Why Preventing Cancer Is Not the Priority in Drug Development

Multicellular organisms have to control the replication and renewal of their cells constantly. In a simplified view, cancer is a loss of that control.

Preventative tools exist today that would significantly reduce the incidence rate of cancer.

Much of them require lifestyle modifications and regulation, unfortunately, which is admittedly very difficult to do. Still, I suspect investment in these areas would likely have a higher return on investment than R&D into broad preventative drugs.

(1) Smoking Cessation: Reducing tobacco use has a =huge= positive effect on cancer reduction - an order of magnitude higher than anything else we can do.

1 in ever 5 deaths of males over the age of 30 is due to to tobacco-induced illnesses, and a third of those are cancer [0]. Globally, 31% of men and 6% of women smoke daily. 17% of Americans are daily smokers. Over 1 billion people are projected to die due to tobacco-related illnesses in the 21st century.

(2) Obesity: A recent epidemiological study found that 4% of cancer in men and 7% in women was due to obesity. It was as high as 40% for some cancers such as endometrial and esophageal adenocarcinoma [1].

(3) Alcohol/Red & Processed Meat: Consumption of alcoholic beverages is a known human carcinogen. A recent study estimated that 3.5% of all cancer deaths can be attributed to alcohol [2]. A separate study found that 3% of all cancers, including 21% of bowel cancers, was attributed to red & processed meats [3].

(4) Environmental & Occupational Hazards: The WHO estimates 19% of all cancers globally are attributable to environmental factors [4]. This includes air pollution, which likely causes 3% to 14% of all lung cancers, as well as exposure to chemicals in the workplace such as asbestos.

[0] http://www.ncbi.nlm.nih.gov/books/NBK54023/

[1] http://www.cancer.gov/about-cancer/causes-prevention/risk/ob...

[2] http://www.cancer.gov/about-cancer/causes-prevention/risk/al...

[3] http://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/...

[4] http://www.who.int/mediacentre/factsheets/fs350/en/

> In reality it's a bit more complex than that, and even very old people can and do contribute to the survival of their children or their close relatives. That's true for human beings. But for most species that is not true. Maybe that's why we are better at longevity than other species (http://www.medcan.com/articles/a_finite_number_of_heart_beat...). But we still have millions of years of evolution that say that it is better to be able to live short and intense than to be able to live long and die before achieving that of disease, predators, etc. Why nature will invest in an extreme long lifespan that is not going to happen? So for most species what happens to you as you grow old is not very important and other traits will be selected before lifespan by evolution.

Ok please... I wasn't, and still am not, seeking to use HN discussion threads to persuade anyone with a strongly held position on medical science to change their position.

I was simply backing up others' suggestions that psychology could play a significant role in serious illnesses like cancer, by pointing out that there are prominent figures with mainstream scientific backgrounds (Lipton was a stem cell researcher and medical lecturer at Wisconsin and Stanford; Tanzi is a senior professor of medicine at Harvard) who have written books explaining and documenting some of the science behind this idea and that I and many others find their work persuasive.

I wasn't seeking to win any argument with an appeal to authority (though you did, along with a straw man dismissal).

I was suggesting some sources of further insight that others may have chosen to pursue if interested.

Then in response to your combative reply, I explained that I have personal experience with the topic. Again, not trying to win any arguments with this, just indicating that I have cause to take this issue very seriously and research it very deeply (I've read far more broadly than just Lipton and Tanzi fwiw).

But still, in response to your demand for hard evidence I linked to one academic paper on the topic and I linked to more in another (far more polite) comment in the thread.

After that discussion I went searching for further journal papers on the topic and found this:

http://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7...

Seriously, I have no dog in any fight other than that I was sick for a long time and now I'm making big strides towards to being very well. And I know there are many people - some I know personally - who are falling through the cracks of the medical system and it's very sad to witness.

I don't care much for any wars over the validity of "mainstream" vs "alternative" medicine. I consider most non-mainstream medicine ineffective and most alternative practitioners (including chiros) to be quacks.

But as a startup guy I'm comfortable with the idea that the most transformative ideas will often come from the fringes, and may well be sitting there already, just waiting to be explored. The fact that one of this year's Nobel Prize winners for medicine was for a discovery that came from traditional Chinese medicine should serve as an important reminder of that.

On the topic at hand: it's uncontroversial that psychology plays a role in the development and healing of physiological illness. The only questions are on the mechanics of how it works, the specifics of how it manifests in particular illnesses, and what techniques may exist or may be developed that could be effective in clinical settings.

In all sincerity, if you genuinely care about this topic and want to discuss it further, I'd be most willing to do so. I'd be happy to share more details about my own illness and recovery, and other sources of evidence that I've found useful.

You can find my details in my profile.

Like I said, I understand the skepticism as I was exactly that way inclined myself not so long ago.

But I'm also familiar with the kind of person who is more interested in picking and winning petty battles than learning about a topic through a good-spirited discussion.

So I'll finish by saying that while I accept my comments could have been more convincing with links to hard evidence (if convincing was what I'd set out to do), your rhetorical style is not of the kind that helps make HN a productive place to discuss interesting ideas, and thus seems contrary to the spirit of participation we try to cultivate here.

That said, I'm still happy to hear from you if you sincerely want to explore the topic further.

Reflecting further on this...

Your comments feature the following fallacies:

- appeal to authority

- poisoning the well

- begging the question

- straw man

- appeal to common belief

- appeal to ridicule

Needless to say, it's against the spirit of HN, which seeks to uphold the principle of charity as a means of working together to find the truth in the topic at hand.

Nevertheless, as requested I've provided links to evidence to support the point of view I was presenting.

I just wish it didn't have involve so much time defending myself against the hostility.

On the upside, I've learned more about the topic, I've developed further thoughts about how to help bring about further research, and I've been reminded just how much of a minefield the topic is and how cautious one needs to be around it. So, some good has come of it.

But seriously, if you value HN as a place of productive discussion, please bring a spirit of charity and enquiry.