Womb Mates and Cancer: Nature, Nurture, or Something Else?
Epigenetics are changing the way we look at cancer. And may help us beat it.
Is our cancer the result of nature or nurture?
Are we the victims of faulty DNA over which we have no control? Or of lifestyle and environmental factors that we can change? Or is there a third option?
Epigenetics is the study of that third option. This fairly new science covers the process by which nurture might affect nature. That is, diet and exercise might actually change the way our DNA influences our body. It’s a complex new field and scientists are even having trouble defining it.
One way of illustrating it is through the lives of twins.
According to the theory of nature’s influence, we are formed by the genes we are born with—twins separated at birth grow up to live eerily similar lives, sharing marital history, criminal pasts, even athletic ability and sicknesses. The theory of the influence of nurture, however, maintains that our environment shapes us—our economic status, parental involvement, exposure to specific risks, diet, exercise, and so on.
Epigenetics, however, demonstrates that environmental factors can actually influence our genes, changing our genetic processes to make us more or less susceptible to disease. Research published in PLOS Genetics on the influence of diet and exercise on the development of breast cancer demonstrates this epigenetic component.
Twins share the same DNA, which can make one more likely to have breast cancer if the other one is diagnosed with the disease.
Identical twins are formed from the same egg and begin in the womb with identical DNA; as the egg splits to become twins, the DNA likewise splits and does not necessarily divide equally, meaning that even identical twins do not have identical DNA. Fraternal twins develop from two different eggs and so they share DNA in the way all siblings do.
That’s the nature argument.
But not all twins share cancer—or any disease. It is common for one twin to get a serious illness that completely misses the other twin. This is the nurture argument—if twins share DNA but don’t share cancer, the environment has to have had some influence.
Twins alike but not alike: Amazon.com: Books
National Geographic’s January 2012 issue has a cover story on epigenetics and twins, with some compelling stories that show how unpredictable disease can be even for people with shared DNA. And that unpredictability is one of the motivators for the study of epigenetics.
As National Geographic writer Peter Miller describes it:
If you think of our DNA as an immense piano keyboard and our genes as keys—each key symbolizing a segment of DNA responsible for a particular note, or trait, and all the keys combining to make us who we are—then epigenetic processes determine when and how each key can be struck, changing the tune being played.
One way the study of epigenetics is revolutionizing our understanding of biology is by revealing a mechanism by which the environment directly impacts genes.
Studies of animals, for example, have shown that when a rat experiences stress during pregnancy, it can cause epigenetic changes in a fetus that lead to behavioral problems as the rodent grows up. Other epigenetic changes appear to occur randomly—throwing a monkey wrench into the engine of nature versus nurture. Still other epigenetic processes are normal, such as those that guide embryonic cells as they become heart, brain, or liver cells, for example.
Epigenetic researcher Alejandro Burga and colleagues, writing in the journal Nature, looked at why the same genetic mutation might affect people differently, using information from the Center for Genomic Regulation in Barcelona Spain. Burga explains that identical cells do not exist:
In the last decade we have learned by studying very simple organisms such as bacteria that gene expression—the extent to which a gene is turned on or off —varies greatly among individuals, even in the absence of genetic and environmental variation. Two cells are not completely identical and sometimes these differences have their origin in random or stochastic processes.
So, while identical twins may appear identical, and while they are as genetically close as two humans can be, they remain individuals on the cellular level. One may be more cancer-prone than the other even without differences in the environment.
So, what is it: Nature? Nurture? Both? Neither?
It seems to be a complex mix of all of the above, with our cancers as unique as we are.
Improving our diet and exercise certainly have been shown in multiple studies to reduce our risk of breast cancer. But sometimes the environmental risks that make one twin more prone to illness are no more under their control than their DNA. The way the fetuses develop in the womb, for example, might improve one twin’s health while imperiling the other’s. And sometimes, that tiny variation in DNA between twins makes all the difference in susceptibility to cancer.
Epigenetics, while not answering the question of what causes cancer, is absolutely getting us closer.
SOURCE: Twins and Cancer: Nature, Nurture, or Something Else? | Psychology Today
How One triplet gets cancer and the other two don’t!
• For another perspective on Epigenetics: Can Human DNA Help Guide Reforestation?
The difference in cancer risk among triplets can be influenced by a mix of genetic, environmental, and lifestyle factors. Here’s a breakdown:
- Genetic Variations: Even identical triplets, who share nearly identical DNA, can have slight genetic differences due to mutations that occur after the initial cell division. Fraternal triplets, on the other hand, have different genetic makeups, which can lead to varying susceptibilities to cancer.
