Language and Cancer

Part 1. Syntax and Semantics

by Ian Magrath

You can make the sound of two hands clapping. Now what is the sound of one hand? Zen koan.

What cannot be heard by the ear, but by which the ear is able to hear - know That alone as Brahman and not this which people worship here. Kenopanishad.

Projection of the whole sky showing minute temperature fluctuations in the microwave background radiation as detected by the Wilkinson Microwave Anisotropy probe (WMAP) mission. Red spots are warmer, blue, colder. The satellite observatory reached its orbital position in October 2001. This map was released in February 2003. The inhomogeneity in the early universe is believed to have been the source of the cosmic structure we see today. Image: NASA/WMAP Science Team. AUM is shown in the bottom left corner.

Most cosmologists believe that the potential universe, i.e., that which existed in the first 10^-43 seconds (Planck time, the smallest possible unit of time) cannot be known, but probably consisted of pure, undifferentiated energy at an extremely high temperature. Having no mass it could have no dimensions, and being one, its symmetry was perfect. Ancient Hindu philosophers reached a similar conclusion, if articulated in different words: Brahman (all of existence) was initially unmanifest. Being unmanifest, i.e., prior to spacetime, it was both incomprehensible and totipotential. The Upanishads (philosophical explanations of the Vedas, the earliest sacred Hindu literature) recount how Brahman became manifest as a primordial vibration, Om or AUM (O, in Sanskrit is equivalent to the diphthong AU). Physicists have postulated that at the instant of manifestation (10^-43 seconds), the perfect symmetry was broken by the separation of gravity from the exceedingly hot universe. Further breaks in symmetry occurred as the universe rapidly expanded - perhaps, for a fleeting instant (known as inflation), faster than the speed of light. Such expansion was necessarily accompanied, according to the laws of physics, by rapid simultaneous cooling. Within a mere 10^-12 seconds (a thousand billionth of a second) the temperature had dropped to 10¹⁵ Kelvin (K), allowing the emergence of the trinity of the three fundamental forces that, in the presence of the attractive gravitational force, led to the creation of matter. First, the strong nuclear force and the electroweak forces emerged, then the electroweak force separated into electromagnetism and the weak nuclear force. AUM is also a trinity. The Sanskrit letters Au, Uu and Mm represent the three elements of Brahman: Brahma, the creator, Vishnu, the preserver and Shiva the destroyer. The insights of the Hindu rishis (seers) who composed the ancient literature bear a remarkable resemblance to the law of conservation of energy and matter - everything that exists (implying preservation for a finite time-span) was created by the destruction (transformation) of something else.

The three elements of AUM are also known as Satchitananda: pure being (Sat), pure consciousness (chit) and pure bliss (ananda). Being is that which is; bliss is not unlike the physicist’s symmetry, but consciousness remains unexplained by modern science. However, quantum mechanical theory predicts that the quantum states of elementary particles or photons created simultaneously remain forever linked (entangled) such that the measurement of the quantum state of one will instantaneously determine the corresponding quantum state of the other no matter how separated the particles may be in spacetime. This has been confirmed in numerous experiments. Since all particles were entangled at the beginning of time, quantum mechanics is a non-local theory - i.e., it invokes a universal awareness, albeit, in everyday life the interactions of countless elementary particles mask their original coherence. In yet another remarkable parallel to modern science, the Uppanishads describe individual souls, or Javatman, as being fragments of the one great soul, or Paramatman.

The symbol for Om contains three curves (see picture), representing the three states of human consciousness: wakeful awareness of the universe, dreaming, or observing the universe from within, and deep sleep, in which the universe is fully absorbed into the mind, thereby eliminating all desire and creating a state of bliss. A semicircle, representing maya, the illusion that lies between us and perfect understanding, separates the three curves of human consciousness from a dot, representing absolute consciousness. Absolute consciousness is seen to illuminate the other conscious states, but to achieve enlightenment (moksha), the Hindu adept must penetrate the veil of maya. In the world of modern science, physicists continue to pursue Einstein’s goal of a unified theory able to definitively link gravity - a force which, his theory of general relativity states, derives from the large-scale structure of spacetime - to the remaining three quantum mechanical forces, which operate at the smallest possible scale (at which gravity has no impact). A unified theory - the physicist’s Om - remains elusive, at least in mathematical terms, but the critical role of gravity (the only fundamental force which acts on all energy and matter) in the creation of the stars, the elements and, ultimately, life and human consciousness, provides a context in which the other three forces become meaningful. Om, then, might be seen as a qualitative representation of the concepts that physicists attempt to express in numerical terms in striving to lift the veil of maya separating them from a unified theory. Perhaps too, such a theory would also explain the phenomenon of entanglement, which is, after all, a form of universal consciousness. Such comparisons of science and eastern religious philosophy might seem spurious or contrived, but however different in outer guise, these two pathways are directed towards the same goal - that of reaching an understanding of the most fundamental question of all - the nature of being.

