Robin Hood Bay, England

Review: Cokin varicolor

A varicolor really starts to shine when you use it on seascapes.

Wouldn’t it be nice to have a real Photoshop filter that screws onto the front of your camera lens and just makes color look better? If landscapes, architecture, seascapes and vehicles are your thing, there is such a filter: the varicolor polarizer.

The varicolor used to make drab dirt and ordinary foliage more interesting
The varicolor used to make drab dirt and ordinary foliage more interesting

The varicolor consists of two tinted polarizers rotated 90 degrees from each other. Thus light is colored by one or other of the two tints depending on its phase… um, that means absolutely nothing to most people, so here’s a better description:

Most landscape scenes have two types of light: direct and reflected light, such as

  • Direct light from the sky vs light that has been reflected from water
  • Direct light from the sky vs reflected light coming from the ground.
  • Reflected light coming from two very different surfaces, typically shiny vs rough.
  • Highlights and reflections vs non-highlights from the same metallic object (typically vehicles).

The varicolor filter will separate the direct and reflected sources and tint them via two different colors. The amount of tint can be varied by simply rotating the filter.

Many photographers assume a varicolor is simply a variable warming and cooling filter, and the packaging on one of the main suppliers of varicolors, Cokin, does little to kill this miss-assumption.

Cokin Packaging, showing a varicolor being used as q variable warming/cooling filter. This is not how it is usually used!
Cokin Packaging, showing a varicolor being used as q variable warming/cooling filter. This is not how it is usually used!

It is true that a varicolor filter can be used just for global warming/cooling, and can totally change the lighting.

Blue/yellow varicolor, used to turn a blue sky (left) into a magenta, orange and violet sky.
Blue/yellow varicolor, used to turn a blue sky (left) into a magenta, orange and deep blue sky.

More usually though, you make slight changes to the ambient. You are more typically not trying to tint the scene so much as tint the direct and reflected light via two complementary colors ( typically, but not always, warming and cooling) to get a visual separation between the two.

In this series of shots, the sky light is rendered bluer, and the ground and foliage yellower
In this series of shots, the sky light is rendered bluer, and the ground and foliage yellower
The cool thing about these photos is that there is almost no color correction going on: the photos pretty much looked like this from the camera live-view when I took them!
The cool thing about these photos is that there is almost no color correction going on: the photos pretty much looked like this from the camera live-view when I took them!
In this scene, the small puddles could not be seen, the ground was a uniform grey, the sky an overexposed solid white and the foliage the same shade of green throughout. All this changed when the varicolor was used, and I saw the change directly through the camera viewfinder, rather than having to do it all in post.
In this scene, the small puddles could not be seen, the ground was a uniform grey, the sky an overexposed solid white and the foliage the same shade of green throughout. All this changed when the varicolor was used, and I saw the change directly through the camera viewfinder, rather than having to do it all in post.

Buying a varicolor filter

Varicolor is an effect most suitable for wide angle lenses. There are two companies that sell wide angle varicolor filters, Singh-Ray (‘gold-n-blue’) and Cokin (P173). Hoya also do them, but in smaller sizes (typically 58mm) that are not really useful as we are nowhere near wide angle diameters.

The Singh-Ray is priced too high for most people’s pockets. The Cokin is about 1/5 the cost and very affordable, but comes as a square cassette for the Cokin P Series holder rather than a standard 77mm filter thread (such as the one I need for my Tokina 11-16mm, a lens that suits a varicolor perfectly).

A Cokin P series filter cassette (l) and the standard 77mm circular filter format (r) most non-Cokin users would prefer.
A Cokin P series filter cassette (l) and the standard 77mm circular filter format (r) most non-Cokin users would prefer.

There is a third option: make your own standard varicolor filter, using a cheap Cokin P173 and an even cheaper no-brand circular polarizer filter.

Making a standard 77mm varicolor filter

The Cokin filter cartridge is easy to open (you just prise it open with a knife at one corner enough to get your fingernails in, then open it with fingers – it opens very easily as it isn’t glued down) to reveal a much more standard looking circular 75mm glass filter body. We next need a standard 77mm CPL (circular polarizing filter) to put the varicolor glass into. It has to be a CPL filter because like a varicolor, the CPL has to be rotatable on the lens for it to work. It also has to be a non-low profile CPL, for reasons we will see next.

The Cokin cassette opens easily. It is just held together by a series of plastic plugs, no clips/glue to overcome.
The Cokin cassette opens easily. It is just held together by a series of plastic plugs, no clips/glue to overcome.

When you take the varicolor filter glass out from the Cokin cassette, the first thing you will notice is how heavy and thick it is. A standard CPL is about 1.5mm thick glass. The varicolor is three times that: 4.5mm. In other words, it is half the thickness of a standard window pane!

