One of the signs of anarchy in a region could be the marching of an army to get a particular situation under control and, if it is indispensible, destroy or suppress anarchists. Similarly, the first response of the body to such uncontrolled growth is the destruction of tumor cells by activating inner mechanisms that lead to cellular suicide (apoptosis). Anarchy is by definition not to accept any border and authority, causing disorder or upheaval. According to twentieth century thinker Nursi, anarchy cuts and throws away norms and laws that organize social life, one by one, thus destroying the order and leading to mischief and rebellion. In addition, anarchism does not consider the rights of any. Analogously, one by one, cancer breaks genetic rules that organizes cell proliferation and eliminates pathways that suppress tumor formation. Thus, it eradicates the order and triggers chaos and malignancy. Again, cancer works against the life of the body without considering the rights of other cells.

Another characteristic of anarchism could be the elimination of its leaders. Thus, once you get rid of the key players, anarchy may not resurface. Likewise, you can use a strategy in certain cancer types where you can specifically target cancer stem cells. As a result, cancer growth could be suspended and it may bring an opportunity to shrink tumor through chemotherapeutical approaches. One such example is the targeting of CD24, a putative cancer stem cell antigen expressed by a minority of adenocarcinoma cells. This cell-based cancer immunotherapy method uses genetically engineered cancer killing T cells, which are directed towards cancerous tissues using chimeric antigen receptors. This is similar to the taking over of trained Special Forces when anarchy becomes malicious and unceasing. Both natural and genetically engineered cancer killer T cells in our body resemble trained Special Forces that patients need to fight against cancer.

Cancer treatments

Cancer is nowadays mainly treated with chemotherapy, radiotherapy and surgery, and to some extent with immunotherapy. The many purposes of chemotherapy include relieving or preventing the suffering of the patient, prolonging the life span, and if possible, completely curing the cancer along with surgery or radiotherapy regimens. Chemotherapy mainly uses cytotoxic drugs that kill cells by attacking one of the main properties of cancer cells—rapid division. Unfortunately, since cancer cells are not the only rapidly dividing cells in the body, chemotherapeutic agents also harm healthy cells. Another fall back of chemotherapy drugs is the lack of specificity that does not provide a therapy against a specific cancer type and their efficacy vary from patient to patient. In these cases, the indispensable path is synergistic use of radiotherapy with chemotherapy.

As its name implies, radiotherapy involves the use of ionizing radiation to kill cancer. It relies on the destruction of dividing cells by introducing DNA damage, which leads to induction of cellular death through apoptosis. Radiotherapy is therapeutically useful in cancers that are localized to one part of the body. It is also useful to prevent tumor relapse after surgical removal such as in breast cancer. However, radiation, which radiotherapy depends on, is itself the potential cause of cancer and leads to various side effects.

Citizens of the body need justice

Chemotherapy or radiotherapy, which harms both healthy and cancerous cells, recalls the practice of absolute justice versus relative justice. Absolute justice requires protection of every individual while punishing the criminals. On the other hand, relative justice is the justice where the rights of one person are ignored for the betterment of the whole. Absolute justice is always the best practice if it can be properly established. However, relative justice may be sought if absolute justice is absolutely out of reach. Current chemotherapy and radiotherapy treatments are like the practice of relative justice, which harms both cancerous and healthy cells. Of course, these treatments are considered as the last resort for many cancer patients but this analogy regarding absolute justice toward cells in the body urges us to seek for cancer therapies that follow absolute justice. In other worlds, we need to practice an approach that is more specific toward cancer cells. This could be, as we mentioned above, the use of cancer immunotherapy where cytotoxic T cells are directed towards cancer cells through genetic engineering by introducing chimeric antigen receptors (CARs). CARs should be able to recognize unique or relatively specific antigens located on the surface of cancer cells to execute them.