A Mantra Manifest

In 1900, Max Planck, in the course of his fundamental work on thermodynamics, developed an equation that fit well with experimental observation of the electromagnetic energy spectra emitted by black bodies at constant temperature (black bodies absorb all incident radiation and emit radiation in proportion to their temperature). Planck demonstrated that the total emitted energy, when divided into equal portions, or quantized, in accordance with a constant, h, is proportional to the frequency of the radiation. The concept of quanta of energy was subsequently transformed by Einstein and others into the branch of physics now known as quantum mechanics. Almost 50 years after Planck formulated his equation, George Gamow (in 1948) predicted that if the universe had originated from a superhot point (a singularity) some 14 to 15 billion years ago, it ought to contain background radiation of the type emitted by a perfect black body. In 1963, while using an ultra-low background (cryogenic) radioantenna to probe the Milky Way at microwave frequency, Arno Penzias and Robert Woodrow Wilson unexpectedly detected low- level radiation that was the same in all directions. Initially interpreted as a technical malfunction, the “static” was subsequently identified as the cosmic microwave background (CMB) whose presence had been predicted by Gamow. Its energy spectrum was shown to fit precisely (the most exact fit ever observed) with the radiation spectrum of a black body predicted by Planck’s formula at the observed temperature of 2.73K. The CMB is believed to have originated from the universe as it was some 300-400,000 years after its origin, by which time its temperature had cooled sufficiently (to 3000K) for electrons to associate with protons, forming hydrogen (and small amounts of lithium, deuterium and helium) and, in the process, drastically reducing the scatter of electromagnetic radiation. In effect, the universe became transparent in the process of creating the seed material from which galaxies of stars would subsequently form under the influence of gravity. The all-pervading vibration of the CMB is seen to be a mantra manifest; Om, continuously chanted by the Universe itself, pointing towards its origins eons before. In the words of the Mundakopanishad, pointing the arrow of human consciousness, through meditation, to “that which is brilliant, smaller than small, that on which all worlds are founded and their inhabitants.” To chant the word, or perhaps to experience the deep hum of the CMB vibrations converted into sound or light, is to be at one with the Universe. AUM, when uttered, begins at the throat, moves to the middle of the mouth, and ends at the lips. Hence, it is also considered to be the basis of all words, and of the sacred Sanskrit language in which the ritual hymns and prayers that comprise the Vedas were composed. All languages can, similarly, be traced back to the events that took place in the primordial universe some 14 or 15 billion years ago, to which the CMB bears witness.

The Dance of Language

Human language in its broadest sense is a remarkable system of symbols, including gestures, sounds, and marks, made on almost any surface that are able to convey information, i.e., to represent a broad range of concepts and thoughts. Such concepts include everything we perceive around us, directly or indirectly, and the changes, or movements, that such “things” continuously undergo. Movement and change are fundamental aspects of language, which represents the dynamic world we live in and which itself is constantly changing. Change, the essence of being, was powerfully symbolized by Hindu philosophers in Shiva Nataraja, an image, usually in stone or bronze, that depicts Shiva performing the cosmic dance of destruction and creation. Shiva Nataraja conveys the same meaning as that of the sacred syllable, AUM, and thus also represents the essence of language, which is movement. Speech begins with the movements of molecules within neurons - the material basis of the thoughts that language conveys. The resultant electrical impulses are transmitted via chemical “neurotransmitters” across synaptic junctions to the motor end plates, where they are converted into the complex dance of the numerous muscles needed to produce speech. The respiratory and laryngeal muscles cause the vocal cords to vibrate, producing a corresponding vibration in the column of air passing over them. The vibrating column of air is shaped by coordinated movements of the muscles of the pharynx, soft palate, mouth, tongue and lips. Consonants are created by constriction or closure of the vibrating air column somewhere in the vocal tract, resulting in an audible turbulence that begins and sometimes ends syllables, the central part of which is comprised of vowel sounds. The resultant sound units (phonemes) are combined and recombined to create syllables, words and sentences in a specific language. Only a small fraction of the sounds that can be made, and an even smaller fraction of their possible combinations, constitute meaningful speech. Voiced (and unvoiced) sounds are generally accompanied by movements of other parts of the face (e.g., eyebrows), as well as the hands, arms and even the entire body (body language) - movements that enhance meaning through the provision of emotional content. Pitch or intonation (part of the music of language), often in conjunction with special words such as amplifiers, interjections and expletives, are also used to add emotional content and in some languages (tonal languages), such as the variants of Chinese, Thai and Vietnamese, to distinguish different words. Intonation provides too, the approximate equivalent of punctuation. Speech and its graphic representation can be readily converted into other kinds of vibrations, such as electromagnetic waves, for propagation beyond the range of audibility - even beyond the planet.

