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Why a Cure For Cancer Is So Elusive

Hugh Pickens DOT Com writes "George Johnson writes in the NYT that cancer is on the verge of overtaking heart disease as the No. 1 cause of death and although cancer mortality has actually been decreasing bit by bit in recent decades, the decline has been modest compared with other threats. The diseases that once killed earlier in life — bubonic plague, smallpox, influenza, tuberculosis — were easier obstacles. For each there was a single infectious agent, a precise cause that could be confronted. But there are reasons to believe that cancer will remain much more resistant because it is not so much a disease as a phenomenon, the result of a basic evolutionary compromise. As a body lives and grows, its cells are constantly dividing, copying their DNA — this vast genetic library — and bequeathing it to the daughter cells. They in turn pass it to their own progeny: copies of copies of copies. Along the way, errors inevitably occur. Some are caused by carcinogens but most are random misprints. Mutations are the engine of evolution. Without them we never would have evolved. The trade-off is that every so often a certain combination will give an individual cell too much power. It begins to evolve independently of the rest of the body and like a new species thriving in an ecosystem, it grows into a cancerous tumor. 'Given a long enough life, cancer will eventually kill you — unless you die first of something else (PDF). That would be true even in a world free from carcinogens and equipped with the most powerful medical technology,' concludes Johnson. 'Maybe someday some of us will live to be 200. But barring an elixir for immortality, a body will come to a point where it has outwitted every peril life has thrown at it. And for each added year, more mutations will have accumulated. If the heart holds out, then waiting at the end will be cancer.'"

26 of 366 comments (clear)

  1. Cancer isn't one disease by kumanopuusan · · Score: 5, Insightful

    Cancer is a whole spectrum of diseases with different causes, effects, mortality rates, etc. This question is only a little less silly than asking why we haven't cured all disease yet.

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    Use of the words "good", "bad" or "evil" is almost invariably the result of oversimplification.
    1. Re:Cancer isn't one disease by Anonymous Coward · · Score: 5, Insightful

      Cancer is a generic term for a large group of diseases that can affect any part of the body.

      - World Health Organisation

      Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues.

      - National Cancer Institute (@NIH)

      Where should he get his definition from?

    2. Re:Cancer isn't one disease by Anonymous Coward · · Score: 4, Informative

      Yes, it is. Some are viral, some by metabolic imbalances in the cells, others by poisoning, some by transcription errors, and a few are bizarrely fungal. The only thing that "cancer" is, if it's anything at all, is a bunch of very different diseases that are characterized by the cells in the body multiplying faster than they should. Not all are even tumorous; think about leukemia.

    3. Re:Cancer isn't one disease by Anonymous Coward · · Score: 5, Insightful

      " if it's anything at all, is a bunch of very different diseases that are characterized by the cells in the body multiplying faster than they should"

      That's a contradictory statement.

      If one guy breaks his leg falling from a ladder, and another breaks his leg in a car accident, does the doctor treat that broken leg differently? Preventative measures for those broken legs may be different, but the result is the same. Likewise, a broken arm and broken leg might be be susceptible to different treatments, but they're both fundamentally broken bones, and it's worthwhile to categorize them as such.

      Cancer can absolutely be categorized as one disease. As you say, it's the pathological replication of a cell. Yes, different types of cells may have different behaviors, although they also all have a litany of identical behaviors. Yes, it's a fruitful avenue of research to treat different cancer types with different methods. But that doesn't mean we should stop looking for broader methods than can treat multiple different kinds of cancers based on their numerous shared characteristics.

      The meme that "cancer is a whole spectrum of diseases" is just that, a meme. Researchers who recite that meme don't believe it literally. They do have a much more nuanced perspective on cancer. But they use that meme in an attempt to deflate journalists' and lay people's expectations about cancer research. And then people echo that meme in an attempt to sound knowledgable and up-to-date.

      Study any topic deeply enough and almost any label will come up short. That doesn't mean the label is wrong. Labels are meant to simplify and aggregate. They sacrifice accuracy for the necessary convenience of relating complex topics in rational discourse.

    4. Re:Cancer isn't one disease by 93+Escort+Wagon · · Score: 4, Funny

      You want room 12A, next door.

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    5. Re:Cancer isn't one disease by cold+fjord · · Score: 5, Funny

      The simple reason is that the people who fund the research feel there is more profit in treating cancer than there ever would be in curing it.

