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Most types of cancer not due to “bad luck” [pdf]

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Re: Most types of cancer not due to “bad luck” [pdf]

#21
post #14

The author makes a few references to the idea of "scientific consensus", which I find curious. It's a phrase that I tend to cast aside as politically motivated. Politicians in the climate change debate like to point to "scientific consensus" as a way of saying, "look, all these intelligent people whose work we personally don't understand agree, so they must be correct." But one tenant of scientific thought is that tr…

The hallmark of science is predictive power. Experiments, replication, peer review are all nice but optional. When you have a general enough theory, you don't need to re-do the exact same experiment. You may not need to experiment at all and get by on mere observation. (Just call it a "natural experiment" when pressed.)

I don't think this is correct. Willingness to accept theories based on our limited understanding of the underlying facts and our observations has led to widespread, incorrect belief before.

Descartes and Galileo accepted atomism because, based on their limited understanding of chemistry, it made sense. It wasn't until experiments like the cathode ray tube experiment and the gold foil experiment revealed more elementary particles and forced people to revise their beliefs.

Philosophers of science like Karl Popper like to focus on falsifiability over induction precisely because we tend to become complacent in beliefs that don't tell the whole story and otherwise obscure more interesting, less intuitive underlying phenomena.

I feel like, if we had it your way, we might still be atomists.

Re: Most types of cancer not due to “bad luck” [pdf]

#22
post #5

> For many cancers, the authors argue for a greater focus on the early detection of the disease rather than on prevention of its occurrence. If misinterpreted, this position could have serious negative consequences from both cancer research and public health perspectives. > In principle ... nearly half of all cancer cases worldwide can be prevented I am not sure what to take from this article. Lung cancer prevention…

Is it a myth that prostate cancer is something you die with, rather than die of?

There is a great difference between the incidence of prostate cancer and the death rate from it. Prostate cancer is currently diagnosed in 15 to 20% of men during their lifetime, but the lifetime risk of death from prostate cancer is only 3%. Source: European prostate cancer guideline (page 45): http://www.uroweb.org/gls/pdf/09%20Prostate%20Cancer_LRLV2.p...

Re: Most types of cancer not due to “bad luck” [pdf]

#23
post #16

Earlier quoted context omitted.

It's not as simple as that. Most "indecisiveness" that appears to come from science is from different studies being taken out of context, or poor media reporting. Most wild claims you see aren't from the researchers themselves. See Steven Novella's recent blog post on this subject. http://theness.com/neurologicablog/index.php/scott-adams-on-...

I'm not sure that matters. It's ok to eat cholesterol now, right? All these "mistakes" give science a black eye. We've already got a Climate Change trustworthyness problem and for some reason people don't trust vaccines, mostly educated people. As a nation, we refused to fund both the Hubble and the Supercollider, which would have been bigger than CERN. It's probably time that we stopped making excuses and think of a…

>It's ok to eat cholesterol now, right?

The position of "science" has been to eat a balanced meal and exercise for as long as I can remember. You won't see a medical journal recommending fad diets. Steve covers this fairly well in the article I linked.

But still, public outreach could be greatly improved. It's unfortunate that many public doctors or educators on the subject are shills like Dr. Oz.

Re: Most types of cancer not due to “bad luck” [pdf]

#24

The author makes a few references to the idea of "scientific consensus", which I find curious. It's a phrase that I tend to cast aside as politically motivated. Politicians in the climate change debate like to point to "scientific consensus" as a way of saying, "look, all these intelligent people whose work we personally don't understand agree, so they must be correct." But one tenant of scientific thought is that tr…

> But one tenant of scientific thought is that truth and factuality are not measures of an individual's or society's belief, but rather, they are discovered by experiments whose results can be replicated.

Discovery and replication can be complex affairs though: was the experiment competently executed, was it interpreted the right way, did any attempt at replication properly replicate the conditions of the original, is there theory to go along with the experiment and how convincing and coherent is that theory, and so on and so on. And if there are points of disagreement, good luck trying to figure out who is right without any domain knowledge.

So, yes, ultimately, as a non-scientist in a lot of cases your best bet is to look at what the scientific consensus is, rather than trying to be a scientist yourself.

Re: Most types of cancer not due to “bad luck” [pdf]

#25

This document is both a political document and, to a lesser extent, a scientific one. On the political front, the document encourages people to reject that cancer predilection is stochastic and to encourage the continued study of cancer. The scientific component attempts to provide an underpinning to the political goal. It uses a handful of epidemiological examples, such as the climbing incidence of colorectal cancer…

The cancer research and cancer epidemiology communities do not really talk to each other (as a cancer researcher for many years I have never been to an epidemiology seminar despite working in a 'cancer center'). So it is really a fight for money and mind influence. Most cancer researchers lean towards drugs targeting molecular mechanisms of cancer, cancer epidemiologists, on the other hand, aim for political decisions that combat environmental factors. Where should most money go? what should be discussed in the media?

Vogelstein proposes a simple model that explains a lot of data. Sure, the implications are bleak, but the scientists I talked to were not really surprised that it finally got out.

Re: Most types of cancer not due to “bad luck” [pdf]

#26

The author makes a few references to the idea of "scientific consensus", which I find curious. It's a phrase that I tend to cast aside as politically motivated. Politicians in the climate change debate like to point to "scientific consensus" as a way of saying, "look, all these intelligent people whose work we personally don't understand agree, so they must be correct." But one tenant of scientific thought is that tr…

> But one tenant of scientific thought is that truth and factuality are not measures of an individual's or society's belief, but rather, they are discovered by experiments whose results can be replicated. Discovery and replication can be complex affairs though: was the experiment competently executed, was it interpreted the right way, did any attempt at replication properly replicate the conditions of the original, i…

This is reasonable -- I admit, I accept as true many results that I don't fully understand precisely because I don't have time to learn everything about every field.

