Why haven't we cured cancer yet?

I didn't see this message the first time. Truly remarkable comment. Am I trolling?

I'll answer with a text from 1863, by the English historian James Anthony Froude:

In the ordinary branches of human knowledge or enquiry the judicious questioning of received opinions has been regarded as the sign of scientific vitality, the principle of scientific advancement, the very source and root of healthy progress and growth. If medicine had been regulated three hundred years ago by Act of Parliament; if there had been Thirty-nine Articles of Physic, and every licensed practitioner had been compelled, under pains and penalties, to compound his drugs by the prescriptions of Henry the Eighth's physician, Doctor Butts, it is easy to conjecture in what state of health the people of this country would at present be found.

Constitutions have changed with habits of life, and the treatment of disorders has changed to meet the new conditions. New diseases have shown themselves of which Doctor Butts had no cognizance; new continents have given us plants with medicinal virtues previously unknown; new sciences, and even the mere increase of recorded experience, have added a thousand remedies to those known to the age of the Tudors.

If the College of Physicians had been organised into a board of orthodoxy, and every novelty of treatment had been regarded as a crime against society, which a law had been established to punish, the hundreds who die annually from preventible causes would have been thousands and tens of thousands.

I suppose it's trolling to remark that Doctor Butts has made quite a comeback. Source: http://books.google.com/books?id=Xc0YHClRwA4C.

Basically - any single chaotic factor outside the narrowly defined boundaries you have mentioned, will bork your entire system.

While this means that we've reached a similar state to where we are today, the current state is advantageous because it is systematic from the ground up.

Omeprazole has been about for nearly quarter of a century; and is fairly well understood - hell I can walk down to my local drug store and pick up a load from the shelves.

What you are describing, IMO, is either one of two things:

- a systemic failure in healthcare provision (not drug development)

- or a valid trade off between cure and side-effect

If what "advancing knowledge" means to you is "we think we know what's going on and we think we can do it better next time,"

The problem here is that you're going to kill a larger number of people in-trial due to mistakes or missteps. We know this because that is what early medicine did. Whether this is more than those who would die without aggressive research is something of a moot argument. Arguing the numbers is largely pointless because it's impossible to predict what will happen (that, after all, is the point).

Now; I see your argument that this is a valid tradeoff. Indeed, I think we should take more risks than we do. But not quite to the extent you are arguing.

You say this like it follows.

I can too. I can read the label as well, which says to take it for no more than 28 days "without the advice of a doctor." Presumably this is the period for which it's been studied.

The idea of doing a double-blind study of the various systemic effects of a decade of induced achlorhydria is... absurd. How can you say it's understood? It's not understood, at all, either by my standards or yours.

So, without perfect information - I decide. I don't like the fact that all my ancestors for 100 million years had HCl in their guts, and I don't. I do like the fact that I'm not in the process of getting Barrett's esophagus and my abdomen doesn't hurt all the time.

Weighing risks and deciding without perfect information: fact of life. Trying to outlaw this process: like legislating that pi equals 3. Classic failure mode of the utopian 20th century.