      That must be true since we know that there are no actual hard problems in medicine, science, math, or engineering. It's because of the oil companies that we don't have warp drive, antigravity, 500 mpg cars, and personal nuclear piles. The airlines, banks, and credit card companies are holding back time travel (no more late bills or missed flights). We have it on the authority of President Obama himself that surgeons do unnecessary surgery out of greed. Fermat's last theorem could have been solved hundreds of years ago except for the abacus and adding machine lobby. Shoe manufacturers are holding back personal jet packs since shoes would rarely wear out if you fly everywhere. And teacher's unions prevent people from learning foreign languages while they sleep, with one weird trick.

      I have no idea where people get these ideas. Maybe food additives have something to do with it. Isn't hydrogenated-crank oil added to some foods? Or maybe it's just a problem due to chronic lack of sleep?

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      much of left-wing thought is a kind of playing with fire by people who don't even know that fire is hot - George Orwell
    6. Re:Cancer isn't one disease by MickLinux · · Score: 3, Insightful

      Okay, it isn't nonsense; it is one of many factors. Yes, cheap cures get removed from the market (mebendazole, anyone?), new cures get challenged before the FDA by johnny-come-latelies until the developers go out of business (angiostatins?), cancers that should remain untreated and monitored instead get invasive surgery (prostate cancer)... yes, chmpanies like to ure the sick and hurting as ATMs.

      That said, it is also correct to say that there is no single cure for cancer.

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      Correct Horse Battery Staple: 72 bits of entropy. Enter "Correct H" into google. When it generates the phrase, that's
    7. Re:Cancer isn't one disease by lgw · · Score: 4, Insightful

      Well, it all comes down to: are your trying to stop it from happening in the first place (in which case it's a broad spectrum of causes), or to cure it after the fact (in which case they all have the same mechanism). Which way you see it likely depends on which part of the problem you're concerned with.

      Genes just need a digital checksum - get on it!

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      Socialism: a lie told by totalitarians and believed by fools.
    8. Re:Cancer isn't one disease by Michael+Woodhams · · Score: 4, Insightful

      An argument about the world is interesting. An argument about a word is not.

      This is an argument about a word. What is "a disease" versus "a spectrum of diseases"?

      Cancers have some common features, and some very important differences. This is the "world", and you agree on it. Stop arguing about the word.

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      Quattuor res in hoc mundo sanctae sunt: libri, liberi, libertas et liberalitas.
    9. Re:Cancer isn't one disease by interkin3tic · · Score: 3, Insightful

      If one guy breaks his leg falling from a ladder, and another breaks his leg in a car accident, does the doctor treat that broken leg differently? Preventative measures for those broken legs may be different, but the result is the same.

      Not really. If you land on your leg from a ladder and get a compound fracture, that's probably your bone being compressed. If you get your leg crushed in a car accident, that's probably going to break a different way. The bone will likely need to be set differently. With crushing, I think there's a greater chance of internal bleeding, can't remember where I heard that. The specific insult will lead to a different type of injury that necessarily affects the treatment, even if they both are very similar overall (like they both require casts).

      Yes, it's a fruitful avenue of research to treat different cancer types with different methods. But that doesn't mean we should stop looking for broader methods than can treat multiple different kinds of cancers based on their numerous shared characteristics.

      Uh, I'm pretty sure no cancer researcher in the world is giving up on curing ALL cancers if they can. I mean, you automaticaly win the nobel prize for sure, get assured to be put on a stamp, and free drinks for the rest of your life if you "cure cancer." If you cure "just" one subtype of cancer, you probably get tenure or plenty of grant money, but you probably won't get automatically laid by saying "I'm the guy who cured multiple myeloma!" in a bar.

      They're focusing on specific types because that seems far more likely than any one treatment curing all types of cancer. For instance multiple myeloma cells appear to be more on the verge of auto-cannibalizing themselves, moreso than other cancers. Researchers got them to undergo unrestrained autophagy and die, that probably won't be the case for other cancers. If it even works in patients for multiple myeloma.

      The meme that "cancer is a whole spectrum of diseases" is just that, a meme. Researchers who recite that meme don't believe it literally.

      I, for one, do actually believe it. And I think it's more than a meme. I think researchers who pursue a grand cure might be modern day alchemists: trying very hard to achieve a goal which is far beyond the current technology. Modern chemistry came about from alchemists. Likewise, researchers who are attemtping to cure ALL cancers can definitely make important contributions even if they don't cure all cancers, so I'm not knocking them. But I do think we'll probably cure individual cancer subtypes before theres a big overall cure.

