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This idea of "curing cancer" as if cancer was a monolithic disease really needs to die. Cancer is just a catch-all term for somatic cell mutations that become

This idea of "curing cancer" as if cancer was a monolithic disease really needs to die. Cancer is just a catch-all term for somatic cell mutations that become unmanageable. There are as many ways to get "cancer" as there are ways to mutate cells into these sort of uncontrollable states. And there are cures for multiple cancers today (Imantinib, Herceptin, etc). There actually have been enormous recent strides in drugs like PD-1 inhibitors that do have a broad spectrum affect against cancers, but I think outside of this one particular example, the real math problem is how do you expect to contain a mutational state of a cell with 10000x ways to reach that state with a single, or even handful of drugs?

melling 2y ago
Yeah, I always make sure to say cancer(s) so we can skip the “it’s not one disease “ digression. It adds nothing to the conversation. According to Craig Venter, early detection is what we need to eliminate cancer(s): https://youtu.be/iUqgTYbkHP8?t=15m37s https://youtu.be/iUqgTYbkHP8?t=15m37s
- lolinder 2y ago
  "It's not one disease" certainly preempts a lot of uninformed takes, but that in itself is a major contribution to the conversation we ought to be having. If your interlocutor is still thinking about cancer as a disease and not a large category of diseases with different causes, different characteristics, and therefore different solutions, there isn't much point to continuing that conversation until the situation has been clarified.
- ekianjo 2y ago
  early detection? there are not enough diagnostic tools that are already applied systematically right now for patients who have known cancers. this kind of idea is great on paper but hardly scales.
  - LarsDu88 2y ago
    Enough diagnostic tools? Hah. Most cancer detection assays are pretty much garbage if you were to compare them to the latest advances in say deep learning image recognition models. You can actually compare the sensitivity/specificity for PSA prostate screens versus something like ResNet for image recognition. The latter is in the high 90s for both metrics. The former can be as low as 0.06 for specificity if you want to actually achieve high sensitivity (detect prostate cancer with extremely extremely high false positives)
- the__alchemist 2y ago
  100% re early det. Some projects to look at: GRAIL, PanSeer (blood cfDNA next-gen sequencing), and several ones looking at the fragmentome. I imagine an effective solution will take the form of something like this, but cheap and convenient enough so that everyone can get it done regularly. "cancer isn't a single disease"is often used as a thought-terminating cliche.
Zenzero 2y ago
Yep. (Doctor here) Im not sure who the target audience is for the article, but it strikes me as one where if the author were more knowledgeable on the subject, they would have many of the answers to what they are asking. It reads to me like someone writing "why are there still bugs in programming? Is it because of too many buttons on the screens?" Im in agreement with you that most people don't grasp just how medicine as an area of study is unfathomably complex. It mimics a fractal in the sense that the deeper we go in trying to understand things it just opens up a wider scope of investigation.
- petermcneeley 2y ago
  Most of the body is cells. Most of cancer would be rogue cells. Cancer can be cured if you can: 1. Identify rogue cells 2. Destroy the rogue cells. You can use technology to do both and pretty much ignore biology.
  - deleted 2y ago
    [deleted]
  - lanternfish 2y ago
    Any technology purpose built to interface with cells would be a biological technology.
    - petermcneeley 2y ago
      Many treatments today focus on simply killing the rogue cells. You dont really need to interface with something if your objective is to destroy it.
      - lolinder 2y ago
        Your first step is to identify it. What mechanism do you propose to use that doesn't somehow interface with biology?
  - killjoywashere 2y ago
Eric_WVGG 2y ago
nice little comic about that — https://phdcomics.com/comics/archive.php?comicid=1162 https://phdcomics.com/comics/archive.php?comicid=1162
inglor_cz 2y ago
"This idea of "curing cancer" as if cancer was a monolithic disease really needs to die." I respectfully disagree. Maybe our problem is that of attitude, which you also exhibit when saying "with a single, or even handful of drugs". Drugs as such may be a dead end. Once upon a time, we decided to study cancer from a biochemical and genetic point of view and look for drugs, which may actually be suboptimal. To give an analogy, what if you tried to debug a faulty program using a beeper instead of a debugger with screen. It would be a nasty work and it would take long. This is not an intrinsic problem of software ("fundamental undebuggability of 10 thousand errors"), it is "just" a wrong approach to debugging. We are not the only mammals, we can look around nature and learn from it. What do we see when we study cancer in other species? Mammalian species that are highly resistant to cancer (whales, bats, naked mole rats etc.) seem not to rely on drugs or their biochemical equivalents, but rather kill cancerous cells biologically, with help of their immune systems. Notably, if a species is highly resistant to cancer, it tends to be highly resistant to all sorts of cancer at once, or, at the very least, to many sorts of cancer at once, which indicates that a common suppressive mechanism for cancer ("cure" or "preventive cure") is well within the realm of possibility and that for all their biochemical diversity, cancer cells can be universally recognized and whacked in an efficient way. The same actually holds about young people. Our own species is highly resistant to almost all cancers at once when young, and incidence of most cancers tends to grow with age along a very similar curve, which, again, indicates some commonalities under that extreme biochemical diversity. Most of the progress in fight against cancer in the 21st century comes from biological approaches, not from better chemicals. The chemical approach may be fundamentally flawed. Yeah, a "cure" in form of a chemical drug is likely impossible. But a "cure" in a form of a genetic treatment etc. may well be possible. Anyone down for adding some whale genome to theirs? :)
pieter_mj 2y ago
Cured, no. But largely preventable, yes. With a paradigm shift from genetic to metabolic.
- avinassh 2y ago
  Can you elaborate? Are there studies showing changes in metabolism preventing cancer?