Cancer killing T-cells: Equipped with chimeric antigen receptors

There are three main approaches in cancer immunotherapy including immunization, use of antibodies and cellular immunotherapy. Immunization by administering a cancer vaccine prepares the patient’s own immune cells to recognize tumor cells as targets to be destroyed. The use of therapeutic antibodies specific to cancer cells recruits immune cells in the patient to abolish tumors. Cellular immunotherapy, on the other hand, uses patients’ own immune cells like the natural killer cells, cytotoxic T cells and so on. Basically, those cells could be stimulated in patients with the administration of interleukins or they could be isolated from the patients’ blood and cultured in the laboratory and following expansion and in vitro training, then transfused back to the patient to fight against cancer.

Cytotoxic T cells are unique immune cells that recognize target cells via T cell receptors. Over the past decade, scientist engineered T cell receptors and developed chimeric antigen receptors that specifically recognize target antigens. This recognition lead to signaling pathways that resulted in apoptosis of tumor cell through the production of granzymes, perforins and cytokines such as IFN-γ, and TNF-α (Figure 1). There are a number of success stories using CAR+ T cells for cancer immunotherapy used in patients. Encouraging results were obtained with CARs targeting lymphoma (by targeting CD19 antigen), coleractal Cancer (by targeting CEA antigen), and melanoma (by targeting melanocyte-specific markers MART1, MELOE-1 and gp100).

Universal chimeric antigen receptors

Two recent studies published by two different groups increased the hopes in the battle with cancer. They developed novel and universal CAR technologies that combines cell based immunotherapy and use of therapeutic monoclonal antibodies. This new approach relies on the recognition of specific molecules such as FITC and Biotin by corresponding Anti-FITC and Anti-Biotin (Avidin) CARs. The decent thing about these specific molecules is that you can attach them to any antibody, ligand, or aptamer known to target specific tumor antigens (Figure 2). One of the universal chimeric antigen receptor, for instance, uses FITC, a fluorescent molecule widely used in flow cytometric assays. Since it is easy to label antibodies, this provides wide range of antibodies to target cancer cells. In addition, scientists using this approach could target more than one tumor antigen or could use another antibody that targets different antigen even if cancer relapses. Moreover, since antibodies used to activate CAR+ T cells will degrade and their bioavailability will decrease in the body by time, there will be no need to kill injected T cells with suicide mechanisms. Once FITC labeled antibodies are stopped from being given to patients, CAR+ T cells will stop attacking cells and cease-fire since their guns (CARs) cannot recognize tumors or anything nonspecific. This approach is highly encouraging and has brought with it great hopes in the treatment of cancer.

Anarchy, spirituality, and prayer therapy

Hunger, poverty, social inequality and economical issues could be asserted as the basis of anarchy within a society. However, according to Nursi, the real basis of anarchy is spiritual weakness and poverty. Similarly, the basis for cancer could possibly be the lack of appropriate spiritual diet that may eventually make a person fall spiritually and physically weak. For example, fasting is a physical and spiritual fast prescribed in monotheistic religions which increases spirituality and has been shown to be synergistically effective in chemotherapy with cancer treatments. It has been observed and scientifically recorded that patients with strong beliefs and continuous prayers and spiritual support overcome diseases much faster than those without. This raises certain questions regarding our spiritual makeup and many other dynamics involved in being sick and getting well. So, are we getting ill because some evil spirits are manipulating our biological condition by settling in the tumors and propagating cellular anarchy? Is radiation, which leads to cellular mutations, a result of spirits that are created of “scorching fire” (The Qur’an 15:27)? Is cancer a result of such manipulations and should we seek cure for it not only through biological medicine but also through spiritual healing?

Various scientifically proven causes are known to increase the likelihood of cancer, which includes, but is not limited to, smoking, viral infections, radiation, and pollutants that lead to internal genetic faults within cells. Considering the fact that there are many cases in which patients have been reported to have recovered from their illnesses by reciting prayers, then such cases are worth examining to find out whether and to what degree non-material factors are involved as causes for our illnesses. Studying these cases may offer science new opportunities to be able to remove the present obstructions and make greater advances in the medical field by perhaps developing cancer therapies that combine prayer therapy and cancer immunotherapy using genetically engineered T cells during the treatment of patients.