    10. Re:Cancer isn't one disease by cold+fjord · · Score: 5, Insightful

      No, what we were presented with is a conspiracy theory for which no evidence was given. If you want people to believe such an extraordinary claim, which would require a massive world-wide conspiracy lasting decades among all manner of countries, governments, and people of varying socio-political-religious orientations, you need to present some actual evidence instead of simply making a bare allegation. In short you are whining because a crank allegation with no supporting evidence was dismissed as such.

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      much of left-wing thought is a kind of playing with fire by people who don't even know that fire is hot - George Orwell
    11. Re:Cancer isn't one disease by gargleblast · · Score: 3, Insightful

      If one guy breaks his leg falling from a ladder, and another breaks his leg in a car accident, does the doctor treat that broken leg differently?

      Actually a doctor most likely will treat those injuries differently. An impact with torn metal will probably be more serious than an impact with soil. For instance, it is more likely to result in a compound fracture. In general, different accidents cause different injuries.

      Cancer can absolutely be categorized as one disease.

      OMG.

      You are going to need to know a heck of a lot more about a disease than "it is cancer" before you can even start considering treatment. In what type of tissue did the cancer originate? What organ is the cancer in now? What oncogenes / suppressor genes were affected by the mutation? Is it one of:

      • Breast cancer due to tumor suppressor gene BRCA1 mutation, metastasized to the lung
      • Prostate cancer due do mutation in Hereditary Prostate Cancer gene 1 (HPC1), unmetastasized

      In other words, what is the disease really?

    12. Re:Cancer isn't one disease by OneAhead · · Score: 5, Informative

      Assuming that it doesn't lead to autoimmune problems down the road, I strongly suspect that immunotherapy (programming the immune system to identify the damaged cells and attack them) will become a much more commonplace treatment for cancer, precisely because it cuts off that metastasis process.

      The immune system already does that; severely immunodeficient individuals are prone to getting cancer. Cancer is a complicated process - 5 to 7 distinct cell mechanisms (depending on how you count) need to be malfunctioning before one can speak of a life-threatening cancer (at first glance, wikipedia seems to have left a few out). One of them is that the cell must lose the ability to display outwards signs of being cancerous to the immune system, else it will be eliminated in short order. Now, if you're going to modulate the immune system to attack cells that don't display outwards signs of being cancerous, then your assumption that "it doesn't lead to autoimmune problems" will likely turn out false. (Mostly experimental) therapeutic approaches involving the immune system rely on the therapeutic agent recognizing tumor cells and making them recognizable to the immune system in turn. The challenge there is that cancers are diverse and have a high mutation rate - even if you're lucky enough to have an agent on the shelf that recognizes the specific cancer you're having, it may stop working in a few months. So you're again in a place where you can never truly cure each and every patient.

      BTW, I'm a cancer researcher. I'm not saying this as an appeal to authority, just to explain where I got this information and to confirm that the view in TFA is somewhat of a consensus in the field. This does not make it a depressing job: as the field progresses we can beat back more cancers for longer with fewer side effects, which is exciting. Some might say that maybe some day we will get so good that 99.9% of people die of other causes before they get the chance to develop a life-threatening cancer we can't cure. However, my (admittedly one-sided) view is that most other age-related causes I can think of are easier to cure than cancer, and that the latter is at #1 to stay (barring a collapse of civilization). And even if I'm proven false, 99.9% is not 100%. We can't cure cancer 100% just like we can't manufacture hard drives with a 0% failure rate. Nature seems to abhor systems that never fail.

    13. Re:Cancer isn't one disease by stoploss · · Score: 4, Informative

      I see you have brought the machine analogies into play.

      Are you conflating "cure" for cancer with "complete prevention" then? To go back to the machine analogy, I believe it is sufficient to define a machine as "not failing" if it can be repaired. I agree with you that machines inevitably fail; however, I don't automatically conflate that with permanent failure.

      Dropping the analogies, if your sole claim is that we will never be able to prevent each and every individual cell from accumulating mutations and failing to undergo apoptosis when critical failures have accumulated, then you may be correct (likely because that problem isn't worth solving). If you are claiming that we will never be able to prevent a single, uncontrolled mutant cell from eventually causing death from metastatic disease (or cerebral disruption) then I suggest you are being fatalistic.

