Mentos and Diet Coke: What really causes ET?

No, Mentos plus Diet Coke does not cause ET (probably),
but the way Mentos and Diet Coke cause a chain reaction
offers an analogy for how ET mutations might occur.
Click to see a cool Mentos/Diet Coke powered car!

Most ET research focuses on treatment and cure instead of what causes the mutations that lead to ET and other MPNs in the first place. In fact, I only found one such study in the International Journal of Research and Public Health. It was done on a relatively small group of mostly PV patients in Pennsylvania in 2015. You can read the whole thing here if you want.

The gist of the study is this: Researchers theorize there may be both a genetic and an environmental component to ET and other MPNs. Let's call it the Mentos and Diet Coke Theory to make things simple:

Imagine that, among the genes that make up your DNA cocktail, you inherited some Mentos-genes. Not everybody has these particular genes, just as some people don't have the genes for blue eyes and curly hair.

Let's also imagine that there are a lot of substances in your environment ... like Diet Coke. Diet Coke isn't a problem for everyone, just as some people (lucky them!) aren't bothered by pollen at hay fever time.

But your Mentos genes are sensitive to the Diet Coke in your environment, and together they create a chain reaction leading to genetic mutation, and ka-boom, you've got ET or some other MPN!

Exactly which genes and environmental chemicals are involved in the mutations that cause ET aren't really known. The 2015 study did identify a string of genes that looked likely, but for now that needs more research. And the study posited that some compounds like benzene, known to cause other types of cancers, might be the environmental culprits. (FWIW, benzene is everywhere, just about like pollen. It's used in the production of gasoline, dyes, synthetic fibers, rubber, lubricant, insecticides, plastic ... you name it and there's benzene involved in it.)

But whether Benzene & Friends are the specific agents that might lead to ET is unknown.

Also unknown is how exposure to carcinogens might (or might not) contribute to the progression of ET.

Complicating the picture is the fact that three different types of mutations have been discovered in ET patients--JAK2, CALR, and MPL. And some patients are triple-negative, having no known mutation. Would the same Mentos-Diet Coke combination cause all these mutations?

Perhaps one reason that more research isn't done on the root causes of MPN mutation (and the mutations that cause so many other, more common cancers) is because there are so many variables to study. Human beings have something like 24,000 genes. There's also a long list of carcinogenic substances science has identified. (Check out the list, and you'll wonder why you're not already dead.) It's not just a matter of figuring out which substances act on which genes, but how much and over what period of time exposure to those substances has to occur.

So you can see this would be a pretty difficult research job.

And, honestly? If, after several decades of exposure, 1 in 2,300 people end up with ET because they're exposed to a chemical needed to produce gasoline, is it realistic to expect that people are going to ban that chemical? Yeah, that made me laugh, too.

But.

What if the substances that trigger ET and other MPNs aren't just dangers to us? What if the environmental factors that cause our cancer threaten many other people and our planet and we just happen to be extra sensitive to them?

We won't know without more research. So I do hope you'll encourage your doctors, legislators, and the research organizations you contribute to to look not only at cures but at causes for our disease. In the 1960s Rachel Carson imagined a "Silent Spring" in which pesticides had so damaged the food chain that there were no more birds singing. Many of those pesticides have since been banned. We ET patients could be the canaries in the cage that warn the rest of the world about dangers to all.

Be well!

UPDATE 3/30: Really interesting article about known hereditary cancers from the National Cancer Institute. Clearly explains how inherited mutations work and why some people who inherit these mutations don't ever get sick. Again, important to remember that research into what causes the genetic mutations associated with MPNs is still in its infancy.

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