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Why haven't we cured cancer yet?

sciencebasedmedicine.org

91–100 of 167 posts

Re: Why haven't we cured cancer yet?

#91
post #88

Given the article talks about decades-long lead times before a cancer metastasizes, I hope that more attention begins to be focused on much earlier-stage detection and treatment. I think a lot of the problem is, by the time a cancer has metastasized and one begins showing symptoms , it's already very late in the game to try and fix things. From the article: Moreover, as was discussed in at least a couple of talks at…

early-stage detection and treatment is critical. I lost love ones to cancer because the cancer was not diagnosed early enough.

somewhat related to the discussion. saw this last week.

Daily Aspirin May Help Prevent and Treat Cancer

“What really jumps out at you in terms of prevention is the striking 75 percent reduction in esophageal cancer and a 40 to 50 percent reduction in colorectal cancer, which is the most common cancer right now,” Dr. Rothwell said. “In terms of prevention, anyone with a family history would be sensible to take aspirin,” he added.

http://www.nytimes.com/2012/03/21/health/research/studies-li...

http://online.wsj.com/article/SB1000142405270230472440457729...

http://www.webmd.com/cancer/news/20120320/daily-aspirin-may-...

Re: Why haven't we cured cancer yet?

#92
post #66

Earlier quoted context omitted.

Here's something interesting about a common chemical compound called Dichloroacetic acid (DCA). Big pharma is ignoring it since it can't be patented (because it's so common). Cancer cells change the way they metabolize oxygen in a way that promotes their survival. In laboratory studies of isolated cancer cells grown in tissue culture, DCA restores the original metabolism, and promotes their self-destruction. This has…

Big pharma isn't ignoring it because of the patent issue, they are ignoring it because it doesn't work that well. They may not be able to get a "composition of matter" patent on it, but they could get a "use" patent on it. For a great example of a VERY common chemical that big pharma is developing, check out BG-12 from Biogen. It's dimethyl fumarate, something you can buy in ton quantities and most labs have jars of…

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.

Re: Why haven't we cured cancer yet?

#93

Earlier quoted context omitted.

This needs some more love. Consider the cycle of academic career: -Grad school for 5-8 years, averaging around 7 for most molecular and cellular biologists. You make $23-28k a year depending on where you live. You steal whatever free food is lying around your department -Post graduation, you obtain a Post-Doc position for ~2 years (if everything goes well). This pays ~40k/year, again varying depending on region. -If…

The difference is people rarely go into academic research for money - it's not just a job, it's a lifestyle choice. If you wanted to do research and receive better compensation you could work in industry or for a government lab - still research but less freedom.

But with better compensation you would have brilliant minds who are only interested in a paycheck looking into the data as well and they would still produce results. Frankly, I'd rather these greedy minds look for cancer cures than into creating new exotic financial instruments.

Re: Why haven't we cured cancer yet?

#94

Because, like AI, molecular biology is complicated and there are no quick hacks . Some things are meant to take time and be right. First time. Survival rates are spectacularly better than they were fifteen or twenty years ago and they are getting better all the time. Also there is no one type of lung cancer, brain tumour or bladder or bowel cancer either. There are many different types. Half the battle is identifying…

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Re: Why haven't we cured cancer yet?

#95
post #66

Earlier quoted context omitted.

Big pharma isn't ignoring it because of the patent issue, they are ignoring it because it doesn't work that well. They may not be able to get a "composition of matter" patent on it, but they could get a "use" patent on it. For a great example of a VERY common chemical that big pharma is developing, check out BG-12 from Biogen. It's dimethyl fumarate, something you can buy in ton quantities and most labs have jars of…

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 use patent. They didn't, so what does that tell you?

Re: Why haven't we cured cancer yet?

#96

Earlier quoted context omitted.

I'm not sure why you're being downvoted. Evolution is simply the changing of allele frequencies over time, which can certainly happen in the absence of mutation. Although, I don't know that I would say "plenty" of evolution can happen without mutations, but I guess that depends on what you think "plenty" is.

Only changing allele frequencies is proven to result in a stable state. You need mutation for evolution.

Changing of allele frequencies can occur by creation of new alleles (ie. mutations), but it doesn't have to. The definition encompasses both possibilities.

Re: Why haven't we cured cancer yet?