      My comment about the rabbits was intended to point out the tautology of any type of claim that cancer will kill you if nothing else does. I believe Larry Niven once threw out a plausible stat that "immortality is ~200 years of life", mostly due to the accumulated odds of accidental death. To put it in terms of biological engineering, we may not be able to reduce the risk of metastatic disease to zero, but we may have a practical "cure" that reduces the risk to a practically infinitesimal level.

      The machine isn't permanently broken if it can be repaired.

    14. Re:Cancer isn't one disease by sandertje · · Score: 5, Informative

      Human cells already do some sort of checksumming on their genes. To start with, polymerases - the proteins that copy DNA - have proof-reading activity. That is to say, they check whether their copied DNA is equal to the parent DNA molecule. Then, if DNA damage occurs - which happens more frequently than you'd think - it gets repaired almost entirely flawlessly. Single strand breaks are easy to repair for the cellular machinery; they can use the opposite strand of the same DNA molecule as a scaffold for repair. Double strand breaks are indeed more difficult to repair, but luckily we have two sets of each chromosome (one from mommy, and one from daddy), so if one breaks, the other pair member is used as a reference. Sure, these pairs of chromosomes are not entirely identical, but for most cases, it suffices. As a result, the human mutation rate is on the order of about once every 100 million times. That's really low. Try to copy a 3GB file (roughly the size of human DNA) 100 million times on your computer, and I'm sure you'd have a lot more corrupted files than just 1. Unfortunately, the human body contains several trillions of cells, leaving enough room for incremental errors. One hallmark of cancer is that it relies on (partially) shutting down this "checksumming", and as such can attain a much higher rate of mutation - and as a result, a much higher rate of evolution - than normal cells. (see: https://www.sciencedirect.com/science/article/pii/S0092867411001279?np=y for a very nice overview). Besides that, just guarding the genes is not enough. Our genetics is more than enough to induce heavy proliferating cells. How else would we be able to grow from a single-celled individual (the fertillized egg) to a fully-grown body of several trillion cells? Healthy humans NEED proliferation (of certain cells), and thus we have genes that code for just that. The key here is activating certain genes in certain environments, and inactivating other genes. Every cell type has a different transcriptional landscape. This is controlled by epigenetics. Just guarding your genes would not guard against any changes in epigenetics, and you would still be prone to cancer.

  2. Mere flesh? by blackiner · · Score: 5, Funny

    But barring an elixir for immortality, a body will come to a point where it has outwitted every peril life has thrown at it. And for each added year, more mutations will have accumulated. If the heart holds out, then waiting at the end will be cancer.'"

    Pffft, I plan on being 100% robot by then. I'd like to see cancer bite my shiny metal ass.

  3. Re:Bollocks by wonkey_monkey · · Score: 5, Insightful

    This simple fact undermines the above hypothesis.

    Not if they all used to die of sleeping sickness before the age of 30.

    Without knowing what did kill them and at what age, the existence of these populations might equally well support the hypothesis, might it not?

    What was the life expectancy of these Pacific island or pre-Western diet African populations? Did they have anything approaching "Western" medicine for coping with all their other ailments?

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    systemd is Roko's Basilisk.
  4. Re:True fact: by Anonymous Coward · · Score: 5, Insightful

    "It's more lucrative to treat a disease than it is to cure it."

    While true at face value, the implication here is that a "cancer cabal" profits as a whole when cures are withheld and it collectively decides to release only incrementally improved treatments. But there is no such cabal, quite the opposite, there is intense competition among researchers and pharma companies and no collective decision, only individuals more than willing to "break the ranks".

    Heck, curing a single type of cancer say prostate or leukemia will guarantee you a Nobel prize and a life time of doing whatever you want whenever you want both from a professional and personal point of view - regardless if the cure is monetizable (patentable) or not. And you expect us to believe researchers are actively hiding cures for the sake of the pharma industry ? Please, not even the Mafia can command such allegiance.

  5. Re:Bollocks by FoolsGold3151 · · Score: 3, Interesting

    Death certificates are a very poor indicator of cause of death. The battle between Cancer and Apoptosis is one theory. It has some merit to it, but it also seems that tumors can be viewed as a fundamental form of life similar to a fetus having its own blood supply and largely anaerobic environment. We keep finding various pathogens in tumors and declare them to be likely causes but are probably a result not a cause. We treat "tumor burden" by lowering the number and size of tumors but we have no idea if this extends the length of life by one second or not or improves the quality of the patient's life at all. We yammer about Free Radicals but make no progress investigating its role in driving the apoptosis pathway.

