the cure for childhood cancer and how my projects can help

I want to say "how permaculture can help" but the conversation gets too broad and debatable.   It is challenging enough to say "my projects."


Seven years ago I stated "the mission" here:  https://permies.com/t/24216/permaculture-projects/mission

I think I left out a big piece.   This is my attempt to provide that big piece.


Let's take more than seven seconds to think about children with cancer.  Starting with this statement I wrote 7 years ago:

In 1950 there was one pediatric oncology ward. Now there are over 200.

I remember many decades ago when learning about a problem like this I would concentrate deeply about solutions.  My mind reeled.   The problem was massive.   And it stuck in my brain, niggling away ...     (and many other global problems - but I'm going to stick to just this one for a moment)   ...   So it seemed too big 30 years ago, but about 15 years ago I think I may have solved it ...


Solving childhood cancer in two steps:

   step 1:   cancer comes from carcinogens.  Known and unknown.   All people everywhere need to reduce the collective carcinogens in their life by 85%.  

   step 2:   people will not eliminate carcinogens from their life as a sacrifice.  But they will do it if there is a benefit.  We need to find those benefits and tell everybody.



I can rework this statement a couple dozen times changing the stuff about cancer to be about a different global problem:

Solving climate change in two steps:

   step 1:   climate change comes from carbon footprint.  All people everywhere need to reduce their collective carbon footprint  by 55%.  

   step 2:   people will not reduce their carbon footprint as a sacrifice.  But they will do it if there is a benefit.  We need to find those benefits and tell everybody.




From the wheaton eco scale: a good 70% of the population is not concerned about environmental issues.  And about 15% are barely interested.  So without this 85%, we cannot make change.  We need bits of information that will give them benefit - by their standards.   And we tell them about those things.  

And before we do that, we need enough data and information to convey to them.   We need to clean up our own back yard, and then send them a picture and explain what benefits we are experiencing that they want.  

These are the bricks to build a better world.  Thousands of bricks.  And we do what we can to deliver these bricks to the level 0 and level 1 people.  

I think we will not change the world for the better through shaming.   We will change the world for the better by doing good things in our own backyard and sharing pictures.


I'm trying to connect all of this to my projects:

    - the content here has now reached more than 100 million people.  And we are trying to grow and reach more.

    - my property is loaded with new projects and people working on getting projects completed and posting pictures

    - to reach people in other ways, I've produced a dozen movies, the cards, videos, podcasts, articles, interviews, and the best of them all - the book.



The book is, I think, the best list of things to add comfort and money to your life that just so happen to also solve global problems.   But I am now thinking that I might not have been clear enough in the introduction about this point.  



To move my projects forward, my forward velocity is limited by resources.   To gain those resources, I try to do the same thing:  create something of great benefit and value.  To provide something in return for resources.   To be generous.  As I type this, I have a kickstarter running where I think that what we return has ten times the value of what people put in.





It isn't perfect. I'm trying all sorts of things.  And I have about a hundred people that are actively pushing me forward - many of whom are doing it in a way where I don't see where they have direct benefit.  My only guess is that they are thinking the same thing I am "this will work if enough of us push."   Some are putting in time on the staff.   Some are here at wheaton labs.  Some are flooding my patreon stuff with coin, or putting heaps of coin into my kickstarter.  And, the one thing that I think moves this all forward the most:  the BRK.   I want to say thanks to all these people.  But "thanks" seems to suggest that they are doing this stuff for me - It's not like I take all this and can now go on some glorious five year vacation as an exploration of deep hedonism (HHH?).  I want to say thanks for understanding what I am trying to do and ...   I am reluctant to say it ...   making sacrifices of your time and/or monies where there is no obvious, direct benefit.  So all this stuff about connecting information to people so they can have a large benefit without sacrifice does still take sacrifice.     And I feel like we are making massive progress on dimes and nickels - especially when compared to "professional" organizations.


What I am trying to say is that global positive change comes from teaching a billion people about the benefit they derive from one simple thing.   And that thing happens to also make a positive, global difference.  And then to share a dozen similar things.  An then a hundred.  

We have hundreds of things to share already.   And we have ideas for hundreds more - which we need to make and then take pics/video of.  And then we need to find the ways to connect these things to billions of people - we're trying stuff there too.

The solutions to global problems are simple.   We just need to demonstrate and share in a way that reaches a billion brains.  Maybe if we had just a little more help ...