Successful cancer control requires understanding of the syntax and semantics of target communities.

The most fundamental classes of words are nouns, which designate “things”, and verbs, which refer to the existence of such “things” and to their relationships and interactions in spacetime. Nouns and verbs may be considered, respectively, as the higher order equivalents of matter and energy, although nouns can represent much more than material objects, being also used to symbolize places, events and non-material “things” such as thoughts - even the fundamental forces! However, to the human mind, naming something (nouns are, in essence, the names of things) confers a material or quasi-material existence upon it, creating mental boundaries, however imprecise or even illusory they may be, for the thing named (e.g., chair, box, electron). Verbs relate to the changes that occur in “things” or to the visible actions that cause change rather than the underlying agents of change. Like matter and energy, which are interconvertible, nouns and verbs blend into each other; whether a word is perceived as a noun or verb depends as much on the function it serves in a sentence as upon its own structure. Specific categories of actions (dancing, reading, etc.) are treated as nouns, while many nouns can be used as verbs (e.g., he papered over the cracks; she agreed to chair the meeting), although these details vary among languages. Many other parts of speech, whether words or phrases, can be used to create, modify or enhance meaning through the coupling of meaning units (morphemes), or the addition of descriptive elements.

The Evolution of Languages

Once a basic stock of words exists, new words and meanings can be created by the same processes that apply equally to atoms, molecules, genes, cells, objects and ideas - transformation and recombination. One form of transformation occurs when a word or phrase with a very specific meaning in the material world is used in a figurative or metaphorical sense (e.g., family tree, high spirits, small minded). Another is when the range of meanings of a word moves into a related but different realm. For example, the adjective nice, derived from the Latin word, nescius, meaning ignorant, has progressed in the course of its 700 years in the English language (which it entered via old French) from its initial sense of foolish, through timid, fussy, fastidious, delicate, precise and delightful, to its present most frequent meanings of charming, tasty or subtle, with occasional references to an earlier sense. The meaning of words often varies with context (e.g., a nice shot, a nice person, a nice distinction), and composite words create new concepts often seemingly unrelated to the meanings of their constituent parts (e.g., anteater, television, hardship, overcome, understand), although some word elements (prefixes for example) - may have a relatively uniform influence on meaning (e.g., belittle, bewitched, contemporary, concomitant).

The richness of language has been greatly enhanced by the evolution of new languages through a process of variant pronunciation (dialect) analogous to genetic mutation. When populations are geographically separated, this may extend to the point of mutual unintelligibility - a process similar to the evolution of species, the hallmark of which is reproductive isolation. When previously separate populations come into contact again, there are many opportunities to borrow words - either complete with meaning, or to use in a different sense, often related; but in either case to expand the range of concepts that can be expressed. This horizontal cross-fertilization parallels the close cooperation that occurs among species in an ecosystem. The use of everyday Greek and Latin words in the creation of scientific terminology is a particularly dramatic example, but many modern languages, such as Urdu and Swahili, are comprised of words derived from several languages. English has also been greatly enriched by loan words. Syntactically a Germanic language, it is estimated that words from its original language family, Old English, Middle English, Old Norse and Dutch, account for only 25% of its vocabulary. More than half its vocabulary is of Latin (28%) or French (28%) origin and 5% from Greek (place names, other languages and words of unknown origin account for the rest).

