[cardguy]

I just want to link to the following blog post. Since it provides an interesting insight which most people overlook.

http://marginalrevolution.com/marginalre...-stat.html

It seems that instead of curing more people of cancer. We are now diagnosing it earlier and earlier. Which gives the statistical illusion that people are living longer with cancer. When - in fact - most of the treatments are not helping them to live any longer in absolute terms.

Personally I am very pessimistic about any cancer cures. It seems that cancer is too closely linked to the very cell division which is at the basis of all biological life. And as such - I feel - that where there is life, there will also be cancer. Eradicating cancer from life - would be like eradicating heat from fire. It seems to me the two are too inextricably linked together.

Of course - I hope I am wrong.

Still - the whole field is very interesting. My favourite book of the past couple of years was The Emperor Of All Maladies. It is a history of the fight against cancer, and went on to win the Pulitzer prize. It is written by a cancer researcher, and was his first book. That it went on to win the Pulitzer prize is very impressive.

http://www.amazon.com/Emperor-All-Maladi...1439170916

Recently - cancer researchers have searched for new insights and fresh ways of thinking. As such, scientists - with no experience in this field - have being comissioned to have a crack at trying to find new approaches.

The physicist, Paul Davies, was one of those who was approached. It is both inspiring and slightly worrying that cancer researchers are looking for complete newcomers to help them look at things anew.

http://www.nature.com/news/2011/110601/f...4020a.html

http://www.telegraph.co.uk/science/scien...ancer.html

http://www.guardian.co.uk/commentisfree/...ogical-age

Now - traditionally, cancer specialists have seen cancer as being due to random mutations in a cell - which then causes it to go out of control by dividing at much faster rates than ordinary healthy cells. And thus becoming cancerous.

This would lead one to imagine that massive animals like whales - would develop cancer much more frequently than humans. Since whales can live much longer than humans - and have far more body cells due to their massive weight. Hence - there are far more opportunities for a random cancerous mutation to occur.

Yet - for some reason they don't develop cancer any more frequently than humans.

http://www.nature.com/news/massive-anima...on-1.12258

This may open an avenue for some interesting developments.

Lastly - to end on an optimistic note. Here is a brilliant article by Stephen Jay Gould discussing his cancer diagnosis. It is an explanation of the differences in averages, medians and means when analysing how long an expected life expectancy will be after diagnosis.

It turns out that there can be very large differences in the different types of averages used when giving such a diagnosis. And understanding this is a powerful, and often reassuring (in the case of Stephen Jay Gould) concept when dealing with such estimates.

http://www.cancerguide.org/median_not_msg.html

[Menace]

One of the problems with cancer is that people think it's one disease, but it is actually many different diseases, although obviously linked by common cellular mechanisms. So asking for a cure for cancer is like asking what's the best sauce.

[speakeasy]

What trips me out is that we all have cancer cells in our body right now. In most cases it just never gets out of control. Until one day it does and you get a tumor.

[cardguy]

One of the problems now is that alot of small tumors are being removed - which would never have being a problem.

And when it happens - they chalk it up as another victory in the war against cancer.

http://articles.chicagotribune.com/1985-...r-patients

[WesternCancer]

(04-18-2013 12:03 PM)Menace Wrote:  

One of the problems with cancer is that people think it's one disease, but it is actually many different diseases, although obviously linked by common cellular mechanisms. So asking for a cure for cancer is like asking what's the best sauce.

I always get angry at those people on facebook who say "scientists have cured cancer but big pharma won't let us have the cure!!!1" and link to a study where cancer cell growth was reduced by one thing or another.

They don't understand that a conservative estimate of the amount of protein coding genes in the human genome is ~20,000. Each of those genes has multiple regulatory regions. There are also 1000 non-coding genes that are also involved in gene regulation called micro RNA which weren't even discovered until recently because they're so damn small. Cancer is caused by unrestricted growth usually due to a mutation in a proto-oncogene or a tumor suppressor gene. These genes get mutated and lose their function. There are 200 known types of cancer and each cancer can be caused by any combination of mutations in many genes in the human genome.

