14 ms·

By 2012, scientists will have announced a cure for breast cancer (2006)

59 points by breck 6y ago

gadf 6y ago
No money in that, unfortunately. Or, not enough anyway. This might be a false notion, but I'm scared that the economics simply don't work to "cure" a major disease. It's more profitable financially to provide treatment to sick people. I hate this...yet am scared it's true. Another notion I hate and are am afraid is true is that: even if corporations were prepared to cure cancer and take the hit, the state would be terrified of increased longevity, at least I think so. Retirement age people are to the state, probably, what post-reproductive organisms are to evolution: dead weight that they can't "afford" to care about. In these areas I think the incentives might be wrong, but we can probably too better somehow. No idea how that can be corrected tho... :'(
- Blikkentrekker 6y ago
  Cancer does not so suitable a target for this, as say, h.i.v. infections. Cancer is not contagious, and something that is treated in the individual case by curing it. The “cure for cancer” would thus simply be a more effective treatment than what is available now. This is fundamentally different from h.i.v. infections, where a patient is a lifelong client, and a cure would amount to a type of treatment that would indeed completely cure the patient of the infection, and thus terminate the client.
- wonnage 6y ago
  I think what might be more likely is that if today's terminal illnesses are managed, we'll simply move the retirement age later and keep people working into their 70s.
  - gadf 6y ago
    I'm not sure that's exclusive with what I'm proposing but I definitely think that will happen and is happening even now. I'd be kind of okay with that world where the incentive to cure people is that we can extract more productive work years from them. It's kind of cynical but I think there's a lot of good probably to be had there as well and it's a step perhaps in the right direction anyway. Even if it's not that great on the face of it.
- cfn 6y ago
  It is hard to believe that there isn't enough money in it. Breast cancer has a thriving industry of surgeries to remove the cancers plus reconstruction surgery plus a number of treatments associated with these surgeries. They easily run into the tens of thousands of euros a pop (if you go private in Europe, I suppose higher in the US).
  - gadf 6y ago
    I suppose you're right. But I don't necessarily think that's evidence against what I'm saying in fact I think it speaks to what I'm saying which is that curing is inherently not that profitable so there's an incentive to kind of spring up a variety and a proliferation of industries around that so that now you have you know all sorts of support services for you know remission stage or cured breast cancer survivors. I'm pretty sure that's interacting with the fact that a surgery that completely removes and cures the cancer is probably cheaper than a long-term treatment option.
- mft_ 6y ago
  You’re verging into conspiracy territory a little too much here. Truth is, there are good economic reasons to cure a disease or cancer: because the cure can be priced according to its (great) value. Quick examples include: * Hepatitis C - can now be cured in ~95% of cases. When the various drugs were released, they made many billions for the manufacturers, as the economic case for their use was clear. * previously-untreated DLBCL (a type of lymphoma) - can be cured in ~2/3rds of patients, and many trials are ongoing (and have been run previously) to try to push this percentage higher. A treatment adding extra cures would be valued highly.
  - gadf 6y ago
    the power of that phrase conspiracy theory is amazing. As soon as I read it I started to doubt my conclusions and I was very open to what you were saying. I think because of its power such a phrase must be regarded with suspicion. I don't think it actually carries any weight in an argument, it's more of a psychological trick... like shaming, like "oh I don't want to be a conspiracy theorist because they are crazy people and if I'm a crazy person then I can't possibly be right so I better agree with what this person accusing me of being crazy is saying otherwise I'll be crazy..." and while I like your points I think the other analysis provided in other comments is also valid. If you're using that conspiracy theory phrase I think either you're verging a little too much into below the belt territory there or maybe you doubt the point you're making so you are compensating for it with this dirty psychological trick. I'm not saying that's how it is for you that's just how it comes across for me.
- unishark 6y ago
  The incentives for market-based research aren't wrong, but they do have a limit. Investors aren't going to spend ten billion dollars on research to find a cure they expect to make only one billion dollars profit from. They aren't running charities. Many other people are running charities, of course, especially for cancers. If you want to help fund them you can. Many people do. The govt also funds a ton of research. As for the motivation to not pursue a profitable cure because you'd rather make more money from treatments, this isn't really the options you get to choose from. The real game they play is to choose either to find and sell the cure if one exists, or to sit back and watch the just-as-smart competition find and sell that cure instead of them. Their profitable treatment loses out either way. Cancer affects many many people who are healthy otherwise and would have had many more productive years. It isn't just a disease of old age. Especially breast cancer. Either way, elderly folks are the most prolific voters, so there's the incentive situation for the govt.
  - codeflow2202 6y ago
    I'd love to believe in this free market utopia where the end result is always in the best interest of the community. In reality it's well known that companies rely on cartels to protect their shared interests. We can't know if pharmaceuticals are actively holding back any cure but it would be naive to completely trust organizations which only need to answer to their shareholders.
  - gadf 6y ago
    I'd say pretty clearly if you hold back a cure for breast cancer because you can't get investors to put in 10 billion dollars when you're going to make one billion on it but long-term treatments for breast cancer at various stages they're going to make 100 billion on that 10 billion I'd say pretty clearly the incentives are wrong in that case. Because you're enabling research through investment which judges value purely on a monetary basis but it's ignoring the value of human life. So I'd say pretty clear that it's not just a case of the incentives having a limit, the incentives are wrong in that case.
- satellite2 6y ago
  I think it's a fallacy to say that pharmaceutical financial interests are not aligned with actually effectively curing diseases. First, when they cure a disease we don't sudenly become immortal, it improves our life quality and expectancy and new diseases become more prevalent at a later stage, so they don't lose their jobs. Second, even if slowing down research could effectively allow them to benefit longer from existing cures, generally you have competitors and inertia tends to not work well in adversarial conditions.
  - jjk166 6y ago
    The argument is that it's more profitable to sell a pill you have to take every day for an extended period of time (or forever) than it is to sell a pill you only have to take once (or a small number of times). Recurring revenue is generally more desirable than a lump sum. There's still a strong incentive to make the disease manageable. It has nothing to do with saving money on research or keeping their jobs.