That makes a kind of sense: the varicolor is two CPL filters, each with its own color filter added on, so we are talking x2 CPLs which takes us up to 3mm, and then x2 color filters on top of that. The upshot of this is that you cannot use a low profile CPL filter ring: it has to be full height.

Even with a full height filter, I had problems putting the varicolor into the CPL filter ring. The varicolor is just too thick! The only way to get it to fit was to reverse the filter retaining ring as shown below. The varicolor is about 2mm smaller in diameter than a standard 77mm CPL, and you can use that space by turning the retaining ring over so it goes down further into the filter, and just enough to become fully threaded into the filter body.

Top, the difference in thickness between a standard CPL and varicolor. Bottom, For a CPL, the retaining ring is screwed well into the filter. To get a varicolor into the same ring,  you typically have to reverse the retaining ring for it to screw in fully.
Top, the difference in thickness between a standard CPL and varicolor. Bottom, For a CPL, the retaining ring is screwed well into the filter. To get a varicolor into the same ring, you typically have to reverse the retaining ring for it to screw in fully.
My completed Cokin P173 Filter in a standard 77mm thread, ready to screw into my Tokina 11-16mm ultra-wide.
My completed Cokin P173 Filter in a standard 77mm thread, ready to screw into my Tokina 11-16mm ultra-wide.

Rotating the completed filter whilst looking through it at the sky, you will see the sky tint from bluish to yellow, going through a series of pinks and magentas at the midpoint. If you have any reflected light in the scene (coming from windows, water, or highlights on pretty much anything), they will take the opposite tint to the sky. This occurs because one CPL is tinting the direct (sky) light and the other one is tinting the reflected light.

Choosing the varicolor tint pair

The secret to using a varicolor is realizing that they move your overall white balance, and you need to fix this in post, removing any introduced color cast and pulling the varicolor effect back towards something much more desirable.

As well as the P173 (blue-yellow), Cokin also do the P170 (red-green) P171 (red-blue) P172 (pink-orange) and P174 (blue-lime). The p173 varicolor is the most popular because its two colors match the white balance temperature range. I’d be tempted to start with a P173, and chances are that it’s the only one you will ever need.

The Lightroom color balance slider, showing that color temperature is a variation between cold (blue) to warm (yellow). This color range is replicated in the Cokin P173.
The Lightroom color balance slider, showing that color temperature is a variation between cold (blue) to warm (yellow). This color range is replicated in the Cokin P173.

So, using the P173, you can tint the two light transmission types (reflected, direct) in a scene so one is warmer and the other is cooler. In the photos of the wood above, the light coming from the sun is cooled via the varicolor, and the leaves and foliage are made warmer. This creates a nice contrast between the two, and the lighting and reflected light thus become more prominent than it was on the day.

Using a varicolor

Although a varicolor can be used to give a nice warm-cool color balance differential between the sky and ground, its standard textbook use is where there is water, reflecting metal, or glass.

Effects of blue-yellow varicolor on water: yellow (left), no filter (center) and blue (right). This is as shot, no photoshop. A pretty strong effect!
Effects of blue-yellow varicolor on water: yellow (left), no filter (center) and blue (right). This is as shot, no photoshop. A pretty strong effect!

The above three photos were all shot with the same P173 filter, rotated to get the leftmost and rightmost versions.

Most people don’t care for this effect. Not only is the water overly tinted, every other color is way off via an undesirable cast. The effect puts a lot of photographers off, until you realize the secret of using varicolors properly…

The secret to using a varicolor is realizing that they move your overall white balance, and you need to fix this in post, removing any introduced color cast and pulling the varicolor effect back towards something much more desirable.

Setting the white balance (in this case by clicking the Lightroom white balance selector tool on the ground below the tree trunk to set it back to its original neutral grey) will also reduce the effect of the tint.

Yellow version pulled back via white balance correction. Much more subtle!
Yellow version pulled back via white balance correction. Much more subtle!

If you are shooting landscape, a bit of white cloud or grey ground will suffice to set white balance, but more generally, you need a grey card. If you don’t have one, an almost perfect stand-in is a square of card from an unwaxed, unbleached breakfast cereal box. The inner side makes a perfect grey card for the purpose of white balance. If you expect to be in direct sunlight, get a smooth stone or a bit of fine emery cloth and sand the grey side down for about a minute so it starts to lighten slightly. I’ve tested such a piece of sanded card against a calibrated X-Rite grey card, and the resulting color balance is consistently within 1% of the calibrated (and very expensive) X-Rite!

