How can a person give themselves cancer?

February 13, 2013 11:05 AM

Hypothetic/literary filter: Book character is looking for ways to die that are self inflicted, but would like it to seem like a deadly disease, but one that kills over a period of about 6 months. All I can come up with are nitrosamines but I don't think that is a sure thing. Any ideas?

Are there substances that can reliably cause cancer or some other illness? Bacterial/viral/etc might also be okay. This is for a story. Thanks!

posted by htid to Health & Fitness (26 answers total)

Exposure to radiation will eventually cause cancer, but I don't know if that's reliable or timeable.
posted by xingcat at 11:07 AM on February 13, 2013

Is this a contemporary story? If not, long-term arsenic poisoning could work as we had a hard time detecting it postmortem until fairly recently.
posted by griphus at 11:08 AM on February 13, 2013

Here's a list of respiratory diseases caused by chemicals.
posted by xingcat at 11:10 AM on February 13, 2013

Polonium poisoning isn't only/always cancer but I think it would suit your purposes very well!
posted by Iteki at 11:11 AM on February 13, 2013

Benzene and asbestos are very reliable carcinogens. DNA stains used in biomedical applications are said to be carcinogenic, but others are skeptical.
posted by Blazecock Pileon at 11:11 AM on February 13, 2013

Response by poster: Some clarifications: must be undetectable, and it's a modern story. The idea is that the person wants to commit suicide, but doesn't want to hurt her family, so she poisons (?) herself to inflict a disease whose course is about 6 months. That gives her family enough time to get used to the idea.
posted by htid at 11:13 AM on February 13, 2013

Massive doses of acetaminophen can totally destroy your liver, causing liver failure that will kill within a months-long timeframe.
posted by Tomorrowful at 11:14 AM on February 13, 2013 [1 favorite]

(My dad used to collect stamps back in the late 1950s-early 1960s, when benzene was used by collectors to dissolve the adhesive attaching stamps to paper. Afterwards, after the solvent had evaporated, he'd lick the "dry" stamp and put it in his album. I'm crossing my fingers that he won't ever get sick from that. Benzene is also released into the atmosphere from combustion of gasoline and other organics. It's pretty nasty stuff and exposure is tied to increased leukemia incidence.)
posted by Blazecock Pileon at 11:15 AM on February 13, 2013

I assume this has to hold up to some level of scrutiny? I don't think Polonium would be great because it would be a lot of work to get hold of Polonium and you'd probably leave some kind of trail. I think something that damages the kidneys (or liver, as Tomorrowful suggests) would be a good bet. But then she'd have to explain how she got poisoned (i.e. "Why did you try to kill yourself by taking all that Tylenol?").

This is pretty tricky... anything that will *probably* kill you in *about* six months also has a very good chance of killing you much faster or not killing you for years or not killing you at all. Very few diseases are invariably fatal.
posted by mskyle at 11:17 AM on February 13, 2013

The idea is that the person wants to commit suicide, but doesn't want to hurt her family, so she poisons (?) herself to inflict a disease whose course is about 6 months. That gives her family enough time to get used to the idea.

Considering that symptoms will show up long before death, will they send her to the doctor? Will there be an autopsy? A cause of death of this sort that is completely undetectable by modern medicine pre- or post-mortem is rare, and much rarer still if it needs to be a sustained poisoning (that guarantees death) and not just a one-time deal.
posted by griphus at 11:21 AM on February 13, 2013

Rabies? If she got it and didn't seek treatment, she'd die, but it could take anywhere from 2 weeks to 6 years.
posted by showbiz_liz at 11:24 AM on February 13, 2013

Sleeping sickness is another one that is invariably fatal if not treated, and is about the right timeline (within six months); if she could contract it without visiting a tsetse-fly-infested area doctors wouldn't be looking for it and might miss it and not treat it? I don't know how you could infect yourself without going to Africa though.
posted by mskyle at 11:34 AM on February 13, 2013

You could have her take a staggered overdose of acetaminophen (Tylenol), which she could easily explain away by just saying she was taking it for headaches.
posted by thewumpusisdead at 11:38 AM on February 13, 2013

Could gene therapy techniques be used to introduce cancer, maybe?
posted by XMLicious at 11:50 AM on February 13, 2013

Best answer: Thallium poisoning would be perfect for this.

Benzene and asbestos would not, and neither would most other chronic environmental hazards. Some people get sick from exposure, and some die, but I've also met plenty of older gentlemen in apparently perfect health who enjoy telling me about the time they installed fluffy asbestos on all the pipes in their facility, or how they grew up chewing asbestos because they couldn't afford chewing gum. (Actual examples.) Also, most forms of asbestos-related illness crop up on a much longer time scale, which is one of the reasons it's so problematic.
posted by pie ninja at 11:55 AM on February 13, 2013 [1 favorite]

Attempted murder by selenium poisoning [PDF]. Notably, this was not caught even when poisoning was first suspected, becuase the patient was at that time screened only for arsenic and thallium poisoning.