    - satellite2 6y ago
      That's what the second argument answers to. If your competitor produce a one time treatment then he wins the entire market.
      - jjk166 6y ago
        That doesn't logically follow. Why would a one time treatment win the market? Lasik is a one time treatment that certainly hasn't eliminated the market for daily contacts. The ability to buy a house hasn't eliminated the market for renting. The one time treatment has to pay for its development in a single dose, the recurring treatment can amortize its costs over many doses. In general, you will have to pay a premium for the convenience of a single dose, and many people can't justify that cost.
        gadf 6y ago
        That's a really good point about lasik. Great example thank you. But at the same time I guess it cuts both ways because lasik exists. but what I'm specially worried about is that cures might be designed to not be perfect so that maybe you need to buy them again in 15 years or something just like a light bulb they can make perfect light bulbs but they design them to be obsolete so they can sell more. Why would not the same economics operate in the pharmaceutical industry I think it's a tragedy that it might when they should stick with their hippocratic principles.
- chefkoch 6y ago
  If all drug companies were a cartel you'd be right, but If a single company could provide a cure they would wipe everyone out of that market and could charge enormous sums. For example BMS had recently a CAR-T therapy approved by the FDA for myeloma, wich is not a cure yet. But the list price is $419 000. https://www.fiercepharma.com/marketing/bristol-myers-bluebird-bio-have-their-bcma-car-t-nod-but-latecomer-j-j-could-have https://www.fiercepharma.com/marketing/bristol-myers-bluebir...
  - dmos62 6y ago
    Does national insurance pay for something like that in US? Unless this is paid in taxes, the price is exorbitent.
    - chefkoch 6y ago
      I don't know yet it was approved some days ago, but i guess yes. Cancer meds are really expensive, a four month cycle in myeloma ( where most of the time 2/3/4 drugs are combined) can cost more than 250k. Revlimid, a maintainance drug often given for years can cost 20k a month (in India it's $150 a month).
  - jjk166 6y ago
    The whole premise of the notion is that managing the disease is more profitable than curing it. So it is not the ones who develop a cure that wipe everyone else out of the market but rather the other way around. Consider a disease has an effective daily pill treatment where each pill costs $.50 to make. Someone comes along with a single pill that costs $1000 to make but cures you. The cure developers have just spent a lot of money on R&D and need to make a profit on the administration of the cure, so they need to price it significantly over their production costs. The established treatment on the other hand has a war chest and can recoup short term losses in the long run, so they can afford to drop their prices or even give it away for free for a limited time. Perhaps some segment of the population will pay a hefty premium just for not having to deal with the hassle of treatment, but most people don't have thousands to spend on such a luxury and will stick with the option they can afford right now, even though it will wind up costing more over the course of their lifetime.
- drdec 6y ago
  > This might be a false notion, but I'm scared that the economics simply don't work to "cure" a major disease. It's more profitable financially to provide treatment to sick people. Others have provided nice arguments as to why this isn't necessarily so, but allow me to add one more that is (I hope) more likely to appeal to a cynic. This is one area where the corporate focus on short-term profits is actually working to the long-term benefit of humans. While it would be more profitable in the long run to sit on a cure and continue to sell therapeutics indefinitely, what CEO could resist the stock-boosting effect of a cure for a major disease? What a time to exercise your options! Long-term profitability is a problem for the next guy.
  - simias 6y ago
    I agree, I always thought that the idea that "big pharma" would be actively suppressing miracle cure for long term profit is rather improbable. There's the reason to point out (why pass the opportunity of a huge short term profit?) but also for these types of diseases there's bound to be a high ranking officer within the company who either directly suffers from the illness or has a close family member who does. I doubt that they'd let themselves or their wives die for the sake of getting a nice +3% to benefits ten years down the line.
    - gadf 6y ago
      now I think you're being too naive. In that case they purchase employees corporation with their evil scheme by providing them with the cure of course.
  - gadf 6y ago
    I like that idea that's really good that is a good counter argument thank you.
Blikkentrekker 6y ago
I find it unlikely that any cure for cancer would be so specific that it would work on breast cancer only. Much of the rhetoric that surrounds breast and prostate cancer irks me as though it be more rooted in identity politics than medicine. — I don't think such a specific claim would easily be made about, say, colon cancer or leukæmia.
- jwdunne 6y ago
  Why? Breast cancer is cancer of the breast tissue. It’s a different disease to prostate cancer, which is again a different disease to colon cancer and leukaemia. That’s why there probably won’t be a universal “cure for cancer”. Breast or prostate cancer are the most common cancers in women and men respectively. No matter what you identify as, if you have either breast or prostate tissue, there’s a real risk to most people. That’s why we hear about it more. We don’t hear as much about mesothelioma because it’s rarer. I don’t think it has anything to do with identity politics and everything to do with the medicine.
  - sterlind 6y ago
    As an example, Gleevec has turned CML from a terminal cancer into a chronic, manageable condition for most patients. Life expectancy for CML is nearly the same as the general population now. [0] But Gleevec doesn't work on prostate or breast cancer. Cancers happen when mutations in a cell cause it to proliferate uncontrollably; the genetic circuits that need to be activated differ by cell type. For instance, prostate cancer can be treated with anti-androgens, since testosterone is required for prostate cells to reproduce. The cancer can evolve to resist anti-androgen therapy by mutating the androgen receptor so it's always stuck on. It's all circuits, and all the circuits are different. 0. https://academic.oup.com/jnci/article/103/7/553/2517175 https://academic.oup.com/jnci/article/103/7/553/2517175
  - Blikkentrekker 6y ago