And people are still trying to tell me you can just have one cure for cancer. Sheiiiiiiiiiiiiiiiiiiiiit.

[cardguy]

Hey WesternCancer,

Does your name link to the fact that you work in this field?

Also - do you have any good book recommendations for those interested in learning more about cancer research? The book I mentioned before (whilst good) was a general overview covering 150 years worth of medical history over 400 pages. So - it didn't get too indepth with the science.

[MidWest]

Well as a cancer survivor myself. (1 year remission from a Stage 4 Hodgkins-Disease Lymphoma) I can say that it sort of an illusion. Cancer is treatable but there is no cure, unless you had mine. I fell under the 1% of Cancers that are curable which are Hodgkin's Disease and Childhood Lukemia. Many people like some have stated here, think of cancer as one universal disease, but in fact there are lots of cancers, all different from each other. 99% of all cancers arent curable, BUT they can be treated with chemo with the hope of having a 5 year survival rate. Oncologists' goal is to give the patient 5 more years of life but dont expect much more. Many patients have lived far more than 5 years and many the chemo didnt even work.

Also what many people dont tell you that the chemotherapy is very hard and toxic on the body and many side-effects are secondary cancers, for instance with the chemo they gave me im at a higher risk of obtaining Acute Lukemia also down the road. Cancer is a tricky thing to deal with and usually it not always works, and people pay thousands upon thousands to live another 5 years and many die anyway. Real stuff.

[WesternCancer]

(04-18-2013 03:01 PM)cardguy Wrote:  

Hey WesternCancer,

Does your name link to the fact that you work in this field?

Also - do you have any good book recommendations for those interested in learning more about cancer research? The book I mentioned before (whilst good) was a general overview covering 150 years worth of medical history over 400 pages. So - it didn't get too indepth with the science.

My name is from a song, but I've taken a class which had a section on cancer genetics. I don't really know any books since we just read a bunch of papers/got lectured.

Maybe try finding one of those free classes online or downloading a university textbook.

Are you more interested in how cells become cancerous or the treatment of cancer?

[cardguy]

A bit of both. I will track down some online lectures - and check out wikipedia.

I just want to get more of a grasp on why it is so hard to cure.

And on a side point. I remember Patrice O'Neal once making an interesting point. He was a bit of a nut at times - so I am not sure how serious he was being.

But - he held the opinion that no disease has ever actually being cured.

Instead - when eradicating diseases - what science has tended to do is to develop a vacinne. Which is given to the people without the disease.

You then wait for those with the disease to die off...

And voila!

No more disease to worry about. If nothing else - it does seem to be the way that alot of diseases are tackled. And in a sense it is a cure. But it really isn't since it doesn't do anything to help those already suffering from the disease.

Just wanted to share this since it is an interesting/ingenious point of view.

[cardguy]

From the book I read before. It seems the main problem with cancer - isn't the killing of the cancer cells. But instead - finding a way to kill the cancer cells whilst leaving the healthy cells alone.

And it is difficult because cancer cells and healthy cells are almost identical. At least in terms of finding a chemical which will kill one and leave the other alone.

Another point. From some reading I did awhile ago. I got the impression that if a cancer is going to kill you. It will. And if it won't - it won't.

As such - I am unsure what the benefits are of finding a cancer early on? Since - the only cancers that get successfully treated are the less aggressive ones which would not have being a problem in the first place.

Indeed - many people have slow growing tumours in them for many decades without ever being any the wiser.

If a cancer cell divides every two years - within 20 years you will have 1024 cancer cells.

But if a cancer cell divides every year - within 20 years you will have 1048576 cancer cells. So - a doubling in the rate of growth - results in a tumour which is 1024 times bigger after 20 years. So - it seems that the key thing is how aggressive the cancer is - and not how early you find it.

