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A Pointless Cancer ‘Moonshot’

nytimes.com

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Re: A Pointless Cancer ‘Moonshot’

#21

Post by yaakov34 »

vectorpush wrote: post #18
yaakov34 wrote: post #15

I am going to go against the grain of the usual sympathetic responses to this type of articles, and I am going to say that this is a case of pernicious and pointless casuistry. Apparently, this now passes for some kind of deep thought on the human condition. Well of course any medical treatment for anything just leads to more medical treatment in the future; that's not a profound statement, not as long as people are…

Totally agree. I'll also add that we don't even need to definitively eradicate the possibility of cancer to consider it effectively "cured". If we can reduce the rate of cancers such that they only start to appear in populations that are approaching, say, 80+ years of age, it will probably become more effective to focus on other leading causes of death rather than dwelling on cancers that end up killing people in the…

Yeah, we'll definitely want a "dementia moonshot", or a few, before we attempt to create a generation of centenarians. However, cancer incidence climbs terrifyingly rapidly when people reach their 60s - long before we are ready to give up on them. A successful cancer moonshot (and the Nixon one, by the way, was quite successful) will let millions of people enjoy many good years with their loved ones; not to mention that it would also save many young people from dying of cancer, although that's a much smaller share of cancer patients.

Re: A Pointless Cancer ‘Moonshot’

#22

Post by mombul »

ams6110 wrote: post #11
openasocket wrote: post #9

It is entirely possible that we can completely cure cancer. Not just a treatment, but actually prevent anyone from ever getting cancer in the first place. It would be super duper difficult, but we know it is possible because of the naked mole rat. Naked mole rats are essentially immune to cancer (I say essentially because this February scientists dicovered two individuals that had cancer, the only two documented case…

Ok I'll state the obvious: people are not rats.

Maybe we should tell the scientists then. Apparently they've been doing it wrong for all these decades...

Re: A Pointless Cancer ‘Moonshot’

#23

Post by maxander »

reasonattlm wrote: post #7

There is a verge that is going to be crossed for cancer soon. The reason that cancer research and development is a slow, expensive, ugly morass is that 99% of the people involved are targeting biochemistry peculiar to a very small number of the thousands of relevant varieties and subtypes of cancer. A year of lab time is much the same ballpark of cost whatever you happen to be doing, give or take. So if it takes a th…

Therapies that could reliably cure any cancer are often worthy of research, but I'd put the expected value of these approaches lower than that of "ugly morass" standard research.

Reason 1; cancer therapies have to effectively kill cancer cells and not important non-cancer cells. Cancer therapies that exist today achieve this by mucking about in mechanisms that are important to cancers and not (or not so much) to other cells. But cancers are diverse- there may just not be anything that's common to all cancer and not shared by healthy cells. Telomere regeneration is a nice candidate, but as you noted, its also important to stem cells- can humans withstand enough damage to their stem cell populations to make a meaningful difference to difficult cancers? (For that matter, telomere regeneration is also important to gametes, so telomere-based therapies may also render the patient infertile.)

Which means we're likely to be stuck dealing with a dozen or hundred-odd different treatments, each of which targets some eccentricity of a specific cancer subtype, but-

Reason 2: There are lots of smart people plugging away at this problem, backed by lots of research money. In addition to being an objectively important problem for humanity, cancer is also an interesting biological conundrum and also the most likely cause of death for a bunch of old people with stratospheric net worths. Even hacking at the problem in bits and pieces, its not unlikely that cancer will become a completely tractable disease (even if a golden-bullet "cure" doesn't arrive) within our lifetimes.

Re: A Pointless Cancer ‘Moonshot’

#24

Post by pc2g4d »

maxander wrote: post #20
yaakov34 wrote: post #15

I am going to go against the grain of the usual sympathetic responses to this type of articles, and I am going to say that this is a case of pernicious and pointless casuistry. Apparently, this now passes for some kind of deep thought on the human condition. Well of course any medical treatment for anything just leads to more medical treatment in the future; that's not a profound statement, not as long as people are…

I was about to post the same- the article has such a "nothing is worth doing" level of pessimism about medicine that halfway through I was wondering if the author was suffering from depression. He's right that an ever-older population will bring about more cancers- so we'd better have ways to treat them . And he's right that the "cancer moonshot" likely won't provide the singular, all-out cure, but no one outside of…

The author acknowledged significant advances in cancer treatment, including one he called a moon landing in its own right (immunotherapy). No need to cast aspersions on his mental state---I think he's clear-eyed yet not despairing, facing the difficulties of cancer treatment (it's like stopping evolution from happening, if you think about it) but still recognizing the progress.