    > Why? Breast cancer is cancer of the breast tissue. It’s a different disease to prostate cancer, which is again a different disease to colon cancer and leukaemia. Yet most cancer treatment at the moment is not so specific. The exact same drugs are used to treat many different forms of cancer[1]; lukæmia is indeed treated with the same drugs as breast cancer is. > Breast or prostate cancer are the most common cancers in women and men respectively. The most common form of cancer is lung cancer[2], and while breast cancer takes a second place, prostate cancer is fairly low down the list at 5. Furthermore, in terms of lethality, both take a rather strong backseat to many other forms[3] > I don’t think it has anything to do with identity politics and everything to do with the medicine. I see no evidence for your claim that breast cancer is so fundamentally different and the link I posted indicates that the same treatments are very much used for different locations of cancer. - [1] https://medlineplus.gov/ency/patientinstructions/000910.htm https://medlineplus.gov/ency/patientinstructions/000910.htm - [2] https://www.wcrf.org/dietandcancer/cancer-trends/worldwide-cancer-data https://www.wcrf.org/dietandcancer/cancer-trends/worldwide-c... - [3] https://www.cdc.gov/cancer/dcpc/research/update-on-cancer-deaths/index.htm https://www.cdc.gov/cancer/dcpc/research/update-on-cancer-de...
lsb 6y ago
We don't have a cure for breast cancer, but we do have a cure for cervical cancer, especially now that we know that's caused by a virus (hpv). And, we have generics to prevent HIV infection, and we have promising new mRNA therapies, that were in development (with woefully little funding!) at U Penn, when this bet was being placed! Perhaps this is unwarranted optimism in the specific case, but as a broader expression of hope in future scientific progress, the long bet wins.
- jillesvangurp 6y ago
  There are more types of cancer than we have organs. The practice of naming cancers after where they are found is maybe a bit misleading. Especially since the aggressive/deadly varieties tend to spread through the body. Some cancers are very treatable at this point. The hard part is usually classifying them correctly and before they do a lot of damage. Breast cancer sounds more specific than it is. The reason it's such a common location for cancer and why it used to be so deadly is that they are connected to the lymphatic system, which how a lot of aggressive cancers spread through your body. Generally very treatable but some varieties still kill young women. Fun fact, the Pfizer corona vaccine was developed by Turkish-German women who has been working on developing a solution on fighting cancer with basically an mRNA vaccine. She pivoted to tackling corona last year but is looking to get back to tackling cancer. https://www.nytimes.com/2020/11/10/business/biontech-covid-vaccine.html https://www.nytimes.com/2020/11/10/business/biontech-covid-v... 2012 was maybe a bit optimistic but the last year has shown we can get results in under 12 months if the stakes are high enough.
  - whizzter 6y ago
    I think that the mRNA vaccines success will lead to a huge influx of universities/investors sponsoring mRNA research and techniques since they see it as something viable now(possibly initially a negative if it means less sharing). Now combine that with decreasing DNA sequencing costs, it should put us on a path where the feasibility of cancer sequencing as a standard method of _exact_ identification and mRNA treatments targeting those identified exactly becomes standard fare within a few years (even if there probably is a bunch of cancerous mutations the number should be somewhat restricted considering much of the risks are hereditary).
christopherham 6y ago
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xvector 6y ago
Can we please just shift the bulk medical research funding to problems like gradual replacement for eventual consciousness upload, so we can “solve” all biological diseases in one go? Seems woefully inefficient to tackle ten thousand independent fatal ailments - and fund each effort separately - when we could be working on abandoning this frail form entirely.
- AnimalMuppet 6y ago
  It seems likely to me that solving breast cancer is easier/quicker than solving consciousness upload. If we do what you propose, a lot of people are going to die from breast cancer while we're waiting for upload to get here.
  - xvector 6y ago
    Still, solving upload is likely much easier than solving the thousands of different fatal ailments out there altogether. These individuals are going to die of some ailment within a few decades regardless of whether breast cancer is cured. Consciousness upload is the only thing that enables a real difference for humanity.
    - AnimalMuppet 6y ago
      If consciousness upload is actually practically possible. But even if it is, it's a long ways out. Even if you can't save them all, even if you can't save them permanently, don't just ignore trying to make progress on diseases that are killing real people now. Don't chase your wonderful dream to the exclusion of real progress that is definitely available if we put resources on some of those thousands of problems.
lez 6y ago
To put in context what "we have a cure for cancer" means: In 1993 Prof. Dr. Somlyai has discovered that cancer cells cannot tolerate low-deuterium environments (as low as 100 ppm). There is solid science behind. He and his workmate, Prof. Dr. Boros even buy the publication fee for their own scientific papers to make them available to the general public because they are open to recieve scientific criticism. The idea of deuterium depletion manifested in a therapy using deuterium depleted water, which is drank regularly or injected directly into tumors. It has been approved for animals and being used in therapy since 15 years with great success. The human experiments have succeeded to demonstrate that mentioned water significantly improves acute survival rate, and survival rate is significantly better after 1 year of treatment. The authorities have declined to approve its use in humans because there were no significant improvement in survival rate after 3 years of treatment. So "we dont have a cure for cancer". Life, since eucaryotic cells have appeared, thrive to deplete deuterium levels inside mitochondria because deuterium kills atpase enzyme, which produces the energy for the whole body. One method of doing this is to keep procaryote cells and fungi in the gut, which in turn tend to concentrate deuterium, which is required for their genes to multiply. Feces is therefore richer in deuterium, getting the body levels lower. Ocean deuterium level is 155. When the water evaporizes, the steam has 2.5% - 4% less deuterium as the water. The cloud then moves around, and rains the deuterium-richer water first, leaving the deuterium depleted rain for the end. When clouds form around the equator, and they quickly fall in the form of summer thunderstorms, they tend to be higher in deuterium. But if the clouds form, move around through the poles, then back to 45 degrees latitude, they can reach the 130 ppm, which is tremenduosly good for mitochondria. We know that cancer is less prevalent as we go closer to poles. The consequence of mitochondria having low deuterium levels is that they produce citric acid with low deuterium content, which later turns into fat. That's why lard has 118 ppm deuterium in it, which generally means that eating a ketogenic diet of such fats (and drinking as little water as needed) is super efficient in depleting deuterium in the body. It takes 2-3 months to reach the equilibrium of deuterium levels after a change in diet/lifestyle. The Wartburg-effect might be a consequence of this. ppm is parts per million, which labels how many deuterium isotopes are present for 1000000 hydrogen atoms. So oceans have roughly one deuterium-containing water molecule every 6600 water molecules. The above is basically what I understood researching the topic, please google Somlyai and Boros for more.
medstrom 6y ago
If you want to make your own long bets (no money, but fun), hop on over to https://predictionbook.com/ https://predictionbook.com/. Actually many short bets are better for calibrating yourself. Gwern writes about it: https://www.gwern.net/Prediction-markets#predictionbook-nights https://www.gwern.net/Prediction-markets#predictionbook-nigh...