I've been interviewed a few times recently about my book, and one of the questions I get asked a lot is "The book says it is for people with a backyard - is there anything in the book for apartment dwellers?"

My answer has evolved a bit to:     The first half of the book is for everybody, including people in apartments.   And the second half of the book is also for apartment dwellers, but more like how those same apartment dwellers do not happen to own a nuclear reactor, but they have a pretty good idea of what they do and how.

----------------------

Another element that comes up a lot is about building codes and insurance around rocket mass heaters.   Part 1 is that there is a lot of progress with both building codes and insurance.  Part 2 is that it is exactly like people smoking pot.  Nobody ever smoked any pot until the government made it legal.  

This came up in the staff meeting on saturday as I was attempting to paint a picture of how the SKIP program is 10,000 times more important than the greenhouse kickstarter.   The greenhouse kickstarter is one brick - that will possibly be a foundation for a home design that will solve a long list of global problems including childhood cancer ...     But the SKIP stuff will be the foundation for accelerating all of these ideas and laying the foundation for new ideas on a global scale - with a much stronger motivator for doing so.   The greenhouse project is awesome for some level 4 or level 5 people.   SKIP will appeal to level 0 and level 1 people.  And be an overall stronger motivator.  

But I think our peeps can understand and support the greenhouse about a hundred times easier right now than SKIP.   So SKIP still has a long ways to go for people to get their heads wrapped around it.

Hi Paul,

I rarely post but often read these forums.  I feel like I have to speak up here because this is right in my wheelhouse.  I'm a paediatric oncologist and proud permie.  My day job is caring for children with cancer and their families with diagnosis, treatment and aftercare and I'm passionate about what I do.  I hear your heart in wanting to help these kids because it's in my heart too, and I also love your master plan and mission.  My concern is in the assertion that childhood cancer is caused by carcinogens when 95% of the time it is not.

You're totally right in that the majority of adult cancers are related to exposures both known and unknown to carcinogens - chemical, radiation, dietary, lack (of exercise particularly).  Childhood cancer is not.  It is primary a genetic disease in that usually it stems from a single genetic mistake in the reproduction of rapidly dividing cells early in life.  We know this is true for several reasons.  Firstly the types of cancers children get do not tend to be epithelial cells (skin, lining of bowel, mouth etc).  They tend to be in developing or growing cells and organs - kidney, liver, brain, bone marrow.  Childhood cancer is also not a disease of multiply accrued mutations over time leading from healthy cells to dysplastic cells to adenoma to carcinoma.  They tend to harbor few mutations but in predictable genes, often at predictable sites.  We also know that as much as 10% of childhood cancer is linked to variant alleles in risk genes which are present in all the child's cells.  RB1 mutations leading to retinoblastoma, NF1 mutations leading to optic pathway glioma, TP53 mutations in many malignancies, PMS2/MSH2 mutations in high grade glioma.

Many studies have looked at environmental factors in the development of childhood cancer and there is little to link them.  The most well proven exposure to correlate is that lack of exposure to bugs in early life may be linked to a modestly increased risk of acute lymphoblastic leukaemia in susceptible individuals.

Your statement about proliferation in paediatric oncology is true, but the reason is not what you think.  70 years ago paediatric oncology wasn't a specialty.  Why not?  Because all children died.  They attended the hospital with their leukaemia, were told the diagnosis and sent home for palliation.  At that time there was no treatment, nor did people think there would ever be treatment.  Now when a child attends hospital with a new acute lymphoblastic leukaemia we can offer an over 90% prognosis, often with minimal late effects.  As treatments are advancing we are offering treatment in more and more situations where before no treatment existed.  That's why paediatric oncology centres are bigger and busier.  There probably is a rise in diagnoses over time, but it is modest, not dramatic.

Respect to you and your mission, but had to correct this misunderstanding.
Sincerely,
Andrew

Andrew, thank you for clarifying things. I've spent my career in veterinary medicine and was aware of the causes for most childhood cancer, but did not have enough knowledge to give a proper response.

Environmental factors do indeed have a significant bearing on many health issues. In vet med I can cite many examples. So a shift to a non-toxic lifestyle such as permaculture would be a major step forward in eliminating at least those environmentally induced or influenced problems. Cancer might be foremost in many persons thoughts when it comes to toxic environments, but in vet med we see far more non-cancer health issues, resulting either directly or indirectly from toxins and pollutants.

Andrew, as much as I am constantly dogged by anonymous heroin addicts pretending to be all sorts of things and challenging me, I'm going to assume you are the real deal.