melling 2y ago

Yeah, I always make sure to say cancer(s) so we can skip the “it’s not one disease “ digression. It adds nothing to the conversation. According to Craig Venter, early detection is what we need to eliminate cancer(s): https://youtu.be/iUqgTYbkHP8?t=15m37s https://youtu.be/iUqgTYbkHP8?t=15m37s

lolinder 2y ago
"It's not one disease" certainly preempts a lot of uninformed takes, but that in itself is a major contribution to the conversation we ought to be having. If your interlocutor is still thinking about cancer as a disease and not a large category of diseases with different causes, different characteristics, and therefore different solutions, there isn't much point to continuing that conversation until the situation has been clarified.
ekianjo 2y ago
early detection? there are not enough diagnostic tools that are already applied systematically right now for patients who have known cancers. this kind of idea is great on paper but hardly scales.
- LarsDu88 2y ago
  Enough diagnostic tools? Hah. Most cancer detection assays are pretty much garbage if you were to compare them to the latest advances in say deep learning image recognition models. You can actually compare the sensitivity/specificity for PSA prostate screens versus something like ResNet for image recognition. The latter is in the high 90s for both metrics. The former can be as low as 0.06 for specificity if you want to actually achieve high sensitivity (detect prostate cancer with extremely extremely high false positives)
the__alchemist 2y ago
100% re early det. Some projects to look at: GRAIL, PanSeer (blood cfDNA next-gen sequencing), and several ones looking at the fragmentome. I imagine an effective solution will take the form of something like this, but cheap and convenient enough so that everyone can get it done regularly. "cancer isn't a single disease"is often used as a thought-terminating cliche.

Zenzero 2y ago

Yep. (Doctor here) Im not sure who the target audience is for the article, but it strikes me as one where if the author were more knowledgeable on the subject, they would have many of the answers to what they are asking. It reads to me like someone writing "why are there still bugs in programming? Is it because of too many buttons on the screens?" Im in agreement with you that most people don't grasp just how medicine as an area of study is unfathomably complex. It mimics a fractal in the sense that the deeper we go in trying to understand things it just opens up a wider scope of investigation.

petermcneeley 2y ago
Most of the body is cells. Most of cancer would be rogue cells. Cancer can be cured if you can: 1. Identify rogue cells 2. Destroy the rogue cells. You can use technology to do both and pretty much ignore biology.
- deleted 2y ago
  [deleted]
- lanternfish 2y ago
  Any technology purpose built to interface with cells would be a biological technology.
  - petermcneeley 2y ago
    Many treatments today focus on simply killing the rogue cells. You dont really need to interface with something if your objective is to destroy it.
    - lolinder 2y ago
      Your first step is to identify it. What mechanism do you propose to use that doesn't somehow interface with biology?
- killjoywashere 2y ago

Eric_WVGG 2y ago

nice little comic about that — https://phdcomics.com/comics/archive.php?comicid=1162 https://phdcomics.com/comics/archive.php?comicid=1162

inglor_cz 2y ago

"This idea of "curing cancer" as if cancer was a monolithic disease really needs to die." I respectfully disagree. Maybe our problem is that of attitude, which you also exhibit when saying "with a single, or even handful of drugs". Drugs as such may be a dead end. Once upon a time, we decided to study cancer from a biochemical and genetic point of view and look for drugs, which may actually be suboptimal. To give an analogy, what if you tried to debug a faulty program using a beeper instead of a debugger with screen. It would be a nasty work and it would take long. This is not an intrinsic problem of software ("fundamental undebuggability of 10 thousand errors"), it is "just" a wrong approach to debugging. We are not the only mammals, we can look around nature and learn from it. What do we see when we study cancer in other species? Mammalian species that are highly resistant to cancer (whales, bats, naked mole rats etc.) seem not to rely on drugs or their biochemical equivalents, but rather kill cancerous cells biologically, with help of their immune systems. Notably, if a species is highly resistant to cancer, it tends to be highly resistant to all sorts of cancer at once, or, at the very least, to many sorts of cancer at once, which indicates that a common suppressive mechanism for cancer ("cure" or "preventive cure") is well within the realm of possibility and that for all their biochemical diversity, cancer cells can be universally recognized and whacked in an efficient way. The same actually holds about young people. Our own species is highly resistant to almost all cancers at once when young, and incidence of most cancers tends to grow with age along a very similar curve, which, again, indicates some commonalities under that extreme biochemical diversity. Most of the progress in fight against cancer in the 21st century comes from biological approaches, not from better chemicals. The chemical approach may be fundamentally flawed. Yeah, a "cure" in form of a chemical drug is likely impossible. But a "cure" in a form of a genetic treatment etc. may well be possible. Anyone down for adding some whale genome to theirs? :)

pieter_mj 2y ago

Cured, no. But largely preventable, yes. With a paradigm shift from genetic to metabolic.

avinassh 2y ago
Can you elaborate? Are there studies showing changes in metabolism preventing cancer?