- tnorthcutt 6y ago
  http://metaculus.com/ http://metaculus.com/ is another site in this vein
  - medstrom 6y ago
    Thanks!
PaulHoule 6y ago
I am amazed nobody challenged that one. People have had unrealistic dreams to cure cancer at least since Nixon. It isn't really one disease so it is a safe bet that 'cancer' will endure even if many subtypes were eliminated. If there is any place where people use science and technology as a religion it is the treatment of deadly diseases. People are always going to have psychological needs that they'll try to address by putting up pink ribbons on everything.
- rtkwe 6y ago
  I'm not sure Long Bets was as well known back then.
  - shagie 6y ago
    Glance at the single and double digit bets... and who was betting (and commenting) on them. https://longbets.org/1/ https://longbets.org/1/ https://longbets.org/8/ https://longbets.org/8/ https://longbets.org/30/ https://longbets.org/30/ And so on. It was well known when it started. It got boring as people used it to pitch business plans and drugs by making poorly thought out "predictions" about them.
- Delk 6y ago
  Finding a cure for cancers originating in a particular organ is at least somewhat narrower than finding a "cure for cancer", and as such probably not quite as unrealistic. You're still right, of course, since there are still (probably, haven't checked) multiple different kinds of breast cancer, and also because no cancer is curable if it has spread wide enough. Testicular cancer nowadays has cure rates of 90 to 95 percent or so (close to 100% for certain types, above 80% for others), thanks to chemotherapy that happens to be very effective against those kinds of tumours. So it's not an entirely unrealistic idea that you could find a cure that works in a large majority of cases if you limit yourself to something narrower than "cancer". Of course how easy or difficult or realistic it is to find that kind of a cure even for a more limited range of cancers still depends on the type of cancer and whatever other factors there are, because, well, it is a bunch of rather different disease.
shagie 6y ago
When it started, there are some rather interesting bets - go and look at the single and double digit bet numbers. Especially look at the qualifications of the rebuttals and their quality... and that the quality of the predictions are also up there. Then... I want to say that they got really boring for a while as various people were using it to pitch their own business. I recall one that was about shipping fresh water somewhere via long plastic tubes on the ocean... and the predictor had a company that he was trying to get funding for to ship water on the ocean via large plastic tubes. This bet falls into the same category of boring, pitching a product (a particular drug). Unfortunately, Long Bets has moved from interesting wagers about the future of people and trying to get people to think about time scales beyond the next few years to something longer - as part of the Long Now foundation ( https://longnow.org https://longnow.org ).
- executive 6y ago
  > shipping fresh water somewhere via long plastic tubes on the ocean Fiji?
  - shagie 6y ago
    Found it - https://longbets.org/175/ https://longbets.org/175/ > Within two years, at least two or more waterbags, connected by the world's strongest zipper into a train, carrying total of at least one and one half million gallons of fresh water, will be successfully towed from Washington State, under the Golden Gate Bridge into San Francisco Bay, and then south to Santa Monica Bay in Los Angeles. ... with the justification: > Because the team I have assembled over the past sixteen years of pursuing this goal will make this happen. ... That's not a bet... that's marketing. Look at 176 for another bit of marketing. Scroll through them and you'll find something that looks more like an obscure, unmoderated blog (with comments).
Melting_Harps 6y ago
Anyone that has ever spent time in what I now call 'Cancer Inc.' will know just how absurd that statement was, whihc oddly enough was exactly when I was in it: from Undergrad to working in Diagnostics. Cancer research is it's own entrenched entity with horrible incentives that promote stagnation and often imbecilic levels of hubris that are at it's core shielded by the general public's ignorance of biological science as well as their nearly child-like level of fantasy of what was possible back then. As biologists we all had hopes and dreams of pursuing these seemingly insurmountable feats to make a dent in the problem, but as we went through the meat grinders of undergrad, and then the soul-crushing reality of the 'Industry' and its machinations and internal politics from the Pharmaceutical Industrial Complex on which it's built on compounded with tons of debt and lowering qualities and standards of living it's no surprise so many biologists ended up quitting life sciences and going into tech--HN revealed to me many things, but also just how common that route is. My short and sweet: Cancer is inevitable of any multi-celled organism on a long enough timeline and preventative health measures and healthy lifestyles are worth more than anything any Corp will ever sell you--they're unpopular because they require personal effort. Eating better, sleeping more, and exercising are better alternatives but rquire effort and possible loss of economic compensation, but if do them and you know that while you are not immune to any malady you are better off than most who are betting on some miracle cure to solve all the health problems they have amassed hoping for a silver bullet. I'm optimistic about the advances the 21st Century will usher in biology, I think the 21st century will be defined by biology in fact, but it's not something that will be egalitarian nor will it be promoted to most who haven't already have made efforts to take their health serious long ago. Most people don't even know about stem cell therapy besides what a influencer Joe Rogan told them, which is... something but still not even scratching the surface.
xyzzy21 6y ago
Cancer is not a specific thing. It's like saying: White People do X - not only not ALL, not often not even more than one. "White People" is a label that ignores individuals and no two are the same. Sometimes similar but never the same. Each type of cancer is as unique as each human is genetically and behaviorally. So when you "get cancer" it's not unusual for the genetic profile and identity to change as much as human genetics changes in a dozen generations for the same reasons that bacteria can evolve super quickly. Most cancer recurrences are a genetic drift that takes over "the cancer" from the prior species that has been put into remission. This is why cancer treatments now are increasingly including full DNA sequencing to figure out exactly what sub-sub-species it is to tailor to known genetic weaknesses and treatment strengths. Honestly it's a complexity explosion rather than any type of "victory". It's proven that there never will be a victory with some type of singular "magic bullet". And in the end, we will all die. No "transhumanism" is NEVER going to change that or save the day. It's childish and reality ignoring to believe it will. We are actually trading between cancer and lifespan - at a molecular level. There's a scientific paper about this from maybe 10 years ago I can't find easily but that's the actual trade-off of living at all. All living things have the same trade-off.