Re: A Pointless Cancer ‘Moonshot’

#26

Post by agumonkey »

reasonattlm wrote: post #10
openasocket wrote: post #9

It is entirely possible that we can completely cure cancer. Not just a treatment, but actually prevent anyone from ever getting cancer in the first place. It would be super duper difficult, but we know it is possible because of the naked mole rat. Naked mole rats are essentially immune to cancer (I say essentially because this February scientists dicovered two individuals that had cancer, the only two documented case…

E.g.: http://www.rochester.edu/news/show.php?id=6572 "These rodents are protected from cancer because their tissues are very rich with high molecular weight hyaluronan (HMW-HA)."

Weird, from what I get from https://en.wikipedia.org/wiki/Hyaluronic_acid#Functions hyaluran helps cell migrations (metastatis)...

Re: A Pointless Cancer ‘Moonshot’

#27

Post by DrScump »

TheOtherHobbes wrote: post #19
yaakov34 wrote: post #15

I am going to go against the grain of the usual sympathetic responses to this type of articles, and I am going to say that this is a case of pernicious and pointless casuistry. Apparently, this now passes for some kind of deep thought on the human condition. Well of course any medical treatment for anything just leads to more medical treatment in the future; that's not a profound statement, not as long as people are…

A while ago I was reading a harrowing description of life in the 1930s. One of the author's memories was the sound of a neighbour in a nearby house screaming - and screaming, and screaming - in unbearable pain while dying of cancer. We've definitely moved on since then. Moonshot or no, anything that helps make that experience less likely has to be a good thing.

That neighbor's tumor type could still well be incurable, but palliative care and pain management have improved significantly since then.

Re: A Pointless Cancer ‘Moonshot’

#28

Post by waterphone »

ams6110 wrote: post #12
ubernostrum wrote: post #8

Earlier quoted context omitted.

It's not mandatory in the US; you just pay a penalty the next time you file your taxes if you went too long without insurance. Spoiler: the penalty is far less than the cost of having insurance, which means it's still cheaper to just be uninsured (so long as you stay relatively healthy) and pay up on your tax return.

No it is mandatory, hence the penalty for not having it.

It effectively is a fine, but it's not a criminal penalty, so it's kind of like an opt-out fee that's significantly cheaper than most of the supposedly affordable plans. (Which are extremely expensive even at the low-end where they're completely useless with $10,000 deductibles.)

Re: A Pointless Cancer ‘Moonshot’

#29

Post by DrScump »

reasonattlm wrote: post #10
openasocket wrote: post #9

It is entirely possible that we can completely cure cancer. Not just a treatment, but actually prevent anyone from ever getting cancer in the first place. It would be super duper difficult, but we know it is possible because of the naked mole rat. Naked mole rats are essentially immune to cancer (I say essentially because this February scientists dicovered two individuals that had cancer, the only two documented case…

E.g.: http://www.rochester.edu/news/show.php?id=6572 "These rodents are protected from cancer because their tissues are very rich with high molecular weight hyaluronan (HMW-HA)."

No, they are protected from cancer because naked mole rats never get cancer, to our knowledge.

HMW-HA is a correlation that has not been proven to be effective for preventing cancer elsewhere. Remember, such claims used to be made about shark cartilage, too.

Re: A Pointless Cancer ‘Moonshot’

#30

Post by DrScump »

ams6110 wrote: post #11
openasocket wrote: post #9

It is entirely possible that we can completely cure cancer. Not just a treatment, but actually prevent anyone from ever getting cancer in the first place. It would be super duper difficult, but we know it is possible because of the naked mole rat. Naked mole rats are essentially immune to cancer (I say essentially because this February scientists dicovered two individuals that had cancer, the only two documented case…

Ok I'll state the obvious: people are not rats.

Naked mole rats aren't even rats, per se - they are the only species in its genus and the only known eusocial mammal. (I wonder if E. O. Wilson studied them?)
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