We Are The Borg
Those of you who are Star Trek fans will remember Jeri Ryan’s character, Seven of Nine. When captured Seven of Nine was a member of the Borg, a collective of humans who had been fitted with devices that made them androids, unquestioning subjects of the queen, and always a member of the collective, always in sync as a single great mind.
Seven of Nine As a Member of The Borg
Following her capture the device syncing her with the Borg was modified (to remove it would have killed her) and gradually, 7 of 9 became a member of the Star Trek crew, but at times felt a great sense of loss at being an individual rather than a part of the hive.
Seven of Nine after Hardware Modification
Most of us think of ourselves as an individual being, but we are far from that. Like the Borg, we are a collective of cells with specific jobs, different lifespans, individually unable to survive alone, but working as a team able to coordinate activities that have as their primary purpose the production of other little collectives.
When 7 of 9 had part of the hardware that kept her in sync with the hive she was able to become independent; an independence we, the audience, all applauded, but an independence she at times deplored.
Independence or Lack of Control?
What do we call it when a member of our hive becomes independent and begins to branch out in a new direction? We call it cancer.
The activities of our cells are coordinated with a common code, our DNA. Different types of cells have parts of the code turned off. For some, like muscle cells and nerve cells, a part of the code that is turned off is the part that tells the cell to divide and form new cells. It is truly amazing that the same code can be driving an intestinal cell, or a white blood cell with totally different jobs and a limited lifespan. Coordination of all of these cell systems is accomplished in large part through messages sent in the form of chemicals called hormones.
Because none of these cells are by themselves sentient they never question their fate.
Social Insects; Borgs of the Natural World
Social insects like bees have an egg laying queen who has no other purpose in life but to lay eggs. The queen is created and maintained by feeding her a special diet of royal jelly. Within that jelly is a hormone that makes her the egg layer.
Other members of the hive, the workers, are sterile females. The workers work every waking hour for about a month and then die. They don’t question their fate, just as the queen doesn’t question hers. The only members of the hive who may complain are the drones. They have one job; to fertilize the queen. When their job is done workers take them to the front of the hive, cut their wings off and toss them to the ground to die. The drones don’t like this treatment, but they have little recourse.
Losing the Code
So, when we develop cancer what goes wrong? In a series of steps cells lose certain restraints. Normally cells that divide, divide in an orderly manner and at a rate that is determined by some feedback loop telling them whether reinforcements are needed. Cells respect their boundaries. Cells do their job.
In cancer cells – according to the “multiple hit” model of the development of cancer – control over growth generally gives way first, and then the cell loses a respect for boundaries, and then cancer cells develop a number of mechanisms that allow them to continue to grow at a cost to other well-behaved cells. Like 7 of 9 someone has modified their link to the Borg.
In some cases loss of the code is caused by ionizing radiation which breaks the bonds in DNA allowing it to recombine in ways that bypass normal controls. In other cases damage to the DNA is caused by exposure to chemicals like benzene that contain a planar ring structure that breaks the chain of DNA. These compounds with benzene rings can be encountered at work, through the tars of tobacco smoke, and other environmental exposures.
It has long been felt that some cancers are caused by viruses. Viruses are very limited creatures in terms of resources. They have scant DNA (or RNA), only enough to get them into the cell they parasitize after which they high jack the host’s DNA and RNA as they multiply and are transmitted to a new host. It is critical that the virus have a susceptible population of hosts to parasitize. Otherwise, the host, when it discovers that an enemy has breached the gate, will find the virus and neutralize it.
A Little Bit About Viruses
When the rinderpest virus crossed species and the first epidemics of measles occurred in the 11th or 12th century, it required, and still does require, a naïve population of about 250,000 individuals in order to survive. There is no carrier state for measles, so the virus depends on being spread by air-borne droplets from an infected to an uninfected individual.
Every year, mostly in undeveloped countries, 30,000,000 individuals develop measles and about 197,000 die. That is a rate of less than 1/150 which may sound high, but in terms of viral success that is good. Killing the host is generally a bad thing for the virus unless it can get itself spread prior to demise of the host.
Smallpox, by contrast, has had mortality rates during epidemics as high as one in four.
Some viruses live, like mistletoe, in or on the host, killing the host very slowly, achieving long periods of infectivity. Hepatitis C is one such virus. Hepatitis C slowly causes damage within the liver, eventually causing cirrhosis and death. During that time it is transmitted by blood and by other less well understood means. Until the individual develops liver failure they may be unaware of their infection.
Some viruses live, sequestered in some area of the body that our immune system can’t see, like nerves, apparently causing no damage and then are activated, and cause a great deal of morbidity such as when the chickenpox virus is activated causing shingles.
What does any of this have to do with cancer?
For a long time viruses were suspected as the cause of cancer, and over time a number of connections were made. Several strains of the HPV (human papilloma virus) - the virus that causes venereal warts - have been identified as involved in the development of cervical cancer. Although the virus causes visible warts (papillomas) on the external genitalia its effects are invisible to the naked eye on the cervix. Nevertheless, the virus exists within surface cells in some cases leading to cancer. This virus and the tumor that it caused were involved in producing the “immortal” cell line known as HeLa cells. The story of this cell line and the woman they came from were the subject of the book, “The Immortal Life of Henrietta Lacks”.
A type of lymphoma, described by Burkitt, that affects children in equatorial Africa, closely follows the belt across Africa affected by mosquito borne malaria. The lymphoma is known to be associated with Ebstein-Barr virus, which also causes infectious mononucleosis, a debilitating, but usually benign disease. The exact mechanism of mosquito borne EBV infection and the development of lymphoma is suspected, but why it causes a malignant tumor there and a benign illness elsewhere to my knowledge is still unknown.
In recent years it has come to light that a polyomavirus known as Merkel Cell virus lies dormant in Merkel Cells, a small cell that sits adjacent to the ends of nerve cells transmitting messages chemically to the nerves of pressure on the skin. How the virus gets there is unknown, and therefore how it is transmitted is unknown. What is known is that it is very common, and affects siblings in childhood. The MCV is involved in about 80% of patients with an uncommon cancer, Merkel Cell Carcinoma. Merkel Cell Carcinoma usually occurs on sun-exposed areas, but not always. So there is some connection between fair skin, sun damage (ionizing radiation), and the MCV in the development of the cancer.
My Own Experience With the Borg
I know about this cancer for a couple of reasons. I am a retired pathologist who looked at a lot of skin biopsies in 30 years of practice always on the lookout for MCC. To my knowledge I saw one case.
Two years ago I became intimately acquainted with this cancer when I developed it on my lower leg in an area that has not received much sun exposure. I almost certainly have the virus that causes the cancer, and could, theoretically, develop a second primary tumor. In some animals poly (many) -oma (tumor) viruses create multiple tumors.
Since diagnosis by biopsy in 2015 I have undergone a wide excision of the biopsy site and skin graft over the excision, a recurrence near the previous biopsy site, seven weeks of radiation to my lower leg in 2016, and am now six months post radiation. My most recent set of imaging studies – a full body PET scan and MRI of my lower leg show no obvious evidence of persistent or metastatic tumor. I have not yet seen my radiation oncologist who will evaluate those studies and the results of the radiation in a couple of weeks.
People talk about fighting cancer as though it was a foreign invader, and in a sense it is, but instead of an alien species, it is more like a part of us has been fitted with modified hardware, a change that causes that part of us to see itself as the true us, and us as the enemy. Their motto is much like that of the Borg, “We are the Borg. Resistance is futile”. Many times it is. At other times we rid the Star Ship of the mutants.
Too bad we don’t wind up with Jeri Ryan in the process.