59 points by breck 6y ago

gadf 6y ago

No money in that, unfortunately. Or, not enough anyway. This might be a false notion, but I'm scared that the economics simply don't work to "cure" a major disease. It's more profitable financially to provide treatment to sick people. I hate this...yet am scared it's true. Another notion I hate and are am afraid is true is that: even if corporations were prepared to cure cancer and take the hit, the state would be terrified of increased longevity, at least I think so. Retirement age people are to the state, probably, what post-reproductive organisms are to evolution: dead weight that they can't "afford" to care about. In these areas I think the incentives might be wrong, but we can probably too better somehow. No idea how that can be corrected tho... :'(

Blikkentrekker 6y ago
Cancer does not so suitable a target for this, as say, h.i.v. infections. Cancer is not contagious, and something that is treated in the individual case by curing it. The “cure for cancer” would thus simply be a more effective treatment than what is available now. This is fundamentally different from h.i.v. infections, where a patient is a lifelong client, and a cure would amount to a type of treatment that would indeed completely cure the patient of the infection, and thus terminate the client.
wonnage 6y ago
I think what might be more likely is that if today's terminal illnesses are managed, we'll simply move the retirement age later and keep people working into their 70s.
- gadf 6y ago
  I'm not sure that's exclusive with what I'm proposing but I definitely think that will happen and is happening even now. I'd be kind of okay with that world where the incentive to cure people is that we can extract more productive work years from them. It's kind of cynical but I think there's a lot of good probably to be had there as well and it's a step perhaps in the right direction anyway. Even if it's not that great on the face of it.
cfn 6y ago
It is hard to believe that there isn't enough money in it. Breast cancer has a thriving industry of surgeries to remove the cancers plus reconstruction surgery plus a number of treatments associated with these surgeries. They easily run into the tens of thousands of euros a pop (if you go private in Europe, I suppose higher in the US).
- gadf 6y ago
  I suppose you're right. But I don't necessarily think that's evidence against what I'm saying in fact I think it speaks to what I'm saying which is that curing is inherently not that profitable so there's an incentive to kind of spring up a variety and a proliferation of industries around that so that now you have you know all sorts of support services for you know remission stage or cured breast cancer survivors. I'm pretty sure that's interacting with the fact that a surgery that completely removes and cures the cancer is probably cheaper than a long-term treatment option.
mft_ 6y ago
You’re verging into conspiracy territory a little too much here. Truth is, there are good economic reasons to cure a disease or cancer: because the cure can be priced according to its (great) value. Quick examples include: * Hepatitis C - can now be cured in ~95% of cases. When the various drugs were released, they made many billions for the manufacturers, as the economic case for their use was clear. * previously-untreated DLBCL (a type of lymphoma) - can be cured in ~2/3rds of patients, and many trials are ongoing (and have been run previously) to try to push this percentage higher. A treatment adding extra cures would be valued highly.
- gadf 6y ago
  the power of that phrase conspiracy theory is amazing. As soon as I read it I started to doubt my conclusions and I was very open to what you were saying. I think because of its power such a phrase must be regarded with suspicion. I don't think it actually carries any weight in an argument, it's more of a psychological trick... like shaming, like "oh I don't want to be a conspiracy theorist because they are crazy people and if I'm a crazy person then I can't possibly be right so I better agree with what this person accusing me of being crazy is saying otherwise I'll be crazy..." and while I like your points I think the other analysis provided in other comments is also valid. If you're using that conspiracy theory phrase I think either you're verging a little too much into below the belt territory there or maybe you doubt the point you're making so you are compensating for it with this dirty psychological trick. I'm not saying that's how it is for you that's just how it comes across for me.
unishark 6y ago
The incentives for market-based research aren't wrong, but they do have a limit. Investors aren't going to spend ten billion dollars on research to find a cure they expect to make only one billion dollars profit from. They aren't running charities. Many other people are running charities, of course, especially for cancers. If you want to help fund them you can. Many people do. The govt also funds a ton of research. As for the motivation to not pursue a profitable cure because you'd rather make more money from treatments, this isn't really the options you get to choose from. The real game they play is to choose either to find and sell the cure if one exists, or to sit back and watch the just-as-smart competition find and sell that cure instead of them. Their profitable treatment loses out either way. Cancer affects many many people who are healthy otherwise and would have had many more productive years. It isn't just a disease of old age. Especially breast cancer. Either way, elderly folks are the most prolific voters, so there's the incentive situation for the govt.
- codeflow2202 6y ago
  I'd love to believe in this free market utopia where the end result is always in the best interest of the community. In reality it's well known that companies rely on cartels to protect their shared interests. We can't know if pharmaceuticals are actively holding back any cure but it would be naive to completely trust organizations which only need to answer to their shareholders.
- gadf 6y ago
  I'd say pretty clearly if you hold back a cure for breast cancer because you can't get investors to put in 10 billion dollars when you're going to make one billion on it but long-term treatments for breast cancer at various stages they're going to make 100 billion on that 10 billion I'd say pretty clearly the incentives are wrong in that case. Because you're enabling research through investment which judges value purely on a monetary basis but it's ignoring the value of human life. So I'd say pretty clear that it's not just a case of the incentives having a limit, the incentives are wrong in that case.
satellite2 6y ago
I think it's a fallacy to say that pharmaceutical financial interests are not aligned with actually effectively curing diseases. First, when they cure a disease we don't sudenly become immortal, it improves our life quality and expectancy and new diseases become more prevalent at a later stage, so they don't lose their jobs. Second, even if slowing down research could effectively allow them to benefit longer from existing cures, generally you have competitors and inertia tends to not work well in adversarial conditions.
- jjk166 6y ago
  The argument is that it's more profitable to sell a pill you have to take every day for an extended period of time (or forever) than it is to sell a pill you only have to take once (or a small number of times). Recurring revenue is generally more desirable than a lump sum. There's still a strong incentive to make the disease manageable. It has nothing to do with saving money on research or keeping their jobs.
  - satellite2 6y ago
    That's what the second argument answers to. If your competitor produce a one time treatment then he wins the entire market.
    - jjk166 6y ago
      That doesn't logically follow. Why would a one time treatment win the market? Lasik is a one time treatment that certainly hasn't eliminated the market for daily contacts. The ability to buy a house hasn't eliminated the market for renting. The one time treatment has to pay for its development in a single dose, the recurring treatment can amortize its costs over many doses. In general, you will have to pay a premium for the convenience of a single dose, and many people can't justify that cost.
      - gadf 6y ago
        That's a really good point about lasik. Great example thank you. But at the same time I guess it cuts both ways because lasik exists. but what I'm specially worried about is that cures might be designed to not be perfect so that maybe you need to buy them again in 15 years or something just like a light bulb they can make perfect light bulbs but they design them to be obsolete so they can sell more. Why would not the same economics operate in the pharmaceutical industry I think it's a tragedy that it might when they should stick with their hippocratic principles.
chefkoch 6y ago
If all drug companies were a cartel you'd be right, but If a single company could provide a cure they would wipe everyone out of that market and could charge enormous sums. For example BMS had recently a CAR-T therapy approved by the FDA for myeloma, wich is not a cure yet. But the list price is $419 000. https://www.fiercepharma.com/marketing/bristol-myers-bluebird-bio-have-their-bcma-car-t-nod-but-latecomer-j-j-could-have https://www.fiercepharma.com/marketing/bristol-myers-bluebir...
- dmos62 6y ago
  Does national insurance pay for something like that in US? Unless this is paid in taxes, the price is exorbitent.
  - chefkoch 6y ago
    I don't know yet it was approved some days ago, but i guess yes. Cancer meds are really expensive, a four month cycle in myeloma ( where most of the time 2/3/4 drugs are combined) can cost more than 250k. Revlimid, a maintainance drug often given for years can cost 20k a month (in India it's $150 a month).
- jjk166 6y ago
  The whole premise of the notion is that managing the disease is more profitable than curing it. So it is not the ones who develop a cure that wipe everyone else out of the market but rather the other way around. Consider a disease has an effective daily pill treatment where each pill costs $.50 to make. Someone comes along with a single pill that costs $1000 to make but cures you. The cure developers have just spent a lot of money on R&D and need to make a profit on the administration of the cure, so they need to price it significantly over their production costs. The established treatment on the other hand has a war chest and can recoup short term losses in the long run, so they can afford to drop their prices or even give it away for free for a limited time. Perhaps some segment of the population will pay a hefty premium just for not having to deal with the hassle of treatment, but most people don't have thousands to spend on such a luxury and will stick with the option they can afford right now, even though it will wind up costing more over the course of their lifetime.
drdec 6y ago
> This might be a false notion, but I'm scared that the economics simply don't work to "cure" a major disease. It's more profitable financially to provide treatment to sick people. Others have provided nice arguments as to why this isn't necessarily so, but allow me to add one more that is (I hope) more likely to appeal to a cynic. This is one area where the corporate focus on short-term profits is actually working to the long-term benefit of humans. While it would be more profitable in the long run to sit on a cure and continue to sell therapeutics indefinitely, what CEO could resist the stock-boosting effect of a cure for a major disease? What a time to exercise your options! Long-term profitability is a problem for the next guy.
- simias 6y ago
  I agree, I always thought that the idea that "big pharma" would be actively suppressing miracle cure for long term profit is rather improbable. There's the reason to point out (why pass the opportunity of a huge short term profit?) but also for these types of diseases there's bound to be a high ranking officer within the company who either directly suffers from the illness or has a close family member who does. I doubt that they'd let themselves or their wives die for the sake of getting a nice +3% to benefits ten years down the line.
  - gadf 6y ago
    now I think you're being too naive. In that case they purchase employees corporation with their evil scheme by providing them with the cure of course.
- gadf 6y ago
  I like that idea that's really good that is a good counter argument thank you.