#97
post #79

What I got from this: - Cancer is complex, its profile is not that of 1 disease but many hundreds of diseases - 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 - Cancer is mutiny combined with the greed of evil dictators. A bunch of cells give up the chain of command and start co-opting resources to feed their opu…

>- 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.

Re: Why haven't we cured cancer yet?

#98

One 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 time you wanted to adjust your ailerons. Your OODA loop is 10-20 years long. If you're in an F-16 with Sidewinder missiles, and I'm in a Wright Flyer with a Colt .45, I'm still going to kill you under these conditions. Cancer is not (usually) a Wright Flyer with a Colt .45.

Lots of programmers are reading this. Here's an example of what life as a programmer would be like if you had to work with a 10-year OODA loop. You write an OS, complete with documentation and test suites, on paper. 10 years later, the code is finally typed in and you see if the test suites run. If bug - your OS failed! Restart the loop. I think it's pretty obvious that given these institutional constraints, we'd still be running CP/M. Oncology is still running CP/M.

Most cancer researchers are not even in the loop, really. For one thing, 90% of your research is irreproducible:

http://www.pharmalot.com/2012/03/many-cancer-studies-are-act...

Even when the science is reproducible, your cell lines and mouse models are crap and bear little or no resemblance to real tumors. You know this, of course. But you keep on banging your heads against the wall.

What would a tight OODA loop look like? Imagine I'm Steve Jobs, with infinite money, and I have cancer. 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.

Second, they operate with no rules. 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. Pharmacokinetics? Just keep doubling the dose until the patient feels side effects. Hey, it worked for Alexander Shulgin.

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. Why shouldn't he be attacking his cancer in 30 ways at the same time? He's a billionaire, after all.

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. Eventually, the unusual becomes usual - and cheap. This is the way all technology is developed.

Of course, someone might screw up and a patient might die. You'll note that a lot of cancer patients die anyway. Steve got a lot, but he didn't get this - why not? It would be illegal, that's why. Sounds like something the Nazis would do. Nazis! In our hospitals! Oh noes!

The entire thrust of our medical regulatory system, from the Flexner Report to today, is the belief that it's better for 1000 patients to die of neglect, than 1 from quackery. Until this irrational fear of quack medicine is cured, there will be no real progress in the field.

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.

What is the source of this phobia? It is ultimately a political fear - based on public opinion. Its root is in the morbid, irrational fear of poisoning. But it also has a political constituency - all the people it employs. In that it has much in common with other "anti-industries," like the software patent mafia.

Re: Why haven't we cured cancer yet?

#99
post #52

Earlier quoted context omitted.

All this genetic diversity seems daunting at first but I think it is also indicative of something that gives me great hope. Cancer isn't like a virus or pathogen that has evolved to avoid it our immune systems and treatments as it passes from individual. It is a degenerative state of the same system that produces healthy cells and fertile humans. It is genetically very diverse. Part of this is because cancers cells o…

A few years ago I did an analysis on common chromosomal deletions in ovarian cancers. I was hoping to find some sort of "required" genetic or metabolic structure retained by the various cell lines. Nada. It was just a big unrelated mess and deemed not interesting enough to write up by my advisor. I wish there was a Journal of Dishearteningly Negative Results.

It makes sense to me. I once read a lung cell has to evade seven different anti-cancer mechanisms to become a malignant stem. If there are ten different ways to get around each defense, that would mean ten million different possible configurations of lung cancer, with all the therapeutic headaches that implies.

Edit: And that's just for one cell type out of the myriad that compose a functioning lung.

Re: Why haven't we cured cancer yet?

#100

Very interesting read... it boggles my mind how complex our organisms are and how cancer forms and takes everything over from the inside. We can't even "cure" a relatively simple virus like the cold or influenza, and cancer is like 10,000x times more complicated - gotta respect all the hackers who're working in the medical field...

Viruses and bacteria evolve much faster than cancer, because they:

* Use horizontal genetic exchange, so different evolutionary branches can share features. This increases evolutionary speed exponentially.

* Evolve over a much larger eco-system, whereas cancer has to evolve "from scratch" in each individual over a relatively short time-span.

Thus, I think cancer should be a much easier problem, from the evolutionary perspective, than bacteria and viruses.

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