I wish to challenge you on a few fronts, but for the moment let's start with just one:   please help me to understand the relationship between toxins that the parents encounter before conception or during pregnancy and childhood cancer.

Andrew Dodgshun wrote:
You're totally right in that the majority of adult cancers are related to exposures both known and unknown to carcinogens - chemical, radiation, dietary, lack (of exercise particularly).  Childhood cancer is not.  It is primary a genetic disease in that usually it stems from a single genetic mistake in the reproduction of rapidly dividing cells early in life.  .....

I'm not really sure, Paul, why it is that you chose childhood cancer as the platform on which to build this argument......seems like any biological or social malady that could be rectified or combated from a Permies approach would be justifiable.  With respect to Andrew's comments above, I feel it important to bring up a crucial distinction even as it may seem like nit-picking.  It is one that the deeper scientific community takes quite seriously.  To say that "(Childhood cancer) ... usually it stems from a single genetic mistake in the reproduction of rapidly dividing cells early in life", is not necessarily incorrect, but it does not answer the question as to whether or not the mutation arose from a natural 'hiccup' in the DNA replication process or whether it arouse as a consequence of some effect of the environment in ways that we don't understand.  This may be the reason that the American Cancer Society used the verbiage ".... the causes of DNA changes in most childhood cancers are not known. Some may have outside causes like radiation exposure, and others may have causes that have not yet been found. But many are likely to be the result of random events that sometimes happen inside a cell, without having an outside cause." (see below)   What is important here is the use of the words "may" and "are likely" as juxtaposed with the the Dr. Dodgshun's use of "usually stems".   Again, may seem like nit-picking, but these are important qualifiers in many such discussions.  

If I'm not mistaken, there is epidemiological *association* (not to be confused with proof or causation) between certain environments and *some* childhood cancer(s).  Lots of unknowns floating about between that data and how those different environments may or may not influence cancer rates and types. See source of the ACS information below.


"Inherited versus acquired gene mutations
Some children inherit DNA changes (mutations) from a parent that increase their risk of certain types of cancer. These changes are present in every cell of the child’s body, and they can often be tested for in the DNA of blood cells or other body cells. Some of these DNA changes are linked only with an increased risk of cancer, while others can cause syndromes that also include other health or developmental problems.

But most childhood cancers are not caused by inherited DNA changes. They are the result of DNA changes that happen early in the child’s life, sometimes even before birth. Every time a cell divides into 2 new cells, it must copy its DNA. This process isn’t perfect, and errors sometimes occur, especially when the cells are growing quickly. This kind of gene mutation can happen at any time in life and is called an acquired mutation.
Acquired mutations are only in the person’s cancer cells and will not be passed on to his or her children.

Sometimes the causes of gene changes in certain adult cancers are known (such as cancer-causing chemicals in cigarette smoke). But the causes of DNA changes in most childhood cancers are not known. Some may have outside causes like radiation exposure, and others may have causes that have not yet been found. But many are likely to be the result of random events that sometimes happen inside a cell, without having an outside cause."  -- https://www.cancer.org/cancer/cancer-in-children/risk-factors-and-causes.html

From Cancer Research Trust NZ:

"Today, Dr Dodgshun, the 2011 winner of the gold medal for the highest overall performance in the Royal Australasian College of Physicians Fellowship (FRACP) exams in paediatrics, continues to work at the Canterbury District Health Board. He is still at the bedside of his child patients with brain cancer, still supporting the families, and now able to provide more accurate diagnosis, prognosis and better treatment regimes, including minimising the number of chemotherapy sessions, as a result of his breakthrough research findings to reclassify paediatric glioma.
...
In 2014, Cancer Research Trust NZ awarded Dr Dodgshun the Murray Jackson Clinical Fellowship to develop a tool for risk profiling and accurate prognostication in paediatric glioma integrating clinical features with epigenetics."

paul wheaton wrote:Andrew, as much as I am constantly dogged by anonymous heroin addicts pretending to be all sorts of things and challenging me, I'm going to assume you are the real deal.

I wish to challenge you on a few fronts, but for the moment let's start with just one:   please help me to understand the relationship between toxins that the parents encounter before conception or during pregnancy and childhood cancer.

