3 ms·

"Cancer" isn't a single disease or problem domain, but what could be categorized as a syndrome that shares some basic commonalities. The governmental "War on C

by fallous 11y ago

"Cancer" isn't a single disease or problem domain, but what could be categorized as a syndrome that shares some basic commonalities. The governmental "War on Cancer" began under Nixon and was pitched as a "moonshot" type of program, which promptly ran aground on the realities of cancers. If only there were some sort of documentation for this kind of effort... perhaps they could call it "The Emperor of All Maladies" or something.

Outdoorsman 11y ago
Excellent PBS documentary you ironically refer to... http://www.pbs.org/show/story-cancer-emperor-all-maladies/ http://www.pbs.org/show/story-cancer-emperor-all-maladies/ Quite a beast to conquer, for the reason you stated...errant DNA replication, probably the single most powerful software on Earth, gone beserk... Obama's "moonshot" reference likely refers to a proposed attempt at re-centralizing the efforts of earlier research projects, to consolidate and benefit from known gains... "Moonshot" is probably simply the hyperbole choice of a speechwriter, designed to inflate the magnitude and importance of the endeavor...
- adenadel 11y ago
  The book is excellent as well http://www.amazon.com/Emperor-All-Maladies-Biography-Cancer/dp/1439170916/ http://www.amazon.com/Emperor-All-Maladies-Biography-Cancer/...
  - ggreer 11y ago
    For those interested in reading this book: Your mileage may vary. I wanted to like it, but I couldn't get over the writing. It had so many flourishes and unnecessary descriptions that I stopped reading halfway through.
nonbel 11y ago
>'"Cancer" isn't a single disease or problem domain, but what could be categorized as a syndrome that shares some basic commonalities.' Cancer is characterized by having cells with an abnormal number of chromosomes and genetic instability. It is one disease. I don't know the origins of it, but this "many disease" claim sounds like an excuse for lack of progress in targeting aneuploid cells. "In contrast to normal cells, aneuploidy--alterations in the number of chromosomes--is consistently observed in virtually all cancers." https://www.ncbi.nlm.nih.gov/pubmed/15549096 https://www.ncbi.nlm.nih.gov/pubmed/15549096
- fallous 11y ago
  Of course cancer is a result of genetics gone amok, but that's about as useful as saying that death is caused by hypoxia... of course it is, all death is the result of lack of oxygen to the brain. Cancer as a disease, in its expression, effects, and treatment, is not a monolith and has been utterly resistant to attempts to treat it as such.
  - nonbel 11y ago
    If you could count the chromosomes in every cell of a patient's body and specifically kill cells with/without certain numbers, you could cure the cancer. For practical purposes it is one disease with a single identifying characteristic and molecular target. Only technical limitations are preventing a cure. No disease manifests exactly the same way in every person, so I don't get the point of calling cancer multiple diseases.
    - jack9 11y ago
      > you could cure the cancer Or you could vaccinate against a virus and prevent the cancer. Not all cancers need to be attacked the same way.
      - nonbel 11y ago
        >"Not all cancers need to be attacked the same way." Ok, but what does that have to do with the (apparently new) idea of calling cancer "multiple diseases"?
    - dnautics 11y ago
      Not all cancers have obvious chromosomal aberrations
      - nonbel 11y ago
        I was very surprised to learn a few years ago that this is <10%, possibly much less depending on measurement error (see my ref above). So then there are two diseases: Aneuploid cancer (>90%) and non-aneuploid cancer (<10%).
dnautics 11y ago
I'm not a huge fan of "war on x" mentality, and even less of government funding these scientific endeavors in general, but it's hard to argue that we haven't made progress fighting cancer. Much of the improvement in treatments have hit the common clinic in the last ten years. A reasonable goal, say, being able to put ~80% of patients who present with cancer into remission, seems possible in the next 20 years, loftier goals, say 95% or "80% with nearly no side effects", I think will be hit by 50 years.
gozur88 11y ago
That's a very enlightening and depressing book.

by fallous 11y ago

Outdoorsman 11y ago

Excellent PBS documentary you ironically refer to... http://www.pbs.org/show/story-cancer-emperor-all-maladies/ http://www.pbs.org/show/story-cancer-emperor-all-maladies/ Quite a beast to conquer, for the reason you stated...errant DNA replication, probably the single most powerful software on Earth, gone beserk... Obama's "moonshot" reference likely refers to a proposed attempt at re-centralizing the efforts of earlier research projects, to consolidate and benefit from known gains... "Moonshot" is probably simply the hyperbole choice of a speechwriter, designed to inflate the magnitude and importance of the endeavor...

adenadel 11y ago
The book is excellent as well http://www.amazon.com/Emperor-All-Maladies-Biography-Cancer/dp/1439170916/ http://www.amazon.com/Emperor-All-Maladies-Biography-Cancer/...
- ggreer 11y ago
  For those interested in reading this book: Your mileage may vary. I wanted to like it, but I couldn't get over the writing. It had so many flourishes and unnecessary descriptions that I stopped reading halfway through.

nonbel 11y ago

>'"Cancer" isn't a single disease or problem domain, but what could be categorized as a syndrome that shares some basic commonalities.' Cancer is characterized by having cells with an abnormal number of chromosomes and genetic instability. It is one disease. I don't know the origins of it, but this "many disease" claim sounds like an excuse for lack of progress in targeting aneuploid cells. "In contrast to normal cells, aneuploidy--alterations in the number of chromosomes--is consistently observed in virtually all cancers." https://www.ncbi.nlm.nih.gov/pubmed/15549096 https://www.ncbi.nlm.nih.gov/pubmed/15549096

fallous 11y ago
Of course cancer is a result of genetics gone amok, but that's about as useful as saying that death is caused by hypoxia... of course it is, all death is the result of lack of oxygen to the brain. Cancer as a disease, in its expression, effects, and treatment, is not a monolith and has been utterly resistant to attempts to treat it as such.
- nonbel 11y ago
  If you could count the chromosomes in every cell of a patient's body and specifically kill cells with/without certain numbers, you could cure the cancer. For practical purposes it is one disease with a single identifying characteristic and molecular target. Only technical limitations are preventing a cure. No disease manifests exactly the same way in every person, so I don't get the point of calling cancer multiple diseases.
  - jack9 11y ago
    > you could cure the cancer Or you could vaccinate against a virus and prevent the cancer. Not all cancers need to be attacked the same way.
    - nonbel 11y ago
      >"Not all cancers need to be attacked the same way." Ok, but what does that have to do with the (apparently new) idea of calling cancer "multiple diseases"?
  - dnautics 11y ago
    Not all cancers have obvious chromosomal aberrations
    - nonbel 11y ago
      I was very surprised to learn a few years ago that this is <10%, possibly much less depending on measurement error (see my ref above). So then there are two diseases: Aneuploid cancer (>90%) and non-aneuploid cancer (<10%).

dnautics 11y ago

I'm not a huge fan of "war on x" mentality, and even less of government funding these scientific endeavors in general, but it's hard to argue that we haven't made progress fighting cancer. Much of the improvement in treatments have hit the common clinic in the last ten years. A reasonable goal, say, being able to put ~80% of patients who present with cancer into remission, seems possible in the next 20 years, loftier goals, say 95% or "80% with nearly no side effects", I think will be hit by 50 years.

gozur88 11y ago

That's a very enlightening and depressing book.