Blikkentrekker 6y ago

I find it unlikely that any cure for cancer would be so specific that it would work on breast cancer only. Much of the rhetoric that surrounds breast and prostate cancer irks me as though it be more rooted in identity politics than medicine. — I don't think such a specific claim would easily be made about, say, colon cancer or leukæmia.

jwdunne 6y ago
Why? Breast cancer is cancer of the breast tissue. It’s a different disease to prostate cancer, which is again a different disease to colon cancer and leukaemia. That’s why there probably won’t be a universal “cure for cancer”. Breast or prostate cancer are the most common cancers in women and men respectively. No matter what you identify as, if you have either breast or prostate tissue, there’s a real risk to most people. That’s why we hear about it more. We don’t hear as much about mesothelioma because it’s rarer. I don’t think it has anything to do with identity politics and everything to do with the medicine.
- sterlind 6y ago
  As an example, Gleevec has turned CML from a terminal cancer into a chronic, manageable condition for most patients. Life expectancy for CML is nearly the same as the general population now. [0] But Gleevec doesn't work on prostate or breast cancer. Cancers happen when mutations in a cell cause it to proliferate uncontrollably; the genetic circuits that need to be activated differ by cell type. For instance, prostate cancer can be treated with anti-androgens, since testosterone is required for prostate cells to reproduce. The cancer can evolve to resist anti-androgen therapy by mutating the androgen receptor so it's always stuck on. It's all circuits, and all the circuits are different. 0. https://academic.oup.com/jnci/article/103/7/553/2517175 https://academic.oup.com/jnci/article/103/7/553/2517175
- Blikkentrekker 6y ago
  > Why? Breast cancer is cancer of the breast tissue. It’s a different disease to prostate cancer, which is again a different disease to colon cancer and leukaemia. Yet most cancer treatment at the moment is not so specific. The exact same drugs are used to treat many different forms of cancer[1]; lukæmia is indeed treated with the same drugs as breast cancer is. > Breast or prostate cancer are the most common cancers in women and men respectively. The most common form of cancer is lung cancer[2], and while breast cancer takes a second place, prostate cancer is fairly low down the list at 5. Furthermore, in terms of lethality, both take a rather strong backseat to many other forms[3] > I don’t think it has anything to do with identity politics and everything to do with the medicine. I see no evidence for your claim that breast cancer is so fundamentally different and the link I posted indicates that the same treatments are very much used for different locations of cancer. - [1] https://medlineplus.gov/ency/patientinstructions/000910.htm https://medlineplus.gov/ency/patientinstructions/000910.htm - [2] https://www.wcrf.org/dietandcancer/cancer-trends/worldwide-cancer-data https://www.wcrf.org/dietandcancer/cancer-trends/worldwide-c... - [3] https://www.cdc.gov/cancer/dcpc/research/update-on-cancer-deaths/index.htm https://www.cdc.gov/cancer/dcpc/research/update-on-cancer-de...