Ali Fethi Toprak is a PhD candidate at University of Texas Southwestern Medical Center.

References

Döğen, Şaban. 2005. “Bediüzzaman and Anarchy.” Köprü Dergisi, No 89.

Nursi, Bediüzzaman Said. Işarâtü’l-I’caz. Şahdamar Yayınları.

Chmielewski et al. 2012. “CAR’s made it to the pancreas.” OncoImmunology 1:8, 1387–1389.

Tamada et al. 2012. “Redirecting Gene-Modified T Cells toward Various Cancer Types Using Tagged Antibodies.” Clin Cancer Res.

Urbanska et al. 2012. “A universal strategy for adoptive immunotherapy of cancer through use of a novel T cell antigen receptor.” Cancer Res.

Gülen. M. Fethullah. “Cinler, Hastalıklara Sebep Olabilir mi?” Retrieved from http://tr.fgulen.com/content/view/708/3/ on 12/24/12.

Bukhari, i’tikâf 8, 11, 12; Muslim, Salam, 24; Ibn Maja, Siyam 65; Abu Dawud, Sawm 79; Adab 81; Muslim and related hadith narrated by Abu Hurayrah, Bukhari 7.582.

¹ See Yücel, Salih. 2010. Prayer and Healing in Islam, NJ: Tughra Books.

In this treatment, radioactive iodine atoms are administered to the patient. These are absorbed only by cells of the thyroid gland which are then eliminated by the radiation; as a result of this process, the over-activity of the thyroid gland is prevented. By the divine will of God, the All-Healing, the All-Wise, iodine is absorbed only by thyroid cells but not by any other cell-a truly wonderful phenomenon. This treatment is known as the “bloodless thyroid operation.”

After he began this treatment, my brother-in-law visited us one day. As soon as she saw him, my small daughter, who loves her uncle very much, ran to him and sat on his lap where she fell asleep after a very short while. But then she woke up within half an hour and suddenly started vomiting. We later understood that the unseen radiation being emitted from the radioactive substance in her uncle’s body first caused my daughter to fall asleep quickly as if she was anesthetized and later had negative effects on her.

Then, an article in a scientific magazine attracted my attention. The concepts of atomic (or nuclear) energy and radiation are usually perceived negatively because of the atomic bombs which were dropped on Nagasaki and Hiroshima or the accident which occurred at the nuclear reactor in Chernobyl. This negative perception has been caused by the sudden deaths of living species, great destruction and the permanent devastating effects observed in the environment after these events. However, the energy within the atomic nucleus also has many potential advantages for humankind. It is just as possible, with this energy, to illuminate houses and work places everywhere as it is to exterminate all the living beings in a city.

Negative effects of radiation

Radiation energy may directly affect molecules within a cell by causing structural disorders especially in its DNA. It also causes ionization of water molecules within a cell and releases free radicals which are harmful to the cell. Damage to molecules and genetic material within a cell may consequently trigger a process that can cause the death of that cell. Thus, it is strongly advised for pregnant women especially to stay away from sources of radiation and also not to expose the body to frequent radiation even for diagnostic purposes, such as X-rays.

Positive effects of radiation

As we consider its beneficial aspects, we realize that nuclear radiation is just one of the innumerable blessings of God. In the field of medicine, for instance, radiation is used to cure diseases like cancer, a disease which, ironically, it sometimes causes. Blood products and medical equipment may be effectively sterilized by the use of radiation. It is also useful in radiological visualization techniques.

Atomic nuclei with unstable composition (radionuclides), which disintegrate without any external interference, display features of radioactivity. The diffusion of energy-bearing rays α, β, γ as a result of this disintegration is called radioactivity and the energy-bearing rays are called radiation. The radioactive substances which are used for the diagnosis and cure of illnesses are known as radioactive medicines or radiopharmaceuticals. This kind of medicine may be composed of pure radioactive nuclei, or they may be compounds which are radioactivated by synthesizing them with radioactive nuclei.

