Day 022 - 12 Sep 94 - Page 42
1 in the hereditary makeup of the family. It does not mean
2 that cancer itself is inherited. What may possibly be
3 inherited is a higher risk of a particular cancer." It
4 says about watching your diet. That is a fair statement,
5 is it?
6 A. Yes. Is that not just what I have been saying though?
7
8 Q. Yes. So the point that I would extract from that is that
9 this seems to say that it is not really known that -- just
10 say within family cancer incidence, there may be other
11 factors apart from genetics?
12 A. Oh, yes.
13
14 Q. Or genetics alone, yes. For example, in a family, is it
15 not true or within certain families, even extended
16 families, there may be similar dietary habits, for
17 example?
18 A. Yes, but the very examples they give are the ones that
19 I have quoted which is breast cancer and large bowel
20 cancer, where you do see the strongest association in
21 families, and where we know that if there is a blood
22 relative with the disease your risk is substantially
23 increased. We have already gone on to say that other
24 factors -----
25
26 Q. Presumably, the migration studies, if they did, showed
27 that people with a prevalence for genetic or familial
28 cancer rates, if those rates changed when they moved to a
29 different environment, then it would show, for example, it
30 could be dietary habit ---
31 A. It may be.
32
33 Q. -- that was the key to somewhere in that process it was
34 diet was playing its part?
35 A. There are obviously other factors working, yes.
36
37 Q. If we just move on to cohort studies.
38
39 MR. JUSTICE BELL: Can I just make sure I understand? Is it
40 inherent in all disease that there must be some genetic
41 abnormality which leads to a propensity to get that kind
42 of disease?
43 A. I am not sure that one can say that for all diseases.
44 I think I could only argue about cancer.
45
46 Q. I suppose if you have a virus then or a bacteriological
47 disease but -----
48 A. What is important there though is the body's natural
49 immunity and defences, and this is something which one
50 acquires in life. I mean, I think when one is getting
51 down to actual abnormalities of the cell, I can really
52 only talk about cancer in that respect because to get a
53 viral infection or a bacterial infection is not really an
54 abnormality of the cell.
55
56 Q. I did not want to misunderstand you. If one puts viruses
57 and bacteriological infections to one side, does it follow
58 if you get a degenerative disease -- I suppose that is the
59 distinction, degenerative disease and viral and bacterial
60 infections -- that you must have had a genetic