- Epigenetics: This refers to changes in gene expression that don’t involve alterations to the DNA sequence itself. Environmental factors, such as diet, stress, or exposure to toxins, can influence epigenetic changes, potentially affecting cancer risk differently among triplets.
- Environmental Exposures: If one triplet is exposed to a carcinogen (like tobacco smoke, radiation, or certain chemicals) more than the others, their risk of developing cancer could increase.
- Random Chance: Sometimes, cancer can occur due to random mutations during cell division, which aren’t influenced by genetics or environment.
- Shared vs. Individual Factors: While triplets may share many environmental and lifestyle factors, individual differences—like immune system responses or personal habits—can play a role.
It’s a fascinating and complex interplay of factors. If you’d like, I can dive deeper into any of these aspects!
The occurrence of cancer in one triplet while the others remain unaffected can be attributed to a mix of genetic, environmental, and random factors. Here’s a breakdown:
- Genetic Variability: Even identical triplets can have slight genetic differences due to mutations that occur after the initial cell division. For fraternal triplets, the genetic differences are more pronounced, which can influence cancer susceptibility.
- Epigenetics: Environmental factors or random events can lead to changes in gene expression without altering the DNA sequence. These epigenetic changes can increase or decrease cancer risk and may differ among triplets.
- Environmental Exposures: Lifestyle choices, diet, exposure to carcinogens, or even infections can vary among individuals, even within the same family, leading to different cancer risks.
- Random Mutations: Sometimes, cancer arises from random mutations during cell division, which are not inherited or caused by external factors. This randomness can explain why one triplet might develop cancer while the others do not.
- Immune System Differences: Variations in immune system function, even among siblings, can influence the body’s ability to detect and destroy cancer cells.
It’s a complex interplay of these factors, and often, no single cause can be pinpointed.
If you’re curious about a specific case or type of cancer, I can help dig deeper!
Jackson’s Troop – Our Journey Through Childhood Leukemia
August 27, 2017 · Jackson on Vimeo
We reference time now by date of diagnosis (August 18, 2017), when Jackson got sick and after Jackson Stout was sick. That date forever changed our perspective and view on life. It’s short, but worth it when you’re surrounded by the ones you love.
On Friday, August 18th, Jackson was diagnosed with Precursor B Cell Acute Lymphoblastic Leukemia or what is often referred to as ALL. It started earlier that day with a visit to the Pediatrician, Dr. Megremis, due to his recurrent low grade fevers and leg pain. After the doctor’s visit, we were sent for blood tests at Peyton Manning Children’s hospital and an x-ray for his leg pain.
The x-ray showed nothing out of the ordinary, but we were going to hear the results of the blood test later that evening. In the meantime, Jax was still fighting a fever. We were planning on attending a pool party that evening with our church family in Indianapolis; Jax insisted that we all go – so we went. It was during that party that we received the devastating news.
The voice on the other line said that she was the On-Call Pediatrician.
She was unable to contact Dr. Megremis, but she needed to share the information before it was too late in the evening. She continued to share that Jackson’s blood test results were abnormal and we needed to get him to the ER immediately. From there came a long pause and all I could hear was sobbing.
The words she said next will change our family forever, “Jackson has Leukemia”.
My heart sank. Levy looked at me and immediately ran over. I told him the news. The doctor kept saying, “I’m sorry” through her tears. At that moment a whirlwind of commotion happened. Levy pulled Jax out of the pool and gathered the girls. I ran straight to our friend, Paula, and began bawling in her arms. Friends were helping us get the kids out of their bathing suits and into their clothes and gathering towels and all our belongings.
We paused and a group gathered and laid hands on Jackson. We prayed. A rush of calmness came over us. I remember thinking to myself, “We can do this”. In a moment’s decision, it was suggested we leave the girls with friends so that we can tend to Jackson. The girls were scared and so was Jax. They gave their brother a hug goodbye and we headed straight for the hospital. We called our family (near and far) on the way and they were able to meet us there, including our Pediatrician. I can say that Jackson’s condition only got worse that night.
Over the next 6 hours and into the early hours on Saturday morning, Jackson was poked for blood draws, which were often unsuccessful, and an IV was started, again after many unsuccessful attempts. We hated watching him go through this. Each of the many blood draw attempts had everyone in the room in tears, especially when Jackson was asking why we were doing this to him. The weekend was tough. He was in so much pain.
We could not even hold or comfort him or even hold his hand. The pain in his bones was becoming more unbearable. We had so many visitors that first weekend which I know helped our spirits. Each morning, he’d ask if people were going to come see him that day. Thanks to our “village”, they kept us sane and gave us a shoulder to cry on. They took care of the girls and kept us well fed. They supported us and jumped to action, even when we had a crazy request for personalized hospital gowns.
