Good God, this article is depressing. I used to think we'd have some therapies to at least suppress new growth in my lifetime. If I'm understanding what he's written they don't even have a game plan for an effective treatment.
Why haven't we cured cancer yet?
101–110 of 167 posts
Re: Why haven't we cured cancer yet?
#102Earlier quoted context omitted.
They don't know DCA doesn't work that well because they are not spending money on R&D. I agree they can get a use patent on DCA, as a matter of fact the researcher from University of Alberta already has a use patent on DCA as a cure for cancer. interesting info on BG-12. thanks.
Big drug companies are CONSTANTLY exploring new areas, trust me, they looked into DCA and found it wanting. I can't personally attest to the amount of R&D dollars spent by pharma on R&D, but it has been EXTENSIVELY studied, just checked out pubmed (gov't funded research). http://www.ncbi.nlm.nih.gov/pubmed?term=dichloroacetate If DCA were an effective agent, they would have handed the U of A a handsome check for that…
Hundreds of millions of dollars and years of clinical trials are needed to prove if DCA is effective or not. You can't just say "trust me, they looked into DCA and found it wanting". Looked at it how? Have they done years of clinical trials? did they spend millions in R&D on this?
Re: Why haven't we cured cancer yet?
#103I have the answer. It's a simple one word answer. GREED. But seriously It's the money that keeps us from curing cancer, or lack thereof. Nothing else. As human beings we really need to decide what's more important....Wealth or our survival and wellbeing. We're too smart as a society to let things like lack of money keep us from curing disease and exploring other planets.
It's not lack of money at all. How many researchers, worldwide, do you think have the expertise necessary to make a nontrivial contribution?
The problem is we simply don't have the technology to develop a cure for cancer, and we don't even know the precursor technologies we need to develop a cure for cancer.
Re: Why haven't we cured cancer yet?
#104We haven't cured a lot of things. Well, we've cured lots of small things, but few of the doozies. A baldness cure has been ten years away for the last thirty years. No cure for blindness, AIDS, lost limbs. Remember the blue denim dye that killed cancer? What happened to it? If something is "ten years away", it means we simply don't know how to do it, we are just hoping for someone else to come up with the tech to sol…
> If something is "ten years away", it means we simply don't know how to do it
In terms of medicine, human trials generally take ten years. If something is ten years away, I would take it to mean there is a promising solution now. It just might not look nearly as promising in ten years, after it has been rigorously tested on people.
Re: Why haven't we cured cancer yet?
#105We haven't cured a lot of things. Well, we've cured lots of small things, but few of the doozies. A baldness cure has been ten years away for the last thirty years. No cure for blindness, AIDS, lost limbs. Remember the blue denim dye that killed cancer? What happened to it? If something is "ten years away", it means we simply don't know how to do it, we are just hoping for someone else to come up with the tech to sol…
Most of the big things we cured where diseases that no-longer seem to be a big deal because they where cured. Food born illness, measles, and smallpox are all things that have killed more people than AIDS and are no longer a problem in the western world. Measles what's that? If vaccinations were stopped, each year about 2.7 million measles deaths worldwide could be expected. http://www.cdc.gov/vaccines/vac-gen/whatif…
Actually creating most of the viral vaccines is more like theming a computer interface, you just need to plugin the new virus into your already well defined research work flow. That's the only reason we even have so many vaccines for so many viruses (even considering mutations and unknown strains).
Drop in one virus (AIDS, H1N1) which is out of the well known workflow and every thing goes haywire. I think the main reason for this whole mess is that, out of all the STEM fields, biology is the most trial and error prone.
It's the equivalent of trying to prove a mathematical formula every single time you want to use it because there are no axioms. Until some one discovers some standard good for everything axioms in biology, it will continue to be retarded cousin of all STEM fields.
Re: Why haven't we cured cancer yet?