Varicolor filters and seascapes

A varicolor really starts to shine when you use it on seascapes.

The situation where a blue-yellow varicolor absolutely excels is when you need to take a photo of the sea on an overcast or very bright day. In this case, both the sky and sea will be the same grey (or blue-white). Grey on grey isn’t a very compelling color scheme. The grey light of the sky is at a different phase to the grey coming from the sea though, so using a varicolor we can save the day by creating a color separation where there was previously only grey. In fact, in this situation, the varicolor is a requirement to getting a decent shot unless you want to do some serious post processing!

In the shot below, I used the varicolor to turn the water blue, ignoring what was happening to the sky.

Out-of camera shot, initial varicolor
Out-of camera shot, initial varicolor. Lots of color separation, but also a pink cast

We now have some color separation between the sky and sea, but white balance has been totally destroyed and we need to reset it in post. We can either select the blue of the sea as our white balance point (which will warm the entire image towards sepia, and might have been appropriate if the sun was in the sky), or the grey of the sky (which will give us a blue sea and grey sky). Both will fix the issue, but will give us a totally different look. I want a blue sea, so have clicked the sky:

Changing white balance to tone down the varicolor: (l) making the sky grey or (r) making the sea grey.
Changing white balance to tone down the varicolor: (l) making the sky grey or (r) making the sea grey.

Tweaking the image further gives us our final photo…

Finished Seacape, with proper color separation between sky and sea.
Finished Seacape, with proper color separation between sky and sea.

In the actual scene, the sky and sea were the same color, and although this final version has been processed for exposure, I have hardly altered color at all apart from the initial white balance correction and lowering yellow from the foam. I left most of the color correction to my trusty real-life Photoshop filter – the Cokin P173.

Another cool use of the P173 is when you are using HDR photography. HDR will take the varicolor tints and overdrive them, giving you a dramatic effect.

Original Shots (top) and white balance corrected for grey sky and ready for HDR (bottom)
Original Shots (top) and white balance corrected for grey sky and ready for HDR (bottom)

When shooting HDR of fast moving water, it makes sense to use a fast shooting camera. The Sony A77 does 12 frames per second. That and its fast WYSIWYG live view make it perfect for landscape HDR, especially if like me you prefer to shoot hand held.

Final photograph: Robin Hoods Bay, North Yorkshire, England.  5 exposure HDR, rendered via HDR Efex Pro. Final correction (exposure dodge/burn) via Lightroom.
Final photograph: Robin Hoods Bay, North Yorkshire, England. 5 exposure HDR, rendered via HDR Efex Pro. Final correction (exposure dodge/burn) via Lightroom.

Disadvantages of the varicolor

As mentioned earlier, the varicolor is really two tinting CPL filters. It comes as no surprise then that the varicolor has such a strong color effect as it is really two filters, each with two elements (CPL+tint).

You will have the usual negative issues of stacking what is really two filters onto a lens, the biggest one being stop loss: you lose up to two stops of light. That’s enough to kill your autofocus even on a bright sunny day. Fast f2.8 glass is pretty much a must, otherwise its down to tripod and manual focus.

Vignette is another issue, so you may need to correct for that in post.

Finally, as mentioned earlier, a varicolor is seriously thick glass: 4.5mm, which is half the thickness of a standard window pane. On the bright side, such a filter is complex, so you simply can’t get cheap knock-off versions, and there are really only two brands available (Singh-Ray and Cokin).

Conclusion

Varicolors are typically only recommended for landscapes with water, and many photographers simply dismiss them as a variable tinting filter, but they can be used for so much more once you realise that the secret to their use is fixing white balance in post. After that, they become very useful, being able to make mundane color look dramatic (and often the focus of the shot).

  • They allow you to set the warmth of reflected light coming from windows in architectural and motor vehicle shots.
  • They allow you to crank up the contrast between the light coming from the sky and the light reflected from the ground, something that can make all landscape shots look different, bringing up color and enhancing lighting.
  • They create iridescence (think ‘body of a peacock’) when you shoot close-up foliage and car bodywork, especially when you have highlights.
  • They can act like an all-in-one warming-to-cooling filter when you have flat lighting

A blue-yellow varicolor is something to try out in all use cases where you would reach for your wide angle lens. It will be a firm favourite with anyone who has one of the affordable super-wide lenses (Tokina or Sigma) but you will need to do some DIY to move the filter glass from a Cokin P series cassette to a screw in filter, or you need to hold your breath and get a Singh-Ray.

Perhaps the best thing about the varicolor is that not many photographers use them. They don’t realise the white balance trick or are off put by the two stop light loss. That makes the varicolor a less used filter than it deserves and far from being an overused effect. In fact, if you pull back the effect with white balance, nobody will guess you created the effect optically!

