July 24, the The Morning News of Northwest Arkansas reported contradictory findings in The Lancet regarding radiation therapy following surgery for lung cancer. 'Patients who had been treated with radiation therapy after surgery were 21 percent more likely to die than those who only had surgery... Researchers are unsure why radiation therapy caused more deaths earlier. ...The detrimental effect was worse in patients in the early stages of the disease... In those with more advanced but still operable lung cancer, the study said radiation therapy did not seem to cause harm although it also did not appear to help.' I developed an explanation of cancer which may explain The Lancet findings.

My brief explanation of cancer was printed in this paper, March 14, 1994, page 4A. If anyone is interested, one may read it there. The important point to this discussion is that I think the hormone, DHEA, must be low to trigger cancer. DHEAS, the source of DHEA, is low in lung cancer (Neoplasma 1994; 41: 101) and significantly low in bronchial carcinoma (Respir Med 1993; 87: 445). If low DHEA is involved in the development of cancer, then DHEA treatment should be beneficial. 'Administration of DHEA to laboratory mice and rats inhibits development of experimental tumors of the breast, lung, colon, liver, skin and lymphatic tissues.' (J Cell Biochem Suppl 1995; 22: 210).

Not only does lung cancer appear during times of low DHEA, hospitalization is directly linked to reduced DHEA. 'In this study of patients admitted to an ICU [intensive care unit], impairment of adrenal steroid secretion appears to be specific for DHEAS.' (J Clin Endocrinol Metab 1988; 67: 223). So, people admitted to hospitals for surgery for lung cancer are already low in DHEA. The levels of DHEA which can support life are idiosyncratic; some can live on smaller amounts than others. I think we die if we run out of DHEA. This is the key to explaining The Lancet findings.

'Total body radiation' used to destroy white cells before bone marrow transplantation is known to significantly reduce DHEA levels (Bone Marrow Transplant 1997; 20: 561) and (Horm Res 1995; 43: 279). Since I think all tissues live on DHEA, I think cancer does also. I think this is the mechanism whereby radiation works against cancers; radiation reduces available DHEA. Since cancers are rapidly growing, they are more sensitive to high levels of DHEA. Radiation reduces DHEA, so the entire person is adversely affected by low DHEA, but the cancer is more affected. The cancer dies before the rest of the person.

Surgery on '[female] patients who were healthy except for localized gynecologic diseases' caused a reduction in their DHEA of 37% which returned to normal levels some days post-surgery (Gynecol Oncol 1990; 37: 178). However, the same study demonstrated that patients with malignancies, or terminally ill, who were treated with radiation or chemotherapy, did not exhibit this same decline in DHEA upon surgery. When a person develops lung cancer, they are, by my definition, low on DHEA. If these patients are very low DHEA, then subsequent radiation will further lower their DHEA to the point of death. Some of these surgery patients reach low levels of DHEA that cannot be further reduced. They will continue to live. However, radiation therapy would have no beneficial effect against cancers in these individuals, because DHEA levels would not be further reduced. I suggest this explains the findings regarding the effects of radiation therapy following lung surgery reported in The Lancet.