Languages contain specialized domains that have their own terminology and sometimes variant syntax, such that they are not accessible to all speakers - for example, legal, religious, literary or other domains. Mathematics is a special case, since its symbols have become essentially universal - i.e., have transcended language barriers. It comprises a set of words that symbolize numbers, the operations to which they can be subjected and the rules that govern such operations. Numerical description allows various characteristics such as size, distance, speed, frequency, intensity, even direction, to be expressed quantitatively and inter-relationships to be represented graphically (Figure 1), or, in the case of locations, mapped, i.e., plotted in correct spacial relationship on a two-dimensional surface. Maps can be used to indicate a broad range of geographical relationships - including the distribution of diseases, such as cancer (Figure 2). The verb “map” is also used to express the relocation of non-geographical locations to other locations. Relationships, including rates of change, can be analyzed through the use of abstract or generalized numbers represented by letters (algebra) and even logical arguments can be expressed numerically. Remarkably, advanced mathematical techniques have permitted profound statements about the universe - such as the relationship between gravity and the structure of spacetime - to be concisely expressed as a small group of symbols.

Communication, of course, is not confined to human language, and similar principles governing effective communication can be seen at all levels of being. Gravity itself, to which all matter and energy is subject, may be the most fundamental form of communication in the universe: its attractive force is ultimately responsible for the continuous creation of the elements. Life is dependent upon complex interdigitating molecular pathways in cells, intercellular communication and at the most complex levels, interactions among species in ecosystems and individuals in communities. Human language can be seen to be a further development of the host of communication systems in animals, plants and fungi, at molecular, cellular or organism levels. A crucial evolutionary step towards this higher level system of communication was the emergence of nervous systems of sufficient complexity to allow deliberation. Existing systems of communication could then be adapted to the sharing of thoughts - an ability that greatly enhances the possibility of concerted effort, resulting in improved efficiency in everyday activities, as well as the ability to capitalize on rare, but potentially immensely valuable ideas that might occur in only one brain in the course of many centuries. Such momentous thoughts, like novel metabolic processes (photosythesis or aerobic respiration), could have an enormous impact on survival and once “captured”- i.e., disseminated to many individuals - can be further developed, sometimes in the course of millennia.

Figure 1. Graphic representation of breast cancer incidence rates in different age groups. There appears to be a disproportionately low incidence in women above the age of 45 in less developed countries as well as Japan. One possible explanation is that there are different risk factors for pre- and post-menopausal breast cancer. Graph created with Globocan 2002.

Syntax and Semantics

Language is seen to be an extraordinarily flexible tool which takes the possibilities inherent in social behavior a quantum leap forward. But in order to create meaning, the symbolic elements of language must be combined according to specific rules. This is not unique to language - nothing can effectively function in the absence of relevant structure. In human language, the classification of words into categories (taxons) and the grammatical rules that govern their meaningful sequential arrangement is known as syntax (syn Gk. = with or together). The basic rules of syntax and its relationship to semantics are almost certainly genetically encoded and must have emerged with the genetic changes associated with the physical ability to speak. The details, however, including the symbols used for words (or more precisely, lexemes, the smallest unit of structure) and the precise way in which parts of speech are meaningfully combined, was left to the interaction of the newly developed nervous system with the world in which it found itself - hence the thousands of existing languages and, doubtless, millions of extinct languages. The existence of a “hard coded” universal grammar means that any healthy child is capable of learning the language or languages to which he or she is exposed, while persons sufficiently fluent in multiple language are able to translate from one to another - i.e., to use other words and syntax to convey the same meaning. Perhaps “culture” - the syntax and semantics of communities - is derived from a similar but more general set of universal rules. If so, there may be no better time than childhood to instill healthy patterns of behavior, which may persist throughout life and significantly impact upon the incidence of many diseases, including cancer.

Figure 2. Map showing geographical variations in the crude incidence of breast cancer, A, and cancer of the uterine cervix, B. Higher incidence is indicated by darker green. The map tells us that, overall, the incidence of both cancers varies with socioeconomic status, but in opposite directions. The incidence of breast cancer increases, while that of cervical cancer decreases, with socioeconomic status. This phenomenon can also be seen in different socioeconomic groups within countries. This raises a series of questions relating to “why.” Maps created with Globocan 2002.