Compared with other radioactive substances, the radiopharmaceuticals used in radiotherapy must have some specific features in terms of radiation type and energy level. Radiopharmaceuticals should be fully absorbed by diseased organ or tissue to be cured and should be applied in such a way that it disseminates the least possible radiation to the rest of the body (so as not to contaminate the body with radiation). That is, the half-life of the radioactive substance should be such that it maintains the correct level of radiation in the tissues to effect the required cure. God has created radioactive substances which emit pure β-rays so that they are ideal for curative purposes.

Radiotherapy

Radioactive nuclear therapy is a treatment for diseased human tissue, usually by the intravenous injection of a suitably formulated radioactive composition. In this treatment, the radioactive composition, when diffused within the body, is held more intensely within the diseased organs, and a kind of radiotherapy at cellular level is thus achieved. The most outstanding example of this kind of therapy is radioactive iodine treatment. This therapy is most frequently applied in cases of excess activity of the thyroid gland in patients with thyroid cancer. As iodine is mostly consumed by the thyroid gland in our body, radioactive iodine (I-131 which is the radioisotope of the element iodine) is particularly suitable for this treatment. The thyroid gland’s feature of absorbing and retaining more iodine than other organs, makes it feasible to treat this organ exclusively by this method when it is diseased. Other peptides marked with particular radioactive nuclei are used in the treatment of other types of cancer and success is observed in some cases. Nuclear therapy is also used in treatment of bone cancers and of pain caused by certain joint diseases.

Radiopharmaceuticals in palliative treatment of bone pain from metastases

The spread of cancerous cells from the diseased organ of the body to other organs is called metastasis. Damage and pain originating from osseous (bone) metastases may cause losses in activity and function for the patient. Radiotherapy has long been used particularly in the treatment of limited bone lesions. However, the side effects of radiotherapy are greater since the body areas exposed to X-rays must be increased where there are widespread osseous metastases.

Radiopharmaceutical therapy is useful for patients who have painful metastases throughout multiple osseous zones. In this therapy the patient receives an intravenous injection of suitably formulated radiopharmaceuticals. In this therapy a radioactive substance is used which rapidly leaves the blood circulation system and concentrates within the skeletal system and especially within metastized zones. Radioactive phosphorus has been used for more than thirty years for this purpose.

Radiopharmaceuticals in therapy for joint disease

Rheumatoid arthritis, also known as inflammatory joint rheumatism, is one of the most widely seen (approximately 1–2 %) of connective tissue diseases.

In this disease, medication in some cases can become ineffective in the long run and can even be the cause of serious side effects. Radionuclide synovectomy (or radiosynovectomy), which is used in some advanced cases of this disease, yields results close to those obtainable by surgical intervention. It has the additional advantages of being less costly, not necessitating the patient’s hospitalization following the therapy and being repeatable.

It can be seen that the use of this blessing for either favorable (good) or unfavorable (bad) purposes depends on human choice, as is the case for all other divine blessings. Thus, it should be our top priority to use for humanitarian causes the blessing of radiation, which has been bestowed on us for our benefit, but which can seem as if it is harmful at first sight.

Notes

1. Al-Bukhari, “Tawhid,” 55; Muslim, “Tawba,” 14-16, Ibn Maja, “Zuhd,” 35.
2. Muhammad ibn Ahmad ibn ‘Uthman al-Dhahabi, Siyar ‘Alam al-Nubala’, 25 vols. (Beirut, 1992), 1:150.
3. Al-Qushayri, Al-Risala, 133.
4. In other words, one should regard Him as an All-Merciful and All-Forgiving Lord, rather than as an All-Punishing One.
5. Al-Bukhari, “Tawhid”, 15; Muslim, “Tawba,” 1; Al-Tirmidhi, “Dawa’at,” 132.
6. Al-Qushayri, Al-Risala, 134.