Homeostasis, Allostasis, And The Truth: What Explains The Persistence Of Hypertension, Cancer, And Nonsense

Homeostasis, Allostasis,
And The Truth: What Explains The Persistence Of Hypertension, Cancer, And Nonsense


Leonard Zwelling

         When I cared for the ill for a living, I was a firm believer
in disorder in homeostasis as an explanation for malfunctions of the body.
Hypertension, for example, was a response to internal stress that
re-establishes a set point for cardiac function and vessel resistance that
gives rise to a detrimental disease, essential hypertension.

         Thus the editorial in the NY Times on Sunday, August 7 by a cardiologist, Sandeep Jauhar,
gave me pause:


         Dr. Jauhar is an advocate for allostasis. This theory posits
that blood pressure elevations are a response to environmental factors and
suggests that the body is constantly resetting itself due to the influence of
stress, poverty and economic downturns. Unlike homeostasis that strives for
“preserving constancy,” allostasis makes the political physiological.  This could explain the epidemic of
hypertension among the poor. The bottom line here is that your environment can
make you sick. If you believe, as I do, that cancer is a loss of the
homeostatic mechanisms that work to prevent the establishment of malignant
foci, if I am wrong and it is allostasis that is more important, then maybe
the environment can cause cancer as well, and I don’t mean just bad air or

         That brings me to another article in the Sunday NY Times:


         In this piece, a former reporter for the Wall Street Journal and NY Daily News named Neil Barsky lays
out the truth about Donald Trump’s business acumen. I’ll summarize. Trump is a
“Bad, Bad Businessman.”

reveals Trump’s real success in real estate and casinos. Not much. Trump has
since recovered with help of loans and gifts from his father, a series of
bankruptcy declarations, and his success as a reality TV star.

         Having considered all this, I wondered what the health of
Trump’s associates was like during his many roller coaster business adventures
and I wonder the same thing about the faculty of MD Anderson. How well are
they? As with the quality of the care the faculty of MD Anderson really
delivers, the health of those doing the delivering is also probably an unknown.
But if it is allostasis that determines the health of the body, the body
politic and the faculty body collectively, all may be under fierce attack from
the environment in which they have to operate.  

         The leadership of Anderson, like Donald Trump, has created a
hostile environment due to its fast and loose relationship with the truth. The
Moonshot Mission has yet to deliver on its promise, locally or nationally, and
the disappearance of the clinical leadership of MD Anderson, replaced by many
insiders, is frightening and not good for the entire “war on cancer,”
especially if that war is with our environment and our bodies’ own mechanisms
to resist malignant transformation.

         Perhaps a careful examination of both the health of the
faculty, including its emotional and mental health, and a compassionate
response thereto might not only lead to a cleansing of the environment, but
more success in the press to decrease the incidence of cancer.

         This theory of allostasis could alter the approach to many
chronic disorders including cancer. It suggests that pollution, of the
atmospheric and managerial kind, can adversely affect the health of individuals
and the body politic of a large institution.

         It does make you think.

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