But I'm not sure that this kind of leniency with respect to evidence for beliefs is incompatible with the idea that we should focus on the results over the individuals.

Re: Most types of cancer not due to “bad luck” [pdf]

#27
post #16

Earlier quoted context omitted.

I'm not sure that matters. It's ok to eat cholesterol now, right? All these "mistakes" give science a black eye. We've already got a Climate Change trustworthyness problem and for some reason people don't trust vaccines, mostly educated people. As a nation, we refused to fund both the Hubble and the Supercollider, which would have been bigger than CERN. It's probably time that we stopped making excuses and think of a…

>It's ok to eat cholesterol now, right? The position of "science" has been to eat a balanced meal and exercise for as long as I can remember. You won't see a medical journal recommending fad diets. Steve covers this fairly well in the article I linked. But still, public outreach could be greatly improved. It's unfortunate that many public doctors or educators on the subject are shills like Dr. Oz.

You could start by providing the links to the science! Why should I trust what you're saying? There's always someone on the Internet making claims. People debate have raging debates and few people actually provide real data.

Re: Most types of cancer not due to “bad luck” [pdf]

#28
Physician here. I think I can provide some clarification for what is going on here. I just read the article the WHO is addressing and this is a line from the final paragraph:

Our analysis shows that stochastic effects associated with DNA replication contribute in a substantial way to human cancer incidence in the United States.

First, the terminology is important to understand. In medicine, "stochastic" is in contrast to "deterministic" which describe the occurences of pathology based on a risk factor. In a "stochastic" model, if you receive 10 severe sun burns then your chances of getting a skin cancer go up over someone who only received 1 severe sun burn, but are by no means certain or even that your cancer will be more severe... simply an increase in probability. In a "deterministic" model, if you receive 5 Grays of radiation then you will have less severe symptoms than someone who received 50 Grays of radiation and for the most part, your symptoms will be certain and predictable.

Now you need to have one element of cancer biology under your belt:

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

This basically says that as cells divide, errors are propagated through their progeny until there is a proverbial 'straw that breaks the camel's back' and the cell becomes cancerous.

In summary, that line from the final paragraph is basically saying that cells that divide more rapidly in the human body are more likely to become cancer. Well, yeah of course!

We have known this for a long time but what this paper did is sort cancers into two groups, one that is primarily stochastic and one that is primarily deterministic. The result appears impressive because they have a lot of cancers on the stochastic side... stating that their incidence is more predicted by cell division rather than the deterministic, preventable factors.

But as the WHO correctly stated, they are incorrectly analyzing this data as described in this paragraph:

These include the emphasis on very rare cancers (e.g. osteosarcoma, medulloblastoma) that together make only a small contribution to the total cancer burden. The report also excludes, because of the lack of data, common cancers for which incidence differs substantially between populations and over time. The latter category includes some of the most frequent cancers worldwide, for example those of the stomach, cervix, and breast, each known to be associated with infections or lifestyle and environmental factors.

The cancers grouped into the stochastic side overall make up a tiny percentage of all cancers and so by number/%/incidence, the deterministic side would be enormous if graphed appropriately. For example, their most 'stochastic' cancer is pancreatic islet cell which only has 2500 cases/year in the US vs their 'lung smokers' cancer which has >220,000 cases/year.

I mean they seem almost willfully blind to their incorrect conclusion. Environmental factors are HUGE and the cancers caused independent of those would not benefit from screening and environmental risk reduction--a fact we already know!

As a last note, the 'most' deterministic cancers--inherited types--have to be agressively treated with screening, prophylactic measures and environmental exposure risk reduction, etc. You can read about a couple of the deterministic cancers they mention in this paper:

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

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

Re: Most types of cancer not due to “bad luck” [pdf]

#29

This shows a severe misunderstanding of statistics. The original paper (here: http://www.sciencemag.org/content/347/6217/78.abstract -- the abstract is enough to deduce the conclusion) is a simple statistical analysis of mutation probability in certain cell types. It's basically saying that many cancers are not necessarily influenced by external factors and can be predicted by nothing more than the number of cell div…

> That, in itself, is a fascinating scientific result

There are plenty of problems with the original paper see

http://www.sciencemag.org/content/347/6219/224.full

http://arxiv.org/abs/1501.04605

http://www.iarc.fr/en/media-centre/pr/2015/pdfs/pr231_E.pdf

Re: Most types of cancer not due to “bad luck” [pdf]

#30

This document is both a political document and, to a lesser extent, a scientific one. On the political front, the document encourages people to reject that cancer predilection is stochastic and to encourage the continued study of cancer. The scientific component attempts to provide an underpinning to the political goal. It uses a handful of epidemiological examples, such as the climbing incidence of colorectal cancer…

Overall, it's not clear to me why this was published.

The fifth paragraph explains why it was published:

“Concluding that ‘bad luck’ is the major cause of cancer would be misleading and may detract from efforts to identify the causes of the disease and effectively prevent it.”

It's fairly obvious that if a study tells people most cancers are caused by bad luck and not bad actions, there will be some subset of the population that rationalizes their bad actions through such a study. If the study is inaccurate it could then actually cause additional cancers through misinformation.

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