I'm not sure about the excretion rate for excess selenium, though—it may not build up in the body enough over the time frame of the very slow sort of poisoning you're trying to find. In fact, the details from the article that the patient recovered in a matter of days after the selenium exposure ceased suggests that it probably doesn't.
posted by DevilsAdvocate at 12:01 PM on February 13, 2013

The character can poison him/herself by inhalation of beryllium, to induce acute beryllium disease. This can present in a number of ways but there is no specific test for beryllium disease so it is often overlooked as a cause, especially if the patient is not in one of the typical at-risk industries (and presumably the character would not report some of the symptoms, such as "metallic taste"). As long as your character can keep inhaling beryllium on the sly, they won't get better and they will die. It also allows for the character to throw people off the trail, i.e. they can reduce exposure for a time to make it seem like some treatment is working then go back to increasing exposure. It's going to be pretty painful though. If they can induce tachycardia (high heart rate) they can add in some intense physical activity to possibly put them over the edge sooner.
posted by mikepop at 12:04 PM on February 13, 2013 [1 favorite]

According to Wikipedia: "After the diagnosis of AIDS, if treatment is not available, survival ranges between 6 and 19 months."
posted by Green With You at 12:14 PM on February 13, 2013

However (also according to Wikipedia) the time between HIV infection and the development of AIDS, without treatment, is 3-20 years, with an average of 8 years.
posted by DevilsAdvocate at 12:33 PM on February 13, 2013 [1 favorite]

Can she simply feign illness for six months and then kill herself? That's one way around your predicament. I think the father in Royal Tennanbaums did something like this.
posted by k8lin at 12:40 PM on February 13, 2013 [3 favorites]

Also, does it have to be non-reversable, even if she has second thoughts around month five? Because with all these awful heavy-metal poisonings, it's possible to recover fairly late in the game if you receive appropriate treatment.

Taking pie ninja's point a little bit further, I don't think anything carcinogenic (except maybe straight-up direct high-dose exposure to radioactive materials, a la the Curies or the Radium Girls) is reliable enough. Cancer is a real crapshoot.
posted by mskyle at 1:08 PM on February 13, 2013

Benzo(a)pyrene might be worth a look.
posted by Good Brain at 3:58 PM on February 13, 2013

This might be instructive. If I remember from the time, the reason the attempt failed was because this poison needed to be administered over time. He got it in one huge dose, so it wasn't able to do as much damage.

The other best way would be to get an alpha emitter and start a-inhaling. (I've even heard that this is the method by which tobacco causes lung cancer. That there is a statistical certainty that there are going to be alpha emitters in the occasional tobacco plant, and once you inhale one it can wreak havoc.)
posted by gjc at 4:27 PM on February 13, 2013

She could go to different Ers and fake flank pain and hematuria so the would scan her for kidney stones. Enough scans would definitely increase your risk significantly.

For the record, Tylenol overdose is horrible and you would get acutely sick and have to go to the er where they would heck your Tylenol level.
posted by mockpuppet at 8:11 PM on February 13, 2013

I agree, mockpuppet, with your point that Tylenol overdose is horrible, and depending on the dosing, you could definitely kill yourself immediately with it by inducing liver failure (rather than on the 6 month timeframe that was specified). However, the symptoms are nonspecific early on i.e. nausea, vomiting, abdominal pain and unless you revealed that it was Tylenol overdose by telling a doctor, it's unlikely that someone would check a Tylenol level until you were manifesting symptoms of liver failure, at which point it could be too late to either use an antidote or even pick up any level of Tylenol on the bloodwork. Chronic poisoning with Tylenol or aspirin is also quite different from acute poisoning - again it depends on the dosing.

That's true of a number of the above poisoning-related answers, so the criticism that the character would have to explain why he/she poisoned him/herself isn't necessarily valid. There are a lot of reasons why a person can get kidney/liver failure, and as long as the drug is metabolized quickly enough, the reason for the damage will not be clear even if testing is done. If the poisoning presents with nonspecific symptoms then you really would need to have a reason to suspect that the case is a poisoning before you would check toxicology labs. Doctors aren't actually like "House MD", and don't always assume the patients are lying to them, unless there is some information that leads them to that suspicion.
posted by treehorn+bunny at 11:38 PM on February 13, 2013

Treehorn-for the record, Tylenol is a standard drug on a serum tox screen which is done often for patients in ERs when their stories don't really add up and their symptoms are confusing. I think if you tried to poison yourself with Tylenol you'd feel so horrible that you would regret it and confess. You could still die though.
posted by mockpuppet at 10:27 PM on February 16, 2013