent (sub-population) population since each has a specific genetic composition. This diversity is one of the major sources of problems in cancer treatment.
A continued relationship of factors with each other in a complex system has critical importance regarding system survival. Metastasis of a tumor not only depends on relations with surrounding cells but at the same time relies on the stimulation of blood vessel synthesis factors (angiogenesis). Two events are required for the dispersal of cancer cells freely; the first is the reduced interaction with other cancer cells. This can be possible with regulation of cell-to-cell connection molecules (adhesion). Second is the formation of new blood vessels via stimulation to connect with the bloodstream from the vicinity of the tumor. Finally, cancer cells that have reached their target of joining the blood stream should be able to leave the circulation, penetrate the new tissue, and manage to grow again. Metastasis is a situation for cancer cells to regulate limiting factors according to their new conditions to survive.
Behaviors in complex systems which display more features (emergent situation) that are not present in the units or even in the total value of constituents are plentiful and complicated, yet principles as causes behind these rich motifs are simple and determine the function of the system. Cancer disease arises from the execution of three simple basic principles of interaction, proliferation, and dispersion in cancerous cells. Interaction, proliferation, and dispersion do result in a healthy cell if it happens properly in the correct place, time, and dosage; otherwise it results in a cancerous cell. These three principles can cause cancer as a complex system disease or a healthy life which also displays characters of a complex system. Critical factors that control the management of these principles are location, position, timing, and dosage.
In complex systems, minor scale changes in initial conditions can lead to major effects after a certain amount of time, like a small snowball getting bigger as it rolls. Metaphorically, this situation is called the "butterfly effect" which assumes the possibility of a hurricane in one part of the world resulting from a complex chain of events starting with the strokes of a butterfly in another far corner of the world. Most of the adaptive complex systems are called "self-organized systems" in the scientific jargon, however these may exhibit such behaviors that are hard to overlook and believers would attribute to Divine guidance rather than to their so-called self-organization capacity. These systems organized with Divine guidance reach a "critical state" at the end. One of the models that were developed to explain this critical state is called the "sand pile model." The system is named sub-critical when sand particles start to pile up on a surface, since at this stage the system is not affected from the fall of the next sand particle. As sand particles pile up, they reach a critical state in which every new particle added to the pile can lead to one of the following: 1. Nothing will happen; this is called the super-critical state. Particle can stay on top or roll down to the bottom of the pile. 2. Particles that hit the top of the pile affect other particles and can cause a small avalanche. 3. Sand pieces hit the top and cause some displacement of other particles. These displaced particles successively can cause a bigger avalanche.
This bigger avalanche again restores the system back into a sub-critical level. All complex systems arrive at these stations of sub-critical, critical, super-critical and again sub-critical successively in the flow of time. At each station they are dressed with a form of existence corresponding to a different macroscopic situation. So the outcome of the next situation is contingent on the mean average of microstates and thus points to a manipulator, who wills it to be that way. As a result, a minor event can lead to a "point of no return," a stage called catastrophe, a super-critical state. These stages result in the continuum of the universe as it transforms and renews itself. A cancer cell also stops by the above mentioned stations and step by step, like a snowball turning into an avalanche, it can impact the whole body after reaching the super-critical stage, and lead to death. That is why early diagnosis (made during sub-critical or critical level) increases the chances of treatment, yet late diagnosis (at super-critical level) decreases therapy outcomes.
There is no hierarchical chain of command or control of causes on each other in complex systems. In other words, not only is there not a single factor in control of the system, but also a great number of factors function in a nonlinear mode of interaction. The development and progression of cancer as a complex system is controlled through interaction of internal and external factors, genetic, epigenetic, physical and metaphysical, tangible and intangible elements. Initial conditions that prepare the basis for cancer progress does exist in human genome, for genes that play a role whether in development, suppression, or regulation of cancer are built in the human genomic library from the beginning. Embryonic development is maintained with proper activation of these regulatory genes in the correct time and place during pregnancy. However, same genes may initiate cancer if not properly expressed in the right time, place, and level after birth. Moreover, all the factors that the zygote is left exposed to during its interaction with the surroundings leave a mark (memory) on the system. This is called "system exposition."
Exposition forms microstates that will lead to positive/negative development of the organism through interaction with genetic and epigenetic memory of the system. That is why programmed cell death is put in place to eliminate damaged and dysfunctional cells that form in the system.
Cancer, as a consequence of progress-dependent corresponding interaction of genome and system exposition, is a system that can display chaotic behavior. Because of this, spiritual factors as well as physical ones may cause a "butterfly effect" in development of cancer and there is no single center of command that is designed to control each of these in the causation chain. This being the case, one cannot help but wonder how causes can comply with the force law of all complex systems and that they share common features without a hierarchical command on each other.
Each complex system is composed of holographic sub-systems. The human body is an ecosystem of various systems placed within each other. The well-being of the ecosystem depends on proper interaction and health of these sub-systems. A tumor can be considered as a local ecosystem (sub-system) where various species and clones exist in a human ecosystem. While each tumor grows, there are living and dead clone populations in it. One billion elements exist in a tumor as small as 1 cm3 (1 gr). If we omit cell death, this corresponds to the 35th generation of an abnormal cell. Ten more generations later this reaches one trillion cells. This way, a population that started out with a single cell exceeds the total number of humans ever lived throughout history. So, human death with cancer starts with the disruption of one single cell. Once reached a super critical stage, system death occurs when the cancer branches out via blood circulation and disperses into various organs, leading to disconnection between them.
Cancerous cell reminds us that there are no minor events in the universe and points out that the health of our social and spiritual world takes shape according to the rules of complex systems. As a side thought, we may easily infer from cancer that underestimating any seemingly minor misbehavior or a sin and failure of immediate action to make up for it may lead to undesired consequences in our social and spiritual lives. It is also significant to be aware that we do not have an absolute control over our future and we cannot determine whether we will attain healing or not; however we can and we should try with science to elucidate some of the tangible causes of the disease and can point out some possible ways of treatment.