Notes

  1. All forest photos shot with an Olympus Stylus 1 (the varicolor was hand-held in front of the lens).
  2. All seascapes shot with a Sony Alpha A77, Tokina 11-16mm, with the varicolor modded to screw onto the Tokina as a standard 77mm filter.

Adobe CC subscription: Telling the Man

If you open Adobe Photoshop in the next couple of days you will get a quick survey question as shown.

Adobe survey popup
Adobe survey popup

If you are also a small company or sole contractor, I suggest you make the same comment as mine;

Q: What would make you more likely to recommend Adobe Photoshop CC to others?

A: CC subscription that is based on time used rather than a straight monthly rent. this would prevent small contractors and other occasional users getting killed by the CC subscription model.

Adobe needs to know that occasional users of Adobe CC should have the option to buy seat hours in advance rather than paying for the same seat for the entire month. This would allow us to budget our software better (i.e. based on our actual monthly needs) rather than having to pay for unused months. Off season photographers, occasional users (or simply folks on holiday) would then have a fairer cost to foot.

It would probably also stop Adobe Photoshop being the second most pirated program after MS Office.

featured_cure_for_Cancer

A Cure for Cancer

Before Cancer

It was autumn 2011. My partner was full of health and energy, and looked pretty good for someone in her late 30s.

Before #1
The ‘Don’t take Photos of me’ look, Christmas 2009, Summer 2010
Summer 2009
Summer 2009
Summer 2010
Summer 2010 (and the only selfie on howgreenisyourgarden)

The Diagnosis

She was diagnosed with cancer in late 2011. An operation was performed in early 2012, and chemotherapy treatment began soon after.

The most discomforting part of it for her was not the cancer itself: unless the tumor pulls adjacent tissue or is near a joint, cancer is often painless to begin with (but eventually fatal if left untreated, a combination that make it deadly). The worst part for her was the chemotherapy.

Important note: the following description (and the rest of the post) relates to women’s breast cancer. Effects of particular chemotherapy treatments vary widely (from minor hair thinning to the effects illustrated in this post). Treatment varies by patient age, cancer type and how long it has being there (and to a lesser extent, which country you are in). You may have radiotherapy only, which is far more targeted and therefore far less invasive than chemotherapy.

Symptoms of the Cure

How does chemotherapy feel? Remember the most drunk you ever got, and then recall the associated hangover. After chemo, you get that hangover for weeks.

Chemotherapy doesn’t involve pumping you full of poison, but in practical terms it’s not far off. Chemotherapy drugs are like vitamins in reverse. Instead of adding the essential elements that your body needs to grow and flourish, chemotherapy drugs prevent your body from absorbing those essential elements, thus stunting fast cell growth. Cancer cells are the fastest growing part of your body so it suffers most from this regime: chemotherapy works by starving and stunting cancer by denying it the nutrients it needs.

Non-cancerous but naturally fast growing parts of your body (such as hair, skin, taste and smell receptors, immune system, stomach and ovary linings, and short term memory cells) also starve with the tumor, so you will lose them (or they will stop growing and start to show signs of wear). You will look and feel differently, both for the worse.

How does chemotherapy feel? Remember the most drunk you ever got, and then recall the associated hangover. After chemo, you get that hangover for weeks. You may also get additional issues, such as constant itching or feeling hot/cold (both caused by chemo affected nerve endings). When your body begins to recover, you have a week or two of a semi-working but spaced-out body before the next chemo course.

Half way through this, she had no head hair nor eye-lashes and was constantly tired with persistent aches. Her memory and concentration were starting to go (‘chemo brain’). Hair loss from the head is one thing, but you’ve probably never considered what your nose becomes when you lose the hair in your nasal passage: a water spout.

The only solids she could stand were mashed potato and vanilla ice cream. Her sense of smell and taste were now so unusually good she could not stand anything else. I did not appreciate this until the week before when she had not been able to sleep, telling me she could smell milk, so I got up, went downstairs and opened the fridge to find a milk carton dripping.

So, anyway, one Sunday she was depressed. She told me she looked ugly. I said she looked beautiful. She said I would say that. There was only one thing for it. She may have only just got up and still in a bathrobe, but I had to cure this.

I got my camera.

Chemotherapy (click to see larger image). Shot with Sony A500
Chemotherapy #1
Chemotherapy #02
Chemotherapy #2
Chemotherapy #3
Chemotherapy #3

She had bought wigs but she didn’t feel confident about them. I said go ahead and put them on: I’ll take some photos and you can see how you look.