Great question. A longitudinal risk factor like the one you proposed is the hardest to disprove.  I honestly can’t hand-on-heart say that it definitely doesn’t have an impact - my gut says it’s not a major player for childhood cancer.  You would expect to see fluctuation by lifestyle and community.  A great example is the Amish.  They are at significantly lower risk of asthma due to lifestyle factors and exposures (more exposure to bugs, less exposure to pollutants).  They’re also at a significantly reduced (like 60%) risk of many types of adult cancers because of the way they live.  Yet their childhood cancer rate isn’t significantly different, or at least nobody has published that it is.

My closer-to-home example is in New Zealand where I live.  We look after children from urban and rural backgrounds, encompassing a wide range of lifestyles.  We look after children of people who have eaten organic food for decades, live rurally among like minded people and never take medication of any kind.  We look after children whose families only eat processed food, have exposure to legal and illegal drugs since day dot.  Our regional rates for childhood cancer are identical across these wildly different communities.

I mentioned about exposure to infectious agents in the last post.  It was based on this research which is worth a read.  https://www.sciencedaily.com/releases/2018/05/180521131746.htm

By the way I am the real deal!

Andrew Dodgshun wrote:By the way I am the real deal!

You are, and I love that you're earning all those apples for writing this information!
With that in mind, can permaculture still help? After all, it's not only about gardening or homesteading. Maybe we can't cure (or prevent) childhood cancer with healthy lifestyle and organic food, but there are other issues that can be solved. Since this type of cancer, as you say, is so unpredictable, it's also super scary. People freak out when something like that happens to them, and it's mostly young parents. There is a children's hospital near me, and yesterday they announced that they cured one boy from leucemia by giving him his own cells, but genetically modified (it's called CAR-T and I probably can't explain it properly...). They say that he wouldn't make it otherwise because he wasn't responding to normal treatment. He's 11 years old and they're expecting him to be completely healthy.
I'm thinking of the social ethics of permaculture - "people care" etc. I'm sure the children and parents are already getting professional psychological support nowadays, but when I had a serious surgery at 12, there was no such thing. In fact, other kids in the hospital were scaring each other by telling stories about ghosts and who will die when. The kids generally seemed less concerned about it than their parents.

Andrew,

Suppose you have a patient named Billy.   And Billy's folks are heavy chain smokers.  Further, Billy's home environment is rather loaded with carcinogens (let your mind run wild).   Things are not looking good for Billy.  You learn that Billy has an Aunt Betty - she is bonkers about permaculture.  Betty is not a smoker, and her home is very low in carcinogens.   Her garden food comes from rich soil with polyculture.  

My impression is that you are saying that Billy's chances for recovery are the same at home or at Aunt Betty's.  True?

My understanding of cancer is that we all have it all the time.  To say "I have cancer" is more accurate to say "I have more cancer than my immune system can deal with."  True?

paul wheaton wrote:Andrew,

Suppose you have a patient named Billy.   And Billy's folks are heavy chain smokers.  Further, Billy's home environment is rather loaded with carcinogens (let your mind run wild).   Things are not looking good for Billy.  You learn that Billy has an Aunt Betty - she is bonkers about permaculture.  Betty is not a smoker, and her home is very low in carcinogens.   Her garden food comes from rich soil with polyculture.  

My impression is that you are saying that Billy's chances for recovery are the same at home or at Aunt Betty's.  True?

From my entirely layman's point of view, I would think that there is a lot of ground between saying that "carcinogens don't cause many childhood cancers" and "being surrounded by carcinogens doesn't affect the chances of recovery from cancer".

A great example is the Amish.  They are at significantly lower risk of asthma due to lifestyle factors and exposures (more exposure to bugs, less exposure to pollutants).  They’re also at a significantly reduced (like 60%) risk of many types of adult cancers because of the way they live.  Yet their childhood cancer rate isn’t significantly different, or at least nobody has published that it is.

The Amish do live a different lifestyle - but it isn't even an organic lifestyle, let alone something like what I advocate.  

I feel this line of research could possibly be indicative of many things, but also shifted by other things.   They still have smokers (pipes) and they still work with a lot of toxic materials.  

We look after children from urban and rural backgrounds, encompassing a wide range of lifestyles.  

Constant air pollution in the city, vs. excessive use of pesticides in the country.  

We look after children of people who have eaten organic food for decades, live rurally among like minded people and never take medication of any kind.  We look after children whose families only eat processed food, have exposure to legal and illegal drugs since day dot.  Our regional rates for childhood cancer are identical across these wildly different communities.

I have met people that insist they eat "only organic" only to discover that their organic diet is about 20%.   And I have met people that insist that everything on their property is organic better, except, of course, when they spray toxic gick.  