#106One angle I feel is often missed in the whole cancer discussion is that it's a multidimensional problem. 1) Developing drugs which can damage cancer cells selectively. Like selecting a few needles in a haystack, cancer cells typically "look" the same as healthy cells, which makes selectively destroying them very difficult. Some cancers (such as CML) have a specific driver mutant proteins which allows for a pinpoint a…
I'm going to be a heretic and argue that the problem with cancer research is institutional, not biological. The biological problem is clearly very hard, but the institutional problem is impossible. You might or might not be familiar with the term "OODA loop," originally developed by fighter pilots: http://en.wikipedia.org/wiki/OODA_loop If the war on cancer was a dogfight, you'd need an order from the President every…
> But if you do this for enough billionaires, the common elements in the problem will start repeating and the researchers will learn a repertoire of common hacks.
No, they'll at best learn nothing, or more likely think they learn something and send the entire field off into the woods for a decade or two. Crack open "the Emporer of all Maladies" for a glimpse at just how difficult it is to judge effectiveness of treatments and preventions in even extremely controlled studies.
And your idea that somehow embracing quackery will lead to effective cancer treatments is just frankly insane.
Re: Why haven't we cured cancer yet?
#107Earlier quoted context omitted.
>- Sequencing Cancers and attempting to find a match to suggest a treatment will not work, each cancer is unique and itself made up of a diverse population It seems to me that sequencing is a must, rather than a "not work," as without that type of intelligence one can't even know what you're up against. You just need to take into account the diversity of mutations, and not assume that you've seen everything that's cu…
You are right. I did not mean that sequencing shouldn't be done, what I meant was that the simple idea of sequence -> nearest match -> most appropriate treatment won't work due to the massive amount of variance involved. So the sequencing will be more useful at higher level. So more understanding patterns and devising strategies than personalizing cocktails.
Ah, I see what you're saying. Though even going with the best treatment in the nearest match is a huge leap forward over what we can currently do. I see two ways forward, using the current class of chemotherapeutics + small molecule/antibody targetted therapies. As straw men, they are:
1) come up with a totally complete model of what everything in the cell does, how the mutations affect those interactions amongst gene products, and change the cell, and then designing some treatment to selectively kill that tumor population and to also block off obvious avenues to evolve resistance.
2) the "dumb" approach, figure out classes of disease, and try to use induction from the results of previous patients in that class of disease to figure out the best treatment for the current patient.
Right now both avenues are being pursued as best as possible. The first straw man is far from being approachable; we know so little about molecular biology, and when physics can't even figure out how to fold a protein, how are we going to be able to figure out changes to protein-protein binding dynamics, etc? Not that it can't be done eventually, but it's a very tough road.
The second approach is probably the best we can do now, and corresponds very well to the type of machine learning that is being researched these days. Even without full understanding of the biological system and the effects of all possible mutations, we can combine what we currently know with machine learning to construct a black-box for the parts of molecular biology that we don't yet know. I think that this is probably the most reasonable path forward for the time being, though we clearly need some intelligent way to guide studies into the combinatorial effect of targeted therapies.
Re: Why haven't we cured cancer yet?
#108Earlier quoted context omitted.
I'm going to be a heretic and argue that the problem with cancer research is institutional, not biological. The biological problem is clearly very hard, but the institutional problem is impossible. You might or might not be familiar with the term "OODA loop," originally developed by fighter pilots: http://en.wikipedia.org/wiki/OODA_loop If the war on cancer was a dogfight, you'd need an order from the President every…
> But if you do this for enough billionaires, the common elements in the problem will start repeating and the researchers will learn a repertoire of common hacks. No, they'll at best learn nothing, or more likely think they learn something and send the entire field off into the woods for a decade or two. Crack open "the Emporer of all Maladies" for a glimpse at just how difficult it is to judge effectiveness of treat…
just how difficult it is to judge effectiveness of treatments and preventions in even extremely controlled studies.
Translation: "just how difficult it is to be absolutely absolutely absolutely * 10^7 sure we're not selling quack medicine."
The treatment of Steveoma is effective if Steve gets better. If not, it isn't. The sample size is 1 by definition.
Obviously, if Steve gets better and he's taking 30 drugs, no one has any way to know which of the 30 worked, which were unnecessary, and which were actually counterproductive. But you still know more than you do when you started - you know that something worked. Lather, rinse, repeat.
And your idea that somehow embracing quackery will lead to effective cancer treatments is just frankly insane.
I love being refudiated in the morning!
Re: Why haven't we cured cancer yet?