Long wig #1
Long wig #1

She got to like the wigs. In the week before the next chemotherapy treatment, she would have a few days of normality, and go out. Modern wigs are very good: they make you look like you have your ‘going out hair’ on all the time but with zero effort. A good trick she learned was when she was getting unwanted attention: she would lift the front of her wig just enough to make it obvious.

Short wig #02
Short wig #1
Short wig #2
Short wig #2
Short wig #04, 05
Short wig #3

This had all happened first thing in the morning, and taken about 10 minutes so far (I was shooting hand-held with only natural light so there was no setup), but she was already by now tired from all the excitement.

Short wig #5
Short wig #4

I put her to bed 30 minutes after she had got up.

Later that month, her eyebrows would fall out, as well as some of her nails. She would forget to take the anti-sickness tablets after one chemo, and that night throw up so hard and fast that she would end up with two black eyes from the pressure.

As of this writing she’s in remission and every now and again she will say ‘how did I get through all that?’. I show her these photos and say, look, you were beautiful.

And you were smiling.

Looking back: what I wish I knew at the start

The best technical cure we have is time. The earlier cancer is detected, the better the outcome.

We’ve met a few people through cancer, some of whom are unfortunately no longer here, but most who are. There is no cure for cancer and there may never be. Cancer is always a genetic disease and thus a disease of chance: you might have it, you might not, and family history (generic disposition) and lifestyle may put you further up or further down the lottery, but (for most people) it is still a lottery.  Science is making the ‘might have it’ closer to ‘might not’, but we’re a long way from ever making it ‘will not’. And anyway, cancer is not a single disease but a class of diseases. We have no less chance of curing cancer as we have of curing all viral diseases or all bacterial diseases.

The best technical cure we have is time. The earlier cancer is detected, the better the outcome. Early treatment has high success rates: it means we know where the cancer is and can be sure it has not spread nor mutated so much that it no longer reacts to chemotherapy. If we detect cancer cells this early, there’s a high chance we can remove the main tumor and/or shrink it via chemotherapy, radiotherapy and hormone drugs.

One particular issue she came up against was age: doctors are trained to expect high incidence of cancer from the mid-fifties onwards but do not expect it in younger patients because its occurrence there is statistically very low, particularly for breast cancer. That means if like her, you actually do have breast cancer in your late thirties it is difficult to get an initial expert diagnosis (your general physician is not an expert when it comes to cancer – the most they can do is suspect cancer and refer you to someone else for proper tests).

We know of at least two people who were told to ‘come back in six months’ because they were too young to be at risk and there was no family history. As I said, time and early diagnosis is the only true healer of cancer, and we ended up at the funeral of one of those two people because of that six month wait. If you feel you may have cancer because of suspect changes in breast or other tissue, ask to see a specialist.

Another issue we found going through the process (and sharing with others experiences) is the effect of the Hippocratic oath. Many physicians will not tell you if  a chemotherapy course has a greater chance for failure.  The modern interpretation of the oath means medics must leave the patient with a sense of hope, but this can reduce remaining physical quality of life. A doctor or surgeon may or may not tell you this based purely on their judgement, but they are duty bound to tell you if you specifically ask. If you do ask, do it in medical terms so there is no room for interpretation.  Ask ‘what is the prognosis of this treatment, given my condition’. You are not then just asking for the success rate of you as a patient (which may be subjective), but also the historic survival rare of previous patients with your condition who underwent your treatment.  If you want to know the prognosis and expected efficacy of the treatment but are not the sufferer, my advice is don’t ask when the sufferer is there.

There are lots of websites out there that claim all sorts of things: vegan or vegetarian food stops you getting cancer (no – my partner has been vegetarian for as long as I’ve known her, and vegan before that), or there are foods that can prevent cancer (there are foods that can boost your bodys ability to detect and kill pre-cancerous cells, but that does not negate things that can cause cancer, such as cigarettes). This issue is compounded by medical staff who do not make the disease understandable. As a carer of someone with cancer, I had to sit down and read several books on cancer. I have written a summary of what cancer is and what causes it as an addendum in the notes section for this post.

Recovery, and a Cure for Cancer

Her hair began returning after treatment.

Hair, exactly one year after chemotherapy ended, and almost exactly one year from today
Hair, exactly one year after chemotherapy ended. Sony Alpha A77

Her hair came back just like hair grows on a newborn (very fine to start off, a little curly at the back, growing unevenly to start off with), so because of that and her propensity to sleep a lot, I called her ‘the baby’ for a while.

( Mostly) Recovered, Autumn 2013. Panasonic Lumix LX7
(Mostly) Recovered, Autumn 2013. Panasonic Lumix LX7

Well… actually, the name has stuck.