lsb 6y ago

We don't have a cure for breast cancer, but we do have a cure for cervical cancer, especially now that we know that's caused by a virus (hpv). And, we have generics to prevent HIV infection, and we have promising new mRNA therapies, that were in development (with woefully little funding!) at U Penn, when this bet was being placed! Perhaps this is unwarranted optimism in the specific case, but as a broader expression of hope in future scientific progress, the long bet wins.

jillesvangurp 6y ago
There are more types of cancer than we have organs. The practice of naming cancers after where they are found is maybe a bit misleading. Especially since the aggressive/deadly varieties tend to spread through the body. Some cancers are very treatable at this point. The hard part is usually classifying them correctly and before they do a lot of damage. Breast cancer sounds more specific than it is. The reason it's such a common location for cancer and why it used to be so deadly is that they are connected to the lymphatic system, which how a lot of aggressive cancers spread through your body. Generally very treatable but some varieties still kill young women. Fun fact, the Pfizer corona vaccine was developed by Turkish-German women who has been working on developing a solution on fighting cancer with basically an mRNA vaccine. She pivoted to tackling corona last year but is looking to get back to tackling cancer. https://www.nytimes.com/2020/11/10/business/biontech-covid-vaccine.html https://www.nytimes.com/2020/11/10/business/biontech-covid-v... 2012 was maybe a bit optimistic but the last year has shown we can get results in under 12 months if the stakes are high enough.
- whizzter 6y ago
  I think that the mRNA vaccines success will lead to a huge influx of universities/investors sponsoring mRNA research and techniques since they see it as something viable now(possibly initially a negative if it means less sharing). Now combine that with decreasing DNA sequencing costs, it should put us on a path where the feasibility of cancer sequencing as a standard method of _exact_ identification and mRNA treatments targeting those identified exactly becomes standard fare within a few years (even if there probably is a bunch of cancerous mutations the number should be somewhat restricted considering much of the risks are hereditary).

christopherham 6y ago

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xvector 6y ago

Can we please just shift the bulk medical research funding to problems like gradual replacement for eventual consciousness upload, so we can “solve” all biological diseases in one go? Seems woefully inefficient to tackle ten thousand independent fatal ailments - and fund each effort separately - when we could be working on abandoning this frail form entirely.

AnimalMuppet 6y ago
It seems likely to me that solving breast cancer is easier/quicker than solving consciousness upload. If we do what you propose, a lot of people are going to die from breast cancer while we're waiting for upload to get here.
- xvector 6y ago
  Still, solving upload is likely much easier than solving the thousands of different fatal ailments out there altogether. These individuals are going to die of some ailment within a few decades regardless of whether breast cancer is cured. Consciousness upload is the only thing that enables a real difference for humanity.
  - AnimalMuppet 6y ago
    If consciousness upload is actually practically possible. But even if it is, it's a long ways out. Even if you can't save them all, even if you can't save them permanently, don't just ignore trying to make progress on diseases that are killing real people now. Don't chase your wonderful dream to the exclusion of real progress that is definitely available if we put resources on some of those thousands of problems.

lez 6y ago

To put in context what "we have a cure for cancer" means: In 1993 Prof. Dr. Somlyai has discovered that cancer cells cannot tolerate low-deuterium environments (as low as 100 ppm). There is solid science behind. He and his workmate, Prof. Dr. Boros even buy the publication fee for their own scientific papers to make them available to the general public because they are open to recieve scientific criticism. The idea of deuterium depletion manifested in a therapy using deuterium depleted water, which is drank regularly or injected directly into tumors. It has been approved for animals and being used in therapy since 15 years with great success. The human experiments have succeeded to demonstrate that mentioned water significantly improves acute survival rate, and survival rate is significantly better after 1 year of treatment. The authorities have declined to approve its use in humans because there were no significant improvement in survival rate after 3 years of treatment. So "we dont have a cure for cancer". Life, since eucaryotic cells have appeared, thrive to deplete deuterium levels inside mitochondria because deuterium kills atpase enzyme, which produces the energy for the whole body. One method of doing this is to keep procaryote cells and fungi in the gut, which in turn tend to concentrate deuterium, which is required for their genes to multiply. Feces is therefore richer in deuterium, getting the body levels lower. Ocean deuterium level is 155. When the water evaporizes, the steam has 2.5% - 4% less deuterium as the water. The cloud then moves around, and rains the deuterium-richer water first, leaving the deuterium depleted rain for the end. When clouds form around the equator, and they quickly fall in the form of summer thunderstorms, they tend to be higher in deuterium. But if the clouds form, move around through the poles, then back to 45 degrees latitude, they can reach the 130 ppm, which is tremenduosly good for mitochondria. We know that cancer is less prevalent as we go closer to poles. The consequence of mitochondria having low deuterium levels is that they produce citric acid with low deuterium content, which later turns into fat. That's why lard has 118 ppm deuterium in it, which generally means that eating a ketogenic diet of such fats (and drinking as little water as needed) is super efficient in depleting deuterium in the body. It takes 2-3 months to reach the equilibrium of deuterium levels after a change in diet/lifestyle. The Wartburg-effect might be a consequence of this. ppm is parts per million, which labels how many deuterium isotopes are present for 1000000 hydrogen atoms. So oceans have roughly one deuterium-containing water molecule every 6600 water molecules. The above is basically what I understood researching the topic, please google Somlyai and Boros for more.

medstrom 6y ago

If you want to make your own long bets (no money, but fun), hop on over to https://predictionbook.com/ https://predictionbook.com/. Actually many short bets are better for calibrating yourself. Gwern writes about it: https://www.gwern.net/Prediction-markets#predictionbook-nights https://www.gwern.net/Prediction-markets#predictionbook-nigh...

tnorthcutt 6y ago
http://metaculus.com/ http://metaculus.com/ is another site in this vein
- medstrom 6y ago
  Thanks!