#109One angle I feel is often missed in the whole cancer discussion is that it's a multidimensional problem. 1) Developing drugs which can damage cancer cells selectively. Like selecting a few needles in a haystack, cancer cells typically "look" the same as healthy cells, which makes selectively destroying them very difficult. Some cancers (such as CML) have a specific driver mutant proteins which allows for a pinpoint a…
Those are all treatments for cancer, not a cure.
Re: Why haven't we cured cancer yet?
#110One angle I feel is often missed in the whole cancer discussion is that it's a multidimensional problem. 1) Developing drugs which can damage cancer cells selectively. Like selecting a few needles in a haystack, cancer cells typically "look" the same as healthy cells, which makes selectively destroying them very difficult. Some cancers (such as CML) have a specific driver mutant proteins which allows for a pinpoint a…
I'm going to be a heretic and argue that the problem with cancer research is institutional, not biological. The biological problem is clearly very hard, but the institutional problem is impossible. You might or might not be familiar with the term "OODA loop," originally developed by fighter pilots: http://en.wikipedia.org/wiki/OODA_loop If the war on cancer was a dogfight, you'd need an order from the President every…
[There's a TL/DR at the bottom]
Everyone's cancer is its own disease (if not several), so the researchers are fighting one disease (or several), instead of an infinite family of diseases. They are not trying to cure pancreatic cancer - they are trying to cure Steveoma. You're absolutely right that this is the mentality that future treatments need to take. In terms of treatment response, a liver tumour could have far more in common with a brain tumour than another liver tumour - the anatomical pigeonholing of cancers is a throwback to pre-molecular diagnostic times (so about 5-10 years ago and before) and is something that will hopefully change over time.
They can find an exploit in Steve's cancer genome on Wednesday, design a molecule to hack it on Thursday, synthesize it on Friday and start titrating it into the patient on Saturday. If this time frame were possible this would be ideal, however, unfortunately each of these steps (if they are possible) takes significantly longer than an evening, and typically far longer than a patient has.
Moreover, Steve isn't on just one drug. He's got thirty or forty teams attacking every vulnerability, theoretical or practical, that may exist in his cancer cells. This is a risky game. How do I (the scientist) know which drugs were effective? How do I know how they'll react with one another? If my focus is Steve, then do I really want to risk killing him through an unexpected cross reaction of my 30-40 untested drugs?
Not everyone is a billionaire. But if you do this for enough billionaires, the common elements in the problem will start repeating and the researchers will learn a repertoire of common hacks. How many billionairs? There are (apparently) 1210 billionairs in the world. So say they all get cancer and get this team of doctors - if any of the patients survive then some aspect of the treatment worked. If they don't some aspect failed. It would be impossible to determine which is which. Considering the heterogeneity in terms of cancer genetics, 1210 would tell you very little at the genetic level.
You'll note that a lot of cancer patients die anyway. But a lot fewer than used to.
The entire process we call "drug development" is an attempt to gain six-sigma confidence that we are not practicing quack medicine. Especially for cancer, do we need all these sigmas? And are we obtaining them in an efficient way? I can't imagine how anyone would even begin to argue the point. This is not the problem with drug discovery (or correct).
[TL/DR] There are aspects of this which ring true (reproducibility is an issue, although how you measure it is also a source of contention, and mouse models have their downside, certainly), however, there are also gross assumptions and misunderstandings which would make this course of action as ineffective as it would be expensive. There is an absolutely imperative need to begin to asses and describe cancers as more related to a patient than a disease title, you are quite right. But to forgo basic research in favour of arbitrary treatment-come-experiments would be to dismiss the last 100 years of biological research which have provide us in a position where you can make your argument. A combined focus of translational and basic research is essential, with a frequent and effective dialogue between the two.
Ultimately, your argument assumes the rate of discovery will be constant. You need to consider the research in the broader picture. Cancer is a genetic disease (in terms of pathological origin, not necessarily in hereditary terms). It cost the (publicly funded) human genome project $3bn to sequence a human genome in about 12 years. Now it costs $5000 in a week or so, and both the cost and the time is coming down. As I said before, it is an exciting time to be a cancer biologist.
-- I can't reply again, but, um, are you trolling?