Semantics, the study of meaning in the context of language, is derived from the Greek for “significant meaning” (semantikos); sema means a sign. Complex meaning is built up by combining words (or more precisely, morphemes) in a grammatically correct manner. Meaning can be destroyed completely, or modified, by errors or changes in individual words or in the syntax of strings of words. But correct syntax does not guarantee precise meaning, for meaning is context- sensitive (as exemplified by example of “nice,” above). Even syntactically correct sentences may contain no meaning, or contradictory meaning (as, for example, in the sentence “this statement is false”) or may be nullified by succeeding sentences. Achieving the highest precision in meaning, or “constructing” the intent of existing laws, accounts for much of legal practice. And since languages and culture undergo continuous change, the meaning of ancient law, or lore, may, with time, become increasingly imprecise and open to interpretation - a problem compounded by the specialized language included in sacred texts or legal documents. These problems apply within a culture or language; how much more likely is misunderstanding among different cultures with different languages? These issues loom larger as the world becomes increasingly connected through efficient transportation and electronic systems. Unfortunately, a large fraction of humanity is left out of this process, and major efforts will be required if the less integrated members of national and international societies are not to be considered “alien” - the “default” setting derived from instinct. Those interested in cancer control (whether national or international) must recognize that the most meaningful interventions are likely to be associated with efforts to understand the syntax and semantics of the target communities.

Cancer in Context

Cancer is a set of diseases in which the progeny of a “founder” cell behave inappropriately - i.e., continuously multiply, fail to die, and encroach upon forbidden territory. It derives ultimately from the malfunctioning of specific molecular pathways consequent upon misinformation derived from the cell genome. Such misinformation results from damage to the cell genome, the likelihood of which depends upon the context - i.e., the genetic background and the lifestyle and environment of the individual. The syntax of the language of life, spelled out in the genomes of living organisms, must be protected from corruption in order to preserve its semantics. Cancer is more likely to occur when the molecular pathways which protect the whole individual, the tissues and organs and the information encoded in the genome itself, are either intrinsically less efficient or, in the case of target cells, damaged through the actions of environmental agents (Table 1). At the level of society, context derives from the political structure and accumulated legislation as well as numerous other cultural elements, including religion and lifestyle (which varies greatly, even within the same society). All of these elements, which are heavily dependent upon language, are relevant to cancer, and may influence the likelihood of exposure to cancer risk factors, the time to diagnosis, access to effective anti-cancer therapy, follow-up and palliative care.

Table 1. Some of the levels at which genetic factors may influence the impact of environmental carcinogens1.   Level of Protection     Genetic Factors     Behavior2     Acquisition of culture, language, character, intelligence     Absorption     Efficiency of absorption     Liver metabolism (detoxification)     Efficiency of detoxification     Intracellular processing in “target” cells     Intracellular metabolism     Neutralization of free radicals     Concentration of protective molecules     Repair of DNA (genetic) damage     Efficiency of excision-repair enzymes     (1) Exposure is heavily influenced by legislation, concentration of the carcinogen in the individual’s environment (occupation, lifestyle), protective measures actually taken (influenced by learned behavior and literacy, personality, available safety measures etc.), and cumulative duration of exposure.   (2)  Behavior is heavily influenced by community structure, family, environment and education.

The advent of writing and electronic communication, particularly the World-Wide Web, have permitted enormous amplification of the possibilities inherent in language, bringing ideas to an ever more extended community where they can be modified or developed to the benefit of all. At the same time, however, the former cultural system of discrete tribal units has largely given way to complex multinational, multicultural and multilingual communities, creating a crisis of allegiance and issues of hegemony at national and global levels. In the modern era it is easier for communities to share ideas and build upon them in domains in which the intellectual component still outweighs issues of power, influence and economics. These include the arts, science and medicine. It is essential that the ideas inherent in these domains are protected and nurtured by their advocates, just as the genome protects its own integrity without stifling its evolution. For these are ideas of great majesty and beauty whose origins reach back to the beginning of time, a beginning invoked by the sacred syllable AUM and its scientific counterpart, the CMB. And just as their origins and existence are in language, so too is their preservation dependent upon language - as indeed, is that of the human race itself.

Part II. Reading the Signs will follow.