Cervical Cancer Cases
Understanding the Tumor Doubling Defense (continued)

Whether one assumes that a cancer cell is 10 µm or 25 µm in diameter, it is easy to see that even at 14 doublings (a more generous number suggested by Spratt), breast cancer would be invisible to mammography. If Spratt's analysis were correct, by the time a cancer diagnosis can be made, effective treatment can no longer be provided. However, no one, including Spratt, has proven in general or in any specific case that the metastasis that kills the patient occurred before 14 doublings or that even if metastasis had occurred, that early treatment would not have been helpful. Cancers, if untreated, eventually kill, either because they interfere with organ function or because cancer tissue competes with normal tissues for nutrients. Eventually, because cancer cells proliferate indefinitely, their number daily multiplying, cancer cells will demand a critical portion of nutrients available to the body as a whole. This critical amount is known as lethal tumor burden. The lethal burden in most patients is reached at 1012 to 1013 cells, a tumor volume containing between 1,000 and 10,000 times the number of cells present after 32 doublings. Often the argument is made that, at 32 doublings (a time when a tumor may weigh as little as 1 gram and is pea-sized), the tumor is nearing its biological end. Plaintiffs' lawyers should remember, however, that during the short remaining life of that same tumor, it would undergo a 1,000 to 10,000-fold enlargement. It takes two-thirds of its life to reach 1/1000th to 1/10,000th of its lethal volume.

Put more simply, a tumor takes two-thirds of its life to go from something much smaller than a grain of sand to something slightly larger than a pea. Yet, the jury is urged to believe that the metastatic potential of this pea must be great because it contains 1,000,000,000 cells. This deception is facilitated by showing that the further growth of the tumor to its lethal volume occurs in a short period of time. Figure one is an example of an illustration seen at trial. The size of the tumor and number of cells required to reach its lethal burden is not depicted. In fact, a mass representative of lethal tumor volume should be just under 5 inches in diameter and contain 1012 cells. The pea-sized mass is in fact a trivial part of the ultimate growth of the tumor to its lethal potential containing 1000 times as many cells. A juror, given the opportunity, is not likely to believe a grain of sand has the malignant potential of a golf ball-sized mass containing 10,000 times as many cells. Proponents of the tumor-doubling defense succeed if they can avoid such common sense comparisons.

The assertion that fatal metastasis has always occurred before the tumor can be detected is sheer speculation and is readily disproven by the remarkable cure rates for diseases such as cervical cancer, which remains eminently curable even after invasive cancer has developed.

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