The most important part of her experience with cancer has been how friends and relatives have treated her. Cancer is a mirror through which the sufferer sees how important things in life really are, and this is especially true of other people. From discussion with others, we have found this is a common theme. Cancer survivors are likely to seek change. Divorce, loss of contact, or new found affection and understanding with family members and close friends is very common, as is a sudden change of life-direction.

We’re both pretty sure that we would have separated within the last two years if it wasn’t for cancer. We had been together for over 15 years, never married and never wanted children, and time was beginning to drag. Cancer lifted the veil of familiarity and showed us what we really thought of each other. And in the end, that was our cure: a change for the better.

And for that, we have cancer to thank.

Conclusion

Cancer is very treatable given early detection, so time is always important. Your physician expects to see adult patients presenting possible cancer symptoms from the early 50s up. The incidence of breast cancer before your 50s is so low that some doctors will underplay its possibility unless there is family history. That’s fine unless you actually have cancer. If they tell you to come back in a few months, remind them that if you really have cancer, that delay in diagnosis may be a death sentence.

Although most people are put off by losing their hair and poor skin and nails (as well as not being able to do much for 6 months of their life), this can be managed. Good modern wigs are indistinguishable from real hair so you won’t be a recluse, but bear in mind they only last a couple of months so don’t get the top of the range one (two or three mid priced ones are better, and bear in mind that they are really hot in summer so get at least one short one.  Oh, and don’t get them from that surprisingly cheap China based site that keeps changing its name (but is always the first or second paid result on Google). That one is a scam. We found out by noting that their photography was ripped from other sites or of celebrities who were clearly not wearing wigs, and further searching yielded scam-victim groups on Facebook). Do your research if you are buying online, and if you have been taken in by them, click on the Google search every couple of days (the clicks are all paid for, and using them will reduce their advertising budget).

If you are not the sufferer, how you treat a spouse or close relative diagnosed with cancer will have a big effect on how they treat you when they recover. Cancer sufferers have a lot of time to consider their past life and future direction, so actions really do speak louder than words here.

Notes: What is cancer

Some foods are beneficial as a cancer-prevention measure… Such foods are not the ‘super-foods’ that some websites will try to sell you, but the normal healthy eating options we all already know about: 5 fruit or vegetable portions a day, don’t eat excessive amounts of red meat nor excessive amounts of any one food.

Cancer is always a genetic disease caused by mutations in your genes. This was not known as a certainty until the 1980s, but has caused massive advances in the treatment of cancer since then. Success rates are now much higher than they were even a generation ago because we now know the underlying cause of cancer.

Generic mutations occur randomly in our cells over time, and can by chance leave a cell in a state where it becomes cancerous.

Think of this process of cumulative mutations as being like a thief trying to unlock a safe. The thief has to find the correct combination by altering the tumbler dials of your genes. This takes time because there are so many combinations, and in most cases, the thief is out of time: you have enjoyed and lived a natural lifespan before the thief gets anywhere.

If  the thief does crack the combination, you have a cancer cell in your body, but there is also a window of opportunity: we can detect cancer fairly easily and eradicate it as long as there is an early diagnosis.

There are several distinct ways the thief finds the combination and gives you cancer:

  1. Inherited predisposition to cancer. Sometimes, part of the safe’s lock is already open when you are born meaning the thief has more chance of getting the full combination before you die. This corresponds to being born with a genetic disposition to getting a particular type of cancer, and is almost always the cause of childhood cancers, unless the patient has been very very unlucky or introduced to strong carcinogens whilst very young.
  2. Carcinogens. Sometimes you help the thief along by speeding up the rate he can make guesses by ingesting something that increases the rate of cell mutation. These ‘somethings’ are called carcinogens. They include cigarette tar, asbestos, soot, radioactivity (which can include too much direct sun), some substances derived from deep underground (most heavy oils will give you cancer if you leave them on your skin over a long time, which has historically affected many industrial workers).  Some foods and drugs can be carcinogenic, and we will look at them under Lifestyle and Cancer.
  3. Retroviral action. Occasionally, the thief gets lucky by having parts of the combination given to him via certain retroviruses such as Human Papillomavirus (HPV). A retrovirus works by combining its genetic information with the host’s genetic information. Unfortunately, thousands of years ago a cancer victim was infected with HPV, and the cancerous gene is now part of the retrovirus. When the HPV virus combines with your genes, you have an increased likelihood of getting cancer because infected cells now contain an inherited predisposition to cancer (point 1 in this list). This mode of cancer infection commonly occurs for women (increased disposition to cervical cancer caused by HPV infection) and can be detected via a smear test, and this is why you should have a regular smear test. It can also happen to either sex for certain stomach viruses.
  4. Chance and old age. The thief can simply get lucky. This becomes more likely as we get older because the thief has more time to get lucky. It is also why, other things being equal, incidence generally increases with age.  As we now live longer, the thief gets more time than he did even a few generations ago. This is one reason why cancer is now a primary cause of premature death in all developed areas of the world.
  5. Premature aging through viral action. Some viruses can overwork or strain an organ so it prematurely ages (or fails to replenish, thus leaving cells that are much older than they should be) a condition that leads to cancer via point 4. For example, cirrhosis of the liver can cause cancer of the liver, and Hepatitis C can cause cirrhosis of the liver, so Hepatitis C is strongly linked to liver cancer. Incidentally, overuse of alcohol can also cause cirrhosis of the liver, and therefore eventually, cancer.
  6. A weakened immune system. As discussed previously, your immune system catches many cancerous cells before they get a foothold. If your immune system is not there to perform this function, your chances of getting a tumor increase
  7. Lifestyle. See the secion below for more on this.

