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

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