PaulHoule 6y ago

I am amazed nobody challenged that one. People have had unrealistic dreams to cure cancer at least since Nixon. It isn't really one disease so it is a safe bet that 'cancer' will endure even if many subtypes were eliminated. If there is any place where people use science and technology as a religion it is the treatment of deadly diseases. People are always going to have psychological needs that they'll try to address by putting up pink ribbons on everything.

rtkwe 6y ago
I'm not sure Long Bets was as well known back then.
- shagie 6y ago
  Glance at the single and double digit bets... and who was betting (and commenting) on them. https://longbets.org/1/ https://longbets.org/1/ https://longbets.org/8/ https://longbets.org/8/ https://longbets.org/30/ https://longbets.org/30/ And so on. It was well known when it started. It got boring as people used it to pitch business plans and drugs by making poorly thought out "predictions" about them.
Delk 6y ago
Finding a cure for cancers originating in a particular organ is at least somewhat narrower than finding a "cure for cancer", and as such probably not quite as unrealistic. You're still right, of course, since there are still (probably, haven't checked) multiple different kinds of breast cancer, and also because no cancer is curable if it has spread wide enough. Testicular cancer nowadays has cure rates of 90 to 95 percent or so (close to 100% for certain types, above 80% for others), thanks to chemotherapy that happens to be very effective against those kinds of tumours. So it's not an entirely unrealistic idea that you could find a cure that works in a large majority of cases if you limit yourself to something narrower than "cancer". Of course how easy or difficult or realistic it is to find that kind of a cure even for a more limited range of cancers still depends on the type of cancer and whatever other factors there are, because, well, it is a bunch of rather different disease.

shagie 6y ago

When it started, there are some rather interesting bets - go and look at the single and double digit bet numbers. Especially look at the qualifications of the rebuttals and their quality... and that the quality of the predictions are also up there. Then... I want to say that they got really boring for a while as various people were using it to pitch their own business. I recall one that was about shipping fresh water somewhere via long plastic tubes on the ocean... and the predictor had a company that he was trying to get funding for to ship water on the ocean via large plastic tubes. This bet falls into the same category of boring, pitching a product (a particular drug). Unfortunately, Long Bets has moved from interesting wagers about the future of people and trying to get people to think about time scales beyond the next few years to something longer - as part of the Long Now foundation ( https://longnow.org https://longnow.org ).

executive 6y ago
> shipping fresh water somewhere via long plastic tubes on the ocean Fiji?
- shagie 6y ago
  Found it - https://longbets.org/175/ https://longbets.org/175/ > Within two years, at least two or more waterbags, connected by the world's strongest zipper into a train, carrying total of at least one and one half million gallons of fresh water, will be successfully towed from Washington State, under the Golden Gate Bridge into San Francisco Bay, and then south to Santa Monica Bay in Los Angeles. ... with the justification: > Because the team I have assembled over the past sixteen years of pursuing this goal will make this happen. ... That's not a bet... that's marketing. Look at 176 for another bit of marketing. Scroll through them and you'll find something that looks more like an obscure, unmoderated blog (with comments).

Melting_Harps 6y ago

Anyone that has ever spent time in what I now call 'Cancer Inc.' will know just how absurd that statement was, whihc oddly enough was exactly when I was in it: from Undergrad to working in Diagnostics. Cancer research is it's own entrenched entity with horrible incentives that promote stagnation and often imbecilic levels of hubris that are at it's core shielded by the general public's ignorance of biological science as well as their nearly child-like level of fantasy of what was possible back then. As biologists we all had hopes and dreams of pursuing these seemingly insurmountable feats to make a dent in the problem, but as we went through the meat grinders of undergrad, and then the soul-crushing reality of the 'Industry' and its machinations and internal politics from the Pharmaceutical Industrial Complex on which it's built on compounded with tons of debt and lowering qualities and standards of living it's no surprise so many biologists ended up quitting life sciences and going into tech--HN revealed to me many things, but also just how common that route is. My short and sweet: Cancer is inevitable of any multi-celled organism on a long enough timeline and preventative health measures and healthy lifestyles are worth more than anything any Corp will ever sell you--they're unpopular because they require personal effort. Eating better, sleeping more, and exercising are better alternatives but rquire effort and possible loss of economic compensation, but if do them and you know that while you are not immune to any malady you are better off than most who are betting on some miracle cure to solve all the health problems they have amassed hoping for a silver bullet. I'm optimistic about the advances the 21st Century will usher in biology, I think the 21st century will be defined by biology in fact, but it's not something that will be egalitarian nor will it be promoted to most who haven't already have made efforts to take their health serious long ago. Most people don't even know about stem cell therapy besides what a influencer Joe Rogan told them, which is... something but still not even scratching the surface.

xyzzy21 6y ago

Cancer is not a specific thing. It's like saying: White People do X - not only not ALL, not often not even more than one. "White People" is a label that ignores individuals and no two are the same. Sometimes similar but never the same. Each type of cancer is as unique as each human is genetically and behaviorally. So when you "get cancer" it's not unusual for the genetic profile and identity to change as much as human genetics changes in a dozen generations for the same reasons that bacteria can evolve super quickly. Most cancer recurrences are a genetic drift that takes over "the cancer" from the prior species that has been put into remission. This is why cancer treatments now are increasingly including full DNA sequencing to figure out exactly what sub-sub-species it is to tailor to known genetic weaknesses and treatment strengths. Honestly it's a complexity explosion rather than any type of "victory". It's proven that there never will be a victory with some type of singular "magic bullet". And in the end, we will all die. No "transhumanism" is NEVER going to change that or save the day. It's childish and reality ignoring to believe it will. We are actually trading between cancer and lifespan - at a molecular level. There's a scientific paper about this from maybe 10 years ago I can't find easily but that's the actual trade-off of living at all. All living things have the same trade-off.