Lifestyle and Cancer

What you are putting into your body (or adverse conditions that your body is going through such as extreme stress) can increase the cancer risk.

If cancer is always caused by genes, how does eating something give you cancer, given that food does not generally change genes?

  • Some foods and drugs are simply carcinogenic: not so poisonous that they kill cells, but instead damage the cell DNA  whilst leaving the cell alive. This causes increased rates of cell mutation (effectively speeding up the rate the thief works against us in getting the combination). Smoking is a good example of this.
  • Other foods contain chemicals that affect the local hormone balance, which can change the way our cells work for the worse. Cheap meat full of animal growth hormone may have some causal effect.
  • Some foods and drugs can overload an organ and lead to premature aging (and because age is related to cancer incidence, premature localised aging increases the risk of cancer in that location). Drinking so much alcohol that your liver begins to die will give you cirrhosis, which in turn can kill you through liver cancer.
  • Some foods are beneficial as a cancer prevention measure. They boost your overall resilience by feeding your immune system and prevent you getting cancers in the digestive system (such as bowel cancer), although you can’t count on these foods curing you if you already have cancer. Such foods are not the ‘super-foods’ that some websites will try to sell you, but the normal healthy eating options we all already know about: 5 fruit or vegetable portions a day, don’t eat excessive amounts of red meat nor excessive amounts of any one food.
  • Stress in itself probably doesn’t have anything to do with it, but it may be an indirect secondary cause (stress tends to prevent you making healthy choices, reduces your immune system and may stress some organs), all of which can be significant if they occur together.
  • Finally, obesity can increase the risk of cancer through associated hormonal changes. Obesity is also a significant complication that may make treatment more difficult.

Except for smoking or drinking heavily, it is not clear whether or not any single lifestyle choice on its own will cause cancer, but it is clear that if you are living under several poor livestyle choices, your probablility of getting cancer will go up.

Adding it all up: probability of getting cancer

So far we have seen that cancer is a game of chance, but there are things that increase it’s likelihood. You can have an inherited predisposition to cancer, a weak immune system or you can simply be long lived so cancer becomes more probable for you. There are also behaviors that make cancer more likely (smoking, long term heavy drinking, never having smear tests, living in a house that sits over a radon gas deposit, sunbathing until your skin burns, working in an oily or sooty environment and not washing it off, or lacking a varied diet so you end up eating too much of certain foods causing a carcinogen build-up in your body).

Finally, as with any game of chance, you can simply be unlucky.

Eating fruit and vegetables will make you healthier (plus give some protection against certain cancers) and bump up your immune system so some pre-cancerous cells are detected and killed naturally by your body, but the reverse effect is far more marked. Eating carcinogens is a much bigger issue and is not negated by eating well: being vegetarian but smoking probably puts you in negative territory overall. You always need to consider the overall risk your lifestyle is introducing.

Further, a healthy immune system only targets a subset of pre-cancer. If you have a family history of breast cancer, filling your body with healthy ‘super-foods’ and vitamins is a start but you really need to be having regular cancer checkups or going on a pre-emptive course of Tamoxifen. Carrot juice on its own will just not reduce an existing tumor.

How cancer can kill you

Cancer is always present in your body: you are actually born with some cancerous cells. The human immune system detects most cancerous cells and will kill them itself, and will do this often throughout your life. We don’t usually talk about such cancerous cells when we talk about cancer because they never come up on our radar. There are some cancers that the immune system does not respond to.

These cancer types are fatal if left untreated because cancer cells prevent the infected organs from carrying out their normal function (cancer cells generally provide no biological function, so are fast growing deadweight that crowds out or starves normal function).

