Thread by @AbudBakri

I have been seeing a LOT of CANCER in younger and younger patients 🦀

Some even in their early 30s 😪

And I’m not the only one noticing it 👀

Here’s what I think is causing a dramatic rise in YOUNG cancer cases 👇🧵

Disclaimer first: I’m a doctor but I’m not YOUR doctor. None of this is medical advice

I also am not a oncologist. This is just what I’ve been noticing in my young career and connections I’ve made

If I knew the absolute answer, I’d win a noble prize

There will be other… twitter.com/i/web/status/1…

I’m not the only one noticing it 👀

The rates are going up in younger people

They are calling it the Birth Cohort Effect 👶

Each successive decade has a higher risk of developing cancer

People born 1970s have higher risk than 1960s have a higher risk than 1950s and so on…

Chadwick Boseman is the example most people remember

Young, fit, successful 🐆

Colon cancer at age 39

Dead by 43

What happening? ⬇️

Immune Escape Phenomena

I view cancer primarily through the lens of immune escape

Everyday there are mistake and damage in cellular replication

These cells become prone to becoming cancerous

Our immune systems hunt them out and DESTROYS them

Something (or many things) is getting in the way of this

And as a result, more cancer evades the immune system and starts to grow

So what’s affecting the immune system? ⬇️

1. Circadian Dysfunction 🔁

Every single cell in our body is tied to a 24 hour clock

This includes the immune cells

Thanks to artificial lights at night, poor sleep schedules, not enough bright light in the day etc

If we want our immune systems at peak shape, we need to… https://t.co/ZCjuaxHdIHtwitter.com/i/web/status/1…

2. Poor Sleep 😴

Building on circadian biology, poor sleep is wrecking HAVOC on the immune system

Sleep is when the immune cells can ‘clean up’ damaged/cancer prone cells

Several studies have found link between sleep deprivation and increased cancer risk

Remember the ‘sleep hormone’ melatonin?

It is intimately involved with immune regulation

Scrolling TikTok with blue light at night?

This lowers your melatonin production

Another chance to negatively influence the immune system that's hunting cancer

(I don’t believe… https://t.co/LgBWG0hcfXtwitter.com/i/web/status/1…

3. Vitamin D ☀️

Building on sleep and circadian rhythms, low vitamin D levels are associated with increased risk of cancer

Vitamin D has a key immune role

Supplementing vitamin D does not seem to improve this

We need sunlight for:

1. Normal circadian health
2. Good sleep
3.… https://t.co/WKLklT3Opytwitter.com/i/web/status/1…

4. Obesity 🍔

We all know obesity is linked to an increase risk of cancer

Fat cells, especially visceral fat release inflammatory cytokines

This may contribute to further immune dysregulation and allow cancer to escape

Obesity is chronic inflammatory state

5. Fatty Livers (NAFLD)

The liver is a key metabolic and immune regulator

Fatty liver disease is sky rocketing allowing with obesity

This is a risk for cancer in the liver AND outside of it

NAFLD is on track to become the primary reason for liver transplants

6. Poor Nutrition 🍎

All of our cells rely on the nutrients we provide to function properly

I’d argue this is more important for immune cells as they rapidly divide

7. Microbiome 🦠

This one is more nebulous, but we are starting to notice a connection between the bacteria that live inside of us and cancer

These bacteria have a crucial immune regulatory role

Keep an eye on this developing field as new research emerges

8. Chronic High Stress 😖

We all known mental health at a population level is in the gutter

People are more stressed out than ever, especially during the pandemic

I and many residents got sick with a cold more often while stressed out on long 28 hour shifts

Your immune… https://t.co/6F6Kz4elpttwitter.com/i/web/status/1…

All the above and more are wrecking havoc on our immune function

Alone none of them can cause cancer

Combined, we are having low grade immune suppression which is allowing cancer to escape

This may also be why we are seeing more autoimmune disease by the same mechanism

But… twitter.com/i/web/status/1…

Cellular Energetics 💥

Aside from immunity, there is a relationship between mitochondrial function and cancer

When I was 17 and taking AP biology in high school, I noticed that the cellular signal for apoptosis (cell death switch) is in the mitochondria

Mitochondria release cytochrome c into the cytoplasm and this tells the cell to die

This may be a key mechanism for cells that are becoming cancer prone to off themselves

Since that day 12 years ago I’ve been mesmerized by this

Poor mitochondrial function = increased cancer risk?

Our mitochondria are all affected by the above things, whether it be the circadian rhythm or obesity.

I wouldn’t be surprised if there is a link here to cancer

For over 100 years we’ve known that cancer metabolism is different than regular cells

Noble Prize Winner Otto Warburg noticed and coined the so called “Warburg effect”

For the last 50 years cancer research has been focused on molecular biology and genetics

We need to look… https://t.co/XJqI1H3EqYtwitter.com/i/web/status/1…

Environmental Toxins? 🚬

We know that environmental toxins can lead to cancer, such as smoking for lung cancer

There are a number of toxins people are worried about, including phthalates, nnEMF, radiation, industrial waste products etc

The jury is still out on these and more… https://t.co/VwnDzfmKJltwitter.com/i/web/status/1…

Are there other environmental toxins we are missing? Probably

Are there microbiome effects? Probably

But I would argue if we had adequate immune function, our bodies could hunt out the cells damaged by whatever we are exposed to in the environment

Immunity is key here

Delayed Cancer Screening 🩻

During the pandemic, many people did not see their primary care doctors. That’s tons of missed colonoscopies, mammograms and basic screening labs

Catching cancer at stage 1 is a simple surgery or radiation treatment with success rate

Stage 4? Good… twitter.com/i/web/status/1…

Next thread? How I approach screening for cancer in myself, my family, and my patients.

Follow ➕along for that one

Should you get a full body MRI? Genetic testing? Liquid biopsy?

More to come

If you found this useful, please bookmark and SHARE the first tweet in this thread 👇

Helps a ton

And let me know what questions you have

https://twitter.com/abudbakri/status/1689329015965003777

And while you’re here check out my last thread 👇

https://twitter.com/abudbakri/status/1684585106491822080

https://twitter.com/abudbakri/status/1689331566085025793