Monday morning came and we received an answered prayer. His procedure was scheduled to get his bone marrow biopsy, lumbar puncture to test his spinal fluid for Leukemia, and a PICC line to replace his IV. It was all a success. Later that evening, we started to see a glimpse of our sweet Jackson again. Tuesday was a great day. We played in the playroom and Jackson dominated in air hockey. It was also our official start to chemo! Each of these past days has brought on their own challenges. We are slowly learning our new “norm”. We want to be prepared for our return home soon. Leukemia
Jackson’s Troop – Our Journey Through Childhood Leukemia
Last night was tough. We got to the ER and immediately started with accessing his port (without numbing cream
) and a peripheral blood draw from his hand, which was unsuccessful thanks to inheriting his Dad’s veins. He did great and was brave through it all! He received more platelets and a blood transfusion overnight. His blood pressure fell and his mouth sores have gotten significantly worse, likely all through his GI tract.
We have a prescription mouthwash to help numb and coat his mouth allowing him to hopefully eat something. He hasn’t eaten since Monday, so he’s receiving fluids and morphine to help with the pain. We will be here until we can eat and drink on our own… likely through the weekend. Prayers appreciated for our little trooper #jacksonstroop #jaxstrong
Jackson’s Troop – Our Journey Through Childhood Leukemia
We are at the hospital today for IVIG Therapy. Jackson has had a runny nose for a couple weeks and just doesn’t have the antibodies to fight it off. This transfusion will give him the “good stuff” to replace what chemo has destroyed. So we are here, watching Paw Patrol and fulfilling all his requests for bacon #jaxstrong#jacksonstroop
Jackson’s Troop – Our Journey Through Childhood Leukemia
“A person standing alone can be attacked and defeated, but two can stand back-to-back and conquer. Three are even better, for a triple-braided cord is not easily broken.” Ecclesiastes 4:12
.The girls were able to join Jackson for his chemo treatment on Christmas Eve – Lumbar Puncture with anesthesia. They stood by him in the “nap room” as he was being put under and were by his side when he woke. He even asked for them as soon as he woke up, laughing and smiling! These three truly have an unbreakable bond. #jacksonstroop#jaxstrong#wombmatesforlife
Jackson’s Troop – Our Journey Through Childhood Leukemia
Another Chemo Day! All went smooth except that Jackson’s ANC came back that he’s neutropenic (basically his immune system is very low). So we are doing the best to stay germ free and out of the hospital! His sisters were by his side today and clearly Jax loves them dearly 
#jaxstrong#jacksonstroop
Jackson’s Troop – Our Journey Through Childhood Leukemia
Today was pretty rough. Jackson woke with a fever, nausea and vomiting accompanied with aches and pains. He is being treated for a virus and tested for the flu. While at the clinic he received his regularly scheduled chemo, lots of fluids and antibiotics. He is also on Tamiflu until we receive the results of the cultures. After many hours at Peyton Manning’s we were home and he was able to eat something and play with Legos! His sisters were there the whole time and did a great job taking care of him. Prayers are appreciated that he doesn’t regress and we stay out of the ER tonight! #jaxstrong#jacksonstroop
Jackson’s Troop – Our Journey Through Childhood Leukemia
At the hospital with Jackson. He woke up screaming in pain with what we think is a very swollen lymph node. It’s causing major swelling in his neck. He had a negative strep test earlier today, so hoping to get his pain under control and figure out what’s causing the swelling. While we are here, we’ve got a whole library of movies to keep us happy and in good spirits!
Jackson’s Troop – Our Journey Through Childhood Leukemia
The CT scan showed inflammation of his salivary gland that goes down the left side and in front of his neck. We have a whole team (hospitalists, Oncology, ENT and Infectious Diseases) working on a game plan for Jax – we know he’s in great hands! We will be here for a couple of days as he’s also severely neutropenic. He’ll also receive IVIG therapy to help get his counts back up! We appreciate your thoughts, prayers and messages. Jackson even got a special video message from his classmates!
Jackson’s Troop – Our Journey Through Childhood Leukemia
The very last part of our Leukemia journey! Jackson is having his port removed. It’s been a long road, but Jackson has officially BEAT CANCER
Prayers work and God is good!
For A Detailed Timeline of Jackson Stout’s Cancer Journey: https://www.facebook.com/JacksonsTroop/
Thank you to all who have been apart of this journey and loving us along the way
RELATED STORY: Doctors Find A Tumor In A Triplet’s Eye. Days Later, They Uncover The Truth About His 2 Brothers
Twins Study Offers Clues to Genetic Risk of Cancer | Live Science
Twin study estimates familial risks of 23 different cancers | ScienceDaily