I think there is a thousand times more to say here, but I wish that the research that was conducted was ... a bit more robust.  

I am glad you are on permies.  And I am glad that I have the opportunity to infect your brain.  

Suppose that five years from now Allerton Abbey is as lovely as ever and surrounded by a jungle of food systems.   A house built without zero cement (commercial cement loaded with hidden toxic waste from other industry), zero paint, and the only plastic is a thin layer buried in the membrane.  A strong focus on a structure to be built to be low in toxins - known and unknown.   And the food is from rich soil with polyculture.   Supposing that Billy lives in a city with his parents in a big brown cloud and has the option to come stay a few weeks at allerton abbey (without his smoking parents) - would you consider it?  



I am not a doctor, let alone a pediatric oncologist.  And I think that Billy has a far better chance of recovery in the environment I suggest.  Not only due to a dramatic reduction of environmental carcinogens, but other toxins as well.  Including toxins that we might be suspicious of, but don't have any hard proof of yet.   So I suppose this could be referred to as a reduction in carcinogenic load for a patient attempting to recover from cancer.  Any patient - including a child.   Further, I think that sort of therapy has not been researched in a way that might be satisfactory to you and your colleagues, but that's my point in creating this thread:   I wish to try.  And I think I am going to make a massive difference.  So my next question to you, posed rather gently:   Do you think my ideas MIGHT bear fruit?

Is Billy the patient already diagnosed with cancer? Such as that 11yo boy I wrote about? If so, and he has that leukemia that doesn't respond to any known treatment, would you just send him to Allerton Abbey and hope for the best?
Or would you send him there now, when he's three months after successful CAR-T treatment and doctors say that he has no more cancer cells in his body?

Such a great conversation, and a really important one.  Great to chat with you Paul and others.

Firstly regarding your point about cancer and the immune system Paul.  What you said is not quite accurate.  It is true that when cells divide mistakes are made.  We have 2 systems to pick them up immediately - the proofreading domain in the DNA polymerase and the mismatch repair system.  If they fail and a mutation slips through there are a number of secondary mechanisms to protect the organism (us) against deleterious effects of the mutation.  Many mutations don’t matter, don’t affect the function of the protein or there’s enough buffer in the system to get on with the job without the use of that copy of the gene.  Many mutations simply cause the cell to die because it can’t function but another cell comes along to take its place.  The rare mutation in a critical gene that causes a cell not to die but to proliferate and lose control is a problem.  There are cellular systems to detect this and cause apoptosis (programmed cell death) to ensure the organism comes to no harm.  The immune system probably plays a role in surveillance for this but is not the major player.  Cancer by definition is when a mutation in a cell has evaded ALL of these systems.  By the time you get to this point you have cancer and no immune function can rescue you.  I note there are some exceptions to this is some forms of cancer but this is the rule for most.  There are some indolent forms of cancer which we “live with”, a significant minority of men in their 70s have indolent prostate cancer that never causes a problem.  But it’s not the immune system keeping it in check, it’s the biology of the cancer itself.

Secondly regarding Billy.  I want to make clear that although I don’t believe environmental exposures are a major CAUSE of childhood cancer I do believe environment has a huge amount to do with recovery.  Billy should go stay with his permie aunt, he’ll do better with proper nutrition and environment to support his recovery during treatment.  I don’t believe that nutrition and environment will cure his cancer (I know other folks here will disagree but that’s my strong belief) but it certainly will support his recovery during and after treatment.  Not because of carcinogens or lack of per se but just in terms of giving the body what it needs to recover.  There are some studies looking at cure rates from childhood cancer in light of nutrition but they’re very crude - underweight, healthy weight, overweight.  They show that under and over weight lead to poorer recovery.  Many parents believe that gross freeze dried powdered vitamins make a difference but I don’t think they do and no evidence has said they do.

Regarding the Amish - I know they’re not a permie equivalent but there is good research on their population through time.  My point is that they have vastly reduced rates of adult cancer indicating their environment is altering the risk of environmentally-associated diseases in a positive way.  If childhood cancer was also due to exposures you would expect that risk to be lowered also.

Regarding your final point - I love your idea and I think it’s worth pursuing.  I don’t think it will affect the incidence of childhood cancer but it sure may affect the quality of recovery.  And even if it doesn’t you’ll definitely affect the rates of other diseases down the track which is actually a much larger impact - heart disease, stroke and adult cancer.