Where cancer infects cells that you can live without, it is still dangerous because it can (and will if left untreated) spread to other, more vital organs. Thus, breast cancer is dangerous not because you cannot live without breast function, but because breast cancer can spread to other organs that you do need to live. Most cancers actually have a number of stages to go through before they become dangerous, and these are

  1. Carcinoma in situ: a small number of cancerous cells that have not yet started to invade nor form into a tumor or lesion. Sometimes this is called a pre-cancer stage because it is not yet dangerous (but will become so if untreated).
  2. Tumor: When a group of cancer cells have invaded the local healthy cell population, stole their blood supply and grown, you end up with a tumor. A tumor’s danger is specified by several things, but generally, these are to do with time (how long it has been there, how big it has got, and how much like normal cells they are), the importance of the organ they are in, and how easy it is for us (and chemotherapy drugs) to get to the tumor.
  3. Node: A tumor does not usually hit the jackpot and start in an organ that can kill you: it normally has to spread before it can kill you. Most of our organs are self contained, separated by membranes, There is only one way out of an organ: through the Lymphatic system. This is effectively a drainage system with an immune system tacked on: it drains your organs of fluid and is a gatekeeper and defense system for when things go wrong. Cancer cells have to exit through the lymphatic system, and we can see when this has happened because some lymph nodes contain cancer cells. If you have very few or no infected lymph nodes then its probable that the cancer has not yet spread from the original organ.
  4. Metastasis: When a large number of your lymph nodes are cancerous it is seen as a sign that the cancer has become mobile and has spread to other parts of your body. This is called the metastatic stage.

Generally the further along these four stages, the more advanced the cancer. Your specialist will certainly discuss how far your cancer has got with you, and often in terms of the stages noted above. Most of the stages have sub-stages. For example, the Tumor stage has different levels depending on the tumor size.

An important feature of a cancer is how far it has mutated vs. how well it remembers its original cell function. If it does remember its original cell function, it becomes easier to treat because the cancer cells will respond well to normal body chemistry, and can therefore be killed by blocking normal cell growth paths (i.e. blocking hormones that the original cells need to grow and thrive via chemotherapy). Another issue is where the original tumor is. A tumor in your brain does not have to get very big before it affects normal function, and a tumor in certain organs (such as your bone marrow) is harder to treat because chemotherapy nor radiotherapy can get to it.

Treatment

Historically, there have been different types of individual treatments, all with some success (but none with 100% success on their own), including tumor removal, disconnection of the affected area from the lymphatic system, chemotherapy, radiotherapy, and long term hormonal drug treatment. Modern treatments combine more than one of these individual treatments so that the success rate is very high. For example for breast cancer, you may get tumor removal and chemotherapy (the exact order dependent on personal preference or the specific cancer), followed by a short radiotherapy course, then a long term (5 years) on Tamoxifen hormonal treatment, and finally regular checkups for life. Having such interleaved treatment vastly increases success rate to the high 90s, and close to 100% for early detection.

Remission

Once you have gone through treatment, you will have tests to find any traces of the cancer. Full remission means no traces of cancer were found. It may mean you are totally clear of cancer, but that is not the same as being totally cured because of the way cancer works. There may still be one or two undetected cancer cells there, which is why you may go on long term hormone therapy such as Tamoxifen: that is targeting the one or two cancer cells that may still be there even though you are in remission. If you have a genetic disposition for cancer, it may mean that there are other pre-cancerous cells in your body, and again, that is what the hormonal treatment is targeting. Finally, a genetic disposition to cancer means that you may get the cancer again. Often the chances are lower than getting it the first time if you get to full remission: you will have died through old age before the thief gets lucky again.

What that all means is that cancer is a lottery, so doctors don’t say ‘cured’, they say ‘in remission’. In practical terms, this means you will have to take regular precautionary tests for the rest of your life. That is not a bad thing: all things being equal, the chances are that you will have lived a long and normal life well before the thief gets to you again.

Photography: Notes

  1. All photographs taken with a Sony A500 DSLR, hand held, natural light, unless otherwise stated. Converted from RAW with DxO Optics, then post-edited in Lightroom.
  2. Some of the shots have extreme depth of field that is greater than that possible on a crop frame camera, and really hard on a full frame camera unless you have very fast and expensive glass. I cheated: it was done in post via Photoshop’s Field blur filter. See here for a youtube tutorial on the process. In addition to this technique, the slight ‘halo’ around the face seen in chemotherapy #2 and chemotherapy #3 is created by increasing the background selection to include about 2-3 pixels of skin. This causes the skin to be part of the field blur and this creates the halo.

 

 

 

Pictures of nice things that grow.

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