Med Hypotheses. 2013 Jun;80(6):698-700. doi: 10.1016/j.mehy.2013.02.011.

Nature’s necrosis factor when associated with erythrocytes may not only explain the surprises in lung cancer metastases but also suggest target therapy.

Onuigbo WI.

Pathology Department, Medical Foundation and Clinic, P.O. Box 1792, Enugu 400001, Nigeria.



Lung cancer is so strategically situated as regards the heart and aorta that it ought to scatter its metastasizing cells far and wide. However, at careful autopsy, instead of giant opportunities, only dwarf deposition may be detected. Indeed, up to seven patterns of its metastases demonstrate surprises. What explains these surprises? Consider the thoracic duct. When this 45 cm long duct was obtained in its entirety, coiled in the Swiss-roll manner, processed in the usual way, and examined on a single microscope slide, necrosis of some transported lung cancer cells was found to be very intimately associated with the erythrocytes. Therefore, let this underlying natural mechanism be named as the “erythrocyte associated necrosis factor”, i.e., EANF. It is argued that this Factor operates differently from the suspected roles of both anoikis and stem cells. Accordingly, it is hypothesized that, if intravital video microscopy is used to obtain subsets of both necrotic and lively cancer cells from the thoracic duct of consenting lung cancer patients, the underlying EANF will definitely materialize. It is predicted that the manipulative replication of this Factor in leading centers will ensure progress. In sum, EANF would not only aid in our understanding of the outlined highly inefficient metastatic processes but also effect a breakthrough in the realms of target therapy. Copyright © 2013 Elsevier Ltd.

PMID: 23528334



The killer lung cancer is unique in the human body. This is because it is best situated next to the heart. Therefore, it is optimally situated to scatter its colonizing cells far and wide. However, this expectation scarcely occurs. Indeed, there are up to seven anomalous patterns of colonization. Now, there is an axiom that a single anomaly can lead to scientific discovery. Therefore, these seven patterns together constitute a strong case indeed for seriously seeking an explanation. Fortunately, the microenvironment of the thoracic duct provides a strong clue. Thus, (i) obtaining the full 45 cm length of this duct, (ii) coiling it in Swiss-roll fashion and (iii) studying the processed material as single microscope slides yield together the evidence that these cells traverse the upward route from the cisterna chyli. Certainly, lung cancer cells as it were made themselves available for research even at the moment of death. In particular, the most important observation was that these cells tended to die in transit when they were distinctly commingled with red cells. This natural unique necrosis pattern speaks much for what keeps happening to millions of lung cancer cells daily during life, i.e., their deaths explain why there are anomalous colonization patterns. Accordingly, there is need for planned surgical cannulation of consenting patients with the aid of the recent technique of intravital videomicroscopy. This combination should facilitate the retrieval of the all important subsets of necrotic and lively cancer cells which are readily obtainable during their transit. Thereafter, scientific manipulation of this choice entity must reveal the hitherto hidden Factor responsible for this specific natural phenomenon. I am persuaded that the phenomenon itself is not a fluke but a fact. Accordingly, it is hypothesized that, on resorting to this seemingly simple gift of Nature, which is probably better than the usual laboratory options, it will lead to a breakthrough in the long quest for target therapy in lung cancer cases and, perhaps, other cancers. In this context, well did a modern thinker stress that “Ideas must be sought after and cultivated”. In this context, as he continued, “We must not be afraid to attempt the impossible; no device or technique that holds out the faintest hope of discovery can be put aside …”

lung cancer-picture 1Fig. 1 shows a specimen obtained lengthwise from the neck down to beyond the aortic bifurcation using the mono-block formalin-fixation method; this facilitated the procurement of the thoracic duct in one stretch.


lung cancer-picture 2

Fig. 2 shows the longitudinal disposition within the thoracic duct of two massed necrotic cancer cells; their retrieval and manipulation in leading laboratories will eventuate in target therapy.

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