Flora Eerschay wrote:

Andrew Dodgshun wrote:By the way I am the real deal!

There is a children's hospital near me, and yesterday they announced that they cured one boy from leucemia by giving him his own cells, but genetically modified (it's called CAR-T and I probably can't explain it properly...). They say that he wouldn't make it otherwise because he wasn't responding to normal treatment. He's 11 years old and they're expecting him to be completely healthy.
I'm thinking of the social ethics of permaculture - "people care" etc. I'm sure the children and parents are already getting professional psychological support nowadays, but when I had a serious surgery at 12, there was no such thing. In fact, other kids in the hospital were scaring each other by telling stories about ghosts and who will die when. The kids generally seemed less concerned about it than their parents.

CAR-T is pretty incredible therapy.  It’s forcing the immune system to recognise the cancer cells as foreign and attack them.  It’s promising for leukaemia in particular but it’s riotously expensive.  To your second point, yes we have wrap around services including play specialist (child life specialists in the US), teachers, psychologists, social work, physio, OT, nursing and medical.  It’s a vastly different experience to the bad old days!

Andrew,

Did you see "The Food Cure"?

Dr. Dodgshun, I would just like to thank you for sharing your information, and doing so in such a gracious manner. I'm finding it fascinating, and it's information I wasn't aware of. I'm looking forward to reading more.

An interesting recent paper that is relevant to this discussion and it appears to be open-access:   https://www.pnas.org/content/117/5/2560

It's unfortunate that pediatric analysis was not included or separated out within the study, but given the study's size, it's understandable that might be dealt with as a separate investigation.  From the Discussion of the paper:

"Despite being a founder population that diverged from other Europeans only very recently (58), the Amish show a mutation rate reduction of about 7%. This reduction persists when controlling for parental age effects and sequence quality metrics, and seems to be driven by reductions in C→A and T→C mutations. Together with our estimation that DNM rate has zero narrow-sense heritability, this suggests that the environment may play a bigger role in modulating the mutation rate than previously appreciated. The Amish lifestyle features preindustrial era aspects, and while modern Amish communities are diverse and have adapted to the usage of some modern items, they continue to limit the influence of technology in their daily lives (59, 60). Given this, it is possible that the Amish are exposed to fewer mutagens, and that this “clean living” may be partially responsible for the reduced mutation rate we report here. For example, studies have shown that rural areas, such as those similar to the areas occupied by the Amish, have fewer carcinogens and mutagens than industrialized areas (61⇓–63). Recent analysis of mutation patterns has also called into question the canonical view that DNMs rise predominantly from replicative errors, and suggests that exogenous mutagens may play a larger role in mutation accumulation than previously appreciated (25). If the Amish do in fact experience less environmentally driven mutagenesis, then one would predict a significant reduction in the rate of cancer in the Amish. This is exactly what has been found in multiple Old Order Amish populations, with a particularly large reduction in cancer rates found in men (64, 65). A similar reduction in overall mortality has been found in Amish men compared with FHS men, which is hypothesized to be due to lifestyle factors, such as reduced tobacco use and increased physical activity (59). Given that DNM mutation in sperm is the single largest driver of DNM accumulation, an Amish environment that potentially limits DNA damage in Amish men is consistent with a lower DNM rate. In accordance with this, the Amish have the lowest estimated parental age effect (Table 1). This is also consistent with the recent finding of significant variability in parental age effects across ancestrally similar families, which also suggests the possibility that environmental factors influence DNM rates (66)."
--Kessler, M.D., Loesch, D.P., Perry, J.A., Heard-Costa, N.L., Taliun, D., Cade, B.E., Wang, H., Daya, M., Ziniti, J., Datta, S. and Celedón, J.C., 2020. De novo mutations across 1,465 diverse genomes reveal mutational insights and reductions in the Amish founder population. Proceedings of the National Academy of Sciences, 117(5), pp.2560-2569.