  6. Hugh Pickens Blog by Luthair · · Score: 4, Insightful

    Seriously, how many articles per day is Slashdot going to feature from this guy? Recently it feels at least 3 per day.

    1. Re:Hugh Pickens Blog by BringsApples · · Score: 3, Funny

      Why hugh pickens on that guy?

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      Politics; n. : A religion whereby man is god.
  7. Re:Money by Sique · · Score: 5, Insightful

    As someone who has had cancer, I have learned a lot. Most importantly, all the various cancer charities are complete frauds. Despite taking in untold Billions of dollars, the number of people dying from cancer has increased, not decreased over the last 20 years. And nobody has ever had their cancer cured because someone wore a pink ribbon or yellow wristband or walked 10 kilometers.

    If you had bothered to actually read even the slashdot article (you don't even need the links), you would understand why the number of people dying of cancer increases. Everyone who has died so far has died of something. Many of the causes people were dying of, we have minimalized or fully eliminated in the last 150 years, Nearly no one dies of the bubonic plague anymore for instance, and most of the other infections are in retreat. With every cause we eliminate, all the remaining causes get a bigger share. And in the end, there are two main causes remaining: coronary diseases and cancer. Everyone of us, given that he dies not of anything else before, will in the end die of either coronary diseases or cancer, which means that they will increase their share, if we further eliminate the other causes for an premature death.

    What is actually increasing is the average age humans die because of coronary diseases or cancer. That means, we are able to push the time further away, when cancer or coronary diseases will get us.

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    .sig: Sique *sigh*
  8. Re:Money by Kjella · · Score: 4, Insightful

    As someone who has had cancer, I have learned a lot. Most importantly, all the various cancer charities are complete frauds. Despite taking in untold Billions of dollars, the number of people dying from cancer has increased, not decreased over the last 20 years.

    That is a statistical fallacy, if we're getting better at treating cancer but even better at treating non-cancer diseases and injuries the relative share of cancer deaths may go up. Most of the people diagnosed with cancer are quite old and while we're getting better at emulating the body's "functions" with artificial hearts, artificial lungs, dialysis machines and so on we're not making the same kind of progress on cancer. I've had several ill and frail relatives but modern medicine kept them alive until the cancer got them, I consider it more of a success than a failure of the medical system. Eventually everybody dies from something.

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  9. Re:Money by dmr001 · · Score: 3, Insightful
    It's an interesting claim that apparently all cancer researchers feel there is so much money to be made in grants, they are careful to reject novel ideas that might lead to cure for cancer so they can securely remain on the gravy train. By interesting, I mean for what it reveals about how people think. Hanging around the parking lots of university-based research facilities did not yield a surfeit of expensive cars. And while a good argument can be made for the plodding progress of research despite all the pink ribbons, breast cancer mortality is in fact steadily decreasing - even for women with tumor that's spread to lymph nodes. From the same website, you'll see even more impressive progress in colon cancer mortality, lung, and prostate cancer, which rounds out the list of the most common fatal cancers.

    In some sense, increasing cancer mortality likely results from people in industrialized nations being killed less often by other stuff (cars, emphysema, smallpox, contaminated water). And walking 10 km (on a regular basis) probably has significantly decreased cancer mortality, probably by changes in hormone balance and metabolism. Cancer research may not always be flashy, but they do seem to dig up useful stuff over time.

  10. Re:Money by RDW · · Score: 3, Informative

    So how do the conspiracy theories explain the dramatic improvement in survival rates in those cancers where research-guided improvements in treatment have been very successful?:

    https://www.stjude.org/stjude/v/index.jsp?vgnextoid=5b25e64c5b470110VgnVCM1000001e0215acRCRD

    http://www.bbc.co.uk/news/health-15726810

    Clearly there's a great deal to be done, and finding 'cures' is a very complex and difficult task. But we finally have the tools to do this in a systematic and rational way, and targeted therapies are already emerging.

  11. Re:Why morons are so prevalent in scientific circl by wisnoskij · · Score: 4, Interesting

    "runs counter to reproductive fitness"

    Wrong. There is a huge reproductive fitness bonus for getting old useless people out of the way as quickly as possible, and more specifically a huge natural selection bonus for death after some maximum amount of years. Death is one of the major pillars of natural selection, and cancer, in many species plays a big part to ensure that we do not too many people living to 80-100+ or comparable.

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