Why haven't we cured cancer yet?

10 times more microbial than 'human' DNA in our body.

- There are not enough Billionaires to meet your needs, statistically you'll need quite a few to find any decent cures. Especially with 30 teams in play on each case; figuring out "what worked" is a bad numbers game in that case.

- Science shows there is unlikely to be one "magic bullet" for cancer, which makes it hard to cure individuals and then take that science into a wider populace; "something here worked, but does it work generally?"

- Cancer treatments are harsh and invasive - by design! 30-40 competing drugs is unsustainable, you would be, to put it mildly, royally fucked. So death could come simply by exhausting the body with treatment, as easily as anything else.

- You invoked Godwin's law, which is never a good sign.

I agree with your general premise; which is that it takes too long to iterate ideas into actual production. But the reason that scenario exists is not just "quack medicine" and other hopeful (but useless) remedies, it is for the case of "oh shit, I just killed a million people because we didn't investigate long term effects".

And that is where your theory really fails; because you are trading an unknown collateral now, for an unknown collateral in the future. I'm not arguing against either as a good or bad thing; but it does highlight the fatal flaw in the argument "you are killing X people right now by not releasing/iterating fast enough"

Yeah, and I'm sure our regulatory infrastructure will catch up sometime in the Obama administration. That is, the Malia Obama administration...

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.

Then speed them up! You might have heard the story of Steve and Gorilla Glass:

http://en.wikipedia.org/wiki/Gorilla_Glass

You're not going to tell me the actual chemical reactions are slow. It's all human labor. The speed of any organization is limited by the schedule on which results are demanded - compare the Manhattan Project to the new Bay Bridge.

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?

Yes, because Steve knows he's at risk of dying anyway. Being an intelligent person, Steve compares the risk of dying from neglect, versus dying from treatment, as apples to apples. Do you?

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.

It would be impossible to determine which is which by the present statistical standards. Ie, it would be impossible to absolutely absolutely 10^7 know which was which. It might be possible for an intelligent person to make a good guess, however.

This is how technique advances in any technical field that can't be reduced to pure mathematics. If you're limited to advancing on the basis of perfect truth that absolutely * 10^7 knows it's right (even if when tested in practice, it's 90% irreproducible), you can barely advance at all. Guess what - we're barely advancing at all.

A combined focus of translational and basic research is essential, with a frequent and effective dialogue between the two.

The best way to have a frequent and effective dialogue is to make basic researchers part of the teams treating patients. The distinction is imaginary, anyway.

This was I believe the case for Steve, but not even for Steve could they do personalized drug development as described. They couldn't even try drug candidates which other developers and/or researchers had abandoned along the way - an enormous library of molecules, if properly collated.

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.

It's a separate discussion, but you're actually making the argument against investing in basic cancer biology. Rather, all the investment should be in sequencers, etc.

Reason: consider the studies you did with the tools of 10 years ago. What was difficult then is trivial now. So in what way did it contribute to what you know now? In no way, which makes it useless - if you hadn't done the work then, expensively, you could do it now, trivially. Now, consider the studies you'll do with the tools of 10 years from now...

Of course, the practical effect of funding cancer biology is to fund tools development. But it's a somewhat indirect way to accomplish the objective...

If moldbug had started with 5 concurrent treatments instead of 30, would you object to that? (Though considering death is coming I personally would rather die of treatment exhaustion from X treatments than the actual cancer, knowing I tried many potential solutions. (This conditional on a cancer that actually threatens my life.))

Lastly, are the "unknown collaterals" equivalent unknowns? Shouldn't we try to estimate them and decide whether ramping up the release/iterate process is worth it? That people are dying because the research system sucks doesn't seem that controversial to me or very unknown in truth-value. How likely do you think it is that someone kills 1 million people with some remedy, and how likely do you think it is that the same 1 million people would have lived much longer without such a remedy being attempted on them?