John Weiland wrote:An interesting recent paper that is relevant to this discussion and it appears to be open-access:   https://www.pnas.org/content/117/5/2560

It's unfortunate that pediatric analysis was not included or separated out within the study, but given the study's size, it's understandable that might be dealt with as a separate investigation.  From the Discussion of the paper:

"Despite being a founder population that diverged from other Europeans only very recently (58), the Amish show a mutation rate reduction of about 7%. This reduction persists when controlling for parental age effects and sequence quality metrics, and seems to be driven by reductions in C→A and T→C mutations. Together with our estimation that DNM rate has zero narrow-sense heritability, this suggests that the environment may play a bigger role in modulating the mutation rate than previously appreciated. The Amish lifestyle features preindustrial era aspects, and while modern Amish communities are diverse and have adapted to the usage of some modern items, they continue to limit the influence of technology in their daily lives (59, 60). Given this, it is possible that the Amish are exposed to fewer mutagens, and that this “clean living” may be partially responsible for the reduced mutation rate we report here. For example, studies have shown that rural areas, such as those similar to the areas occupied by the Amish, have fewer carcinogens and mutagens than industrialized areas (61⇓–63). Recent analysis of mutation patterns has also called into question the canonical view that DNMs rise predominantly from replicative errors, and suggests that exogenous mutagens may play a larger role in mutation accumulation than previously appreciated (25). If the Amish do in fact experience less environmentally driven mutagenesis, then one would predict a significant reduction in the rate of cancer in the Amish. This is exactly what has been found in multiple Old Order Amish populations, with a particularly large reduction in cancer rates found in men (64, 65). A similar reduction in overall mortality has been found in Amish men compared with FHS men, which is hypothesized to be due to lifestyle factors, such as reduced tobacco use and increased physical activity (59). Given that DNM mutation in sperm is the single largest driver of DNM accumulation, an Amish environment that potentially limits DNA damage in Amish men is consistent with a lower DNM rate. In accordance with this, the Amish have the lowest estimated parental age effect (Table 1). This is also consistent with the recent finding of significant variability in parental age effects across ancestrally similar families, which also suggests the possibility that environmental factors influence DNM rates (66)."
--Kessler, M.D., Loesch, D.P., Perry, J.A., Heard-Costa, N.L., Taliun, D., Cade, B.E., Wang, H., Daya, M., Ziniti, J., Datta, S. and Celedón, J.C., 2020. De novo mutations across 1,465 diverse genomes reveal mutational insights and reductions in the Amish founder population. Proceedings of the National Academy of Sciences, 117(5), pp.2560-2569.

That study seems to agree with exactly what the doctor said, that carcinogens do indeed have much to do with higher rates of cancer in adults.

We have a very large Amish population here, and in general, it seems they are much healthier than the average American living in this same area. They eat a much healthier diet, get far more exercise, and have much lower obesity rates than the rest of the population in this area, along with less exposure to common carcinogens. I would think all those things come into play.  I think the fact that they are spiritual and have a very close knit and supportive community also factors in, although I admit that is simply conjecture on my part.

paul wheaton wrote:Andrew,

Did you see "The Food Cure"?

I haven’t watched the film but I am very familiar with the Gerson protocol.  I’ve come across all sorts of things in my time in paediatric oncology.  Gerson, alkaline diet, fasting, intermittent fasting, macrobiotic, vegan, multivitamins, garlic, megadose vitamin C, aromatherapy etc etc etc.

I have had a number of patients where there were no more conventional options for cure pursue these things.  Every one died.  Every.  One.  Not one patient I have been involved with has done the Gerson protocol and lived.  There’s also an increasing literature around treatment abandonment to pursue these things.  Again the numbers are shocking.  Patients with curable cancers die for lack of appropriate therapy.

Again I want to reiterate - food is medicine.  What we put in our bodies and what we do with our bodies (activity) has FAR more impact on our health and mortality than anything else.  Including medications.  But cancer is one of those situations where you have a rogue series of cells which simply will not go away with supplements or food-based cures.  We have the luxury in paediatric oncology of boasting about an overall 85% cure rate for all cancers.  That’s a totally different kettle of fish to adult cancers.  I absolutely understand why an adult would choose not undergo chemotherapy that can offer no chance of cure, just prolonging of life at the cost of quality.  But in paeds we are in a different scenario.  I love nothing more than discharging a patient, cancer free, cured, with little to no late effects from the therapy they’ve received.  No dietary therapy can achieve that.

That is so interesting, that the Amish have lower rates of asthma and adult cancer but not lower rates of childhood cancer. That is a very impressive fact, there.

I see how permaculture can help.
During treatment: while the patient is at the hospital, the parents and families are wrecked. When a big problem like this comes, the small problems (and other big problems) don't go away. Community support can be enormous help for such parents to keep going, while the doctors treat their child. Like Andrew mentioned, it's much better now than it used to be, but it's still hard and many people are just scared of all that. Permaculture is good at creating community support.

