The Lancet in 1963 published my hypothesis entitled “AN INDEX OF THE FATE OF CIRCULATING CANCER CELLS”.¹ Since then, there has been another development based on the strict observation of necrosis occurring among lung cancer cells when they are commingled with red cells in the thoracic duct.² Indeed, the next step was to name, as “Erythrocyte Associated Necrosis Factor” (EANF), the natural explanatory element involved.³

Thereafter, in a series,^4-10 it was repeatedly demonstrated that this Factor is at work in explaining some anomalies detected in the colonization patters of lung cancer. On this account, what of the anomaly of glomerular deposits being relatively rare in lung cancer?

For instance, Willis¹¹ was struck by the common feature of normal glomeruli standing out unscathed among parenchymatous metastases in the kidney? Figure 1 of my original paper. Let us go back to the 1842 original work of Bowman.¹² He argued thus: “Hence must arise a greater retardation of the blood in the (glomerular) tuft, then occurs probably in any other part of the vascular system; a delay that must be increased by the tortuosity of the channels to be tranversed.” Note the words, “retardation” and “delay.” These phenomena must increase the commingling of cancer cells and red cells, i.e., the very essence of that Factor which I named as EANF.

Figure 1 Two arrowed unscathed glomeruli immersed in secondary growths.

As in other bodily curious compartments, such as the superior vena cava⁷ and the spleen,¹³ the natural role of the Erythrocyte Associated Necrosis Factor is an explanatory hypothesis. It contributes further light on the fate of the circulating cancer cells which interested the medical masters of yester years.¹⁴ I am persuaded that the dollar supported Translational Laboratories should be able to identify this Factor.¹⁵ As in the old days, bleeding was the bane of mankind until the Coagulation Factor¹⁶ was identified. And may it be so with breakthrough in EANF targeting!

None.

The authors declare no conflicts of interest.

None.

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2. Onuigbo WIB. The carriage of cancer cells by the thoracic duct. Br J Cancer. 1967;21(3):496–500.
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11. Willis RA. The spread of tumors in the human body. Butterworths, London, England, 1952. p. 197.
12. Bowman W.  Structure and the use of the Malpilghean bodies of the kidney. On the observations on the circulation through the gland. Philosophical Transactions of the Royal Society of London 1842;132(1842):57–80.
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16. Laurence DR. Clinical Pharmacology, (6th Edn), Churchill Livingstone, London, England, 1987. pp. 567–570.