After treatment: if the patient recovers, they may be free of cancer but weak after spending a long time in hospital bed. They need to gradually get back to life. It should totally be the healthy lifestyle with truly organic food, but not every Billy has a permaculture-obsessed Aunt Betty to go to. Did you see "The Secret Garden", a 1993 movie by Agnieszka Holland? It's about a lonely kid who recovers with the help of his friends, while they're taking care of an abandoned garden.

Also, the billionaires could donate some billions to make the riotously expensive therapies more affordable.

Edited to add: how many members in this forum have more apples than messages posted? There should be a special award for that.

Andrew Dodgshun wrote:

paul wheaton wrote:Andrew,

Did you see "The Food Cure"?

I haven’t watched the film but I am very familiar with the Gerson protocol.  I’ve come across all sorts of things in my time in paediatric oncology.  Gerson, alkaline diet, fasting, intermittent fasting, macrobiotic, vegan, multivitamins, garlic, megadose vitamin C, aromatherapy etc etc etc.

I have had a number of patients where there were no more conventional options for cure pursue these things.  Every one died.  Every.  One.  Not one patient I have been involved with has done the Gerson protocol and lived.  There’s also an increasing literature around treatment abandonment to pursue these things.  Again the numbers are shocking.  Patients with curable cancers die for lack of appropriate therapy.

First, of course, everybody that you have helped has died or will die.  We all die.  I think what you were getting at was that they would have lived longer if not from dying when they did of cancer.

I know that when I had my gallstone event, it was clear that they wanted to pop that gallbladder out immediately.  The idea of any other path seemed silly.   One doctor was willing to say that I can dodge gallstones through diet, but nobody has ever done it.  Every patient of hers that has ever tried that path had another gallstone attack and then did the surgery.  Every last one.  All.  100%.  Absolute.  And here I am, two and a half years later and I still have my gallbladder and I haven't had an issue.

Not the same as cancer.  Not the same as childhood cancer.  

I've just met so many people that have beat cancer with nothing but diet and/or environment changes.  Including Helen Atthowe - and we recorded some podcasts about that.  But those people are adults.  And that data is anecdotal.

So childhood cancer:  it was in the movie.  I think it was five adults and one infant.  And they all made it past the five year mark after the cancer was discovered.  My understanding is that that is considered the mark for being a cancer survivor.  

And then there is "The Beautiful Truth".  



I am reminded of how most of the world is utterly certain that it is not possible to go to mars - until somebody has gone to mars, written a white paper about it, and that white paper has been published in a reputable journal.  

It seems that nearly all of my life is doing stuff that is "impossible".  And there will be a long parade of people lined up to tell me that I am wrong.   And then I try ...    and there have been a lot of things I have accomplished that were previously thought "impossible" and there are a lot of things where the lesson was that I was wrong.  


It sounds like confirmation that I want to try something that has not been tried.   And the odds, according to one professional (decorated?) pediatric oncologist, are against me.    I suspect that 98% of all pediatric oncologists will say the same thing:  slim to no chance of this bearing any fruit.


Solving childhood cancer in two steps:

  step 1:   cancer comes from carcinogens.  Known and unknown.   All people everywhere need to reduce the collective carcinogens in their life by 85%.  

  step 2:   people will not eliminate carcinogens from their life as a sacrifice.  But they will do it if there is a benefit.  We need to find those benefits and tell everybody.



And I'm still gonna try.  And it might be a hundred years after the both of us are dead that the final results are in:  that I was a fool and wasted my time, or my work was the pre-cursor to the good stuff.  

I have a philosophy that I believe will cure childhood cancer.  I am going to try to create that environment - and I suspect that no sane person will subject their sick child to my natural world with polyculture food from a rich soil.   And if there were, I suspect that every layer of government will prevent any children with cancer to come within a county mile of my place.   But, at the moment, I am allowed to grow a garden and build natural buildings.  So I will.  And maybe 40 years from now there will be a million similar places and the white papers will flow ...

I have to say Paul, I don't always agree with you, but I truly admire your perseverance and willingness to try things that other people tell you won't work.

Paul, I respect your dedication and optimism.  Nothing at all bad can come from your venture, provided you don’t start advertising your services as an alternative to proven treatment in children who can be cured.  We can agree to disagree on the stated final outcome of your idea but since it will undoubtedly have fantastic knock-on effects in other areas of health I fully support it.

I heard something very wise from a friend last night that I think is very applicable here - “We can sit with difference and still be in unity”.