It is pretty interesting to consider that a cancer which is only twice as aggressive as another - will result in a tumour over a thousand times larger than the other over a period of 20 years.

Again. I am no expert. But - I remember thinking along these lines awhile ago. And as such I am happy to be corrected since I am an amateur in this field.

Still - I am interested in how much of our 'success' in the fight against cancer is due to catching the less aggressive (and usually non-fatal) cancers early?

Are we chalking up genuine wins - or false wins?

[cardguy]

An interesting interview with a famous advertising executive here in the UK. He talks about his plans to get the law changed so that experimental cancer treatments can be used in future...

http://www.telegraph.co.uk/health/100242...-love.html

[tenderman100]

I spent some time a few years back doing consulting work for an unnameable organization that does cutting edge medical research, including work on cancer.

The researchers frustration at making progress is palpable. These are tough, tough problems.

One research team spend years devising a strip of RNA that can be delivered by a nano-particle into the nucleus of specific kind of cancer, and snip off a piece of DNA -- and only that piece of DNA -- which piece regulates the production of ONE essential protein for the cancer cell's survival. Through years of laborious effort, they got the particle size just right so it would enter the cancer cells and not any other cells, yet not so small it would pissed out through the kidneys. They worked years piecing together the RNA. Years seeing that, yes, it did cut the DNA and stop protein production. And in trials with animals, it seemed to work.

With humans? The trials failed.

I admire the hell out these researchers. They work hard. They are smart as shit. They are painstaking. It is sometimes unbelievably boring work. And then...failure. Years of work...then failure.

This is what we are up against gents. It is very very very hard.

[Menace]

Another thing to keep in mind, which goes along with tenderman's post, is that animal models of disease have no correlation with human disease models. Something stops cancer in mice? Reduces inflammation in rabbits? Great. But there is no way to predict whether it will work in people. Why do them then? In some ways, there isn't much choice. There are regulatory realities, and you have to start somewhere, even if it is a shit model. Ideally you'd just put it into humans to see what happens, but in practice that isn't possible. So you have to go through a bunch of mice, rabbits, rats, dogs, marmosets, to get some idea of efficacy and definitely to get a handle on your tox window.

[cardguy]

http://www.nytimes.com/2007/03/13/health...c=rss&_r=0

Quote:

Imagine two patients with lung cancer. Even if both die at age 70, a patient with cancer diagnosed by spiral CT screening at age 59 has a longer survival than one with cancer diagnosed because of symptoms (cough, weight loss and so on) at age 67. The first patient survives 11 years; the second 3 years. But both died at the same age. Survival is increased, but mortality is the same.

Quote:

A second source of distortion results from overdiagnosis, when screening finds cancers that were never destined to progress and cause death. Overdiagnosis bias can also drastically inflate survival statistics, even if mortality is unchanged.

[RichieP]

If, as you say cardguy, the biggest factor in cancer lethality is growth/aggressiveness, then lifestyle changes that slow growth would make sense, both as prevention and treatment.

Ketogenic (i.e. very low carb) diets are showing promise:
http://www.time.com/time/health/article/...84,00.html

In that study, all that stuck with it for 3 months had tumors that slowed, stopped growing or shrunk. n='a handful', sure... but the cancer specialists say it's promising. And it just makes sense knowing what we know about cells: Normal ones can use ketones as fuel, cancer cells can't. Somewhat staggering that the cell biology has been known since the 1930s, and only now are we seeing studies on low-carb for cancer...

Just an aside that I read about today: Fasting for two days before chemotherapy could decrease the negative side effects of it by making normal cells more resistant, and also increase the cancer's susceptibility to the chemo:
http://www.scientificamerican.com/articl...oost-chemo

Kind of sad that these free and easy promising treatments are always slow to get studied. Understandable though I suppose in an industry where much of the funding $$ is for developing profitable drugs.

Would be nice if governments invested more in studying simple, wholistic treatments for these things.

[LeBeau]

(04-18-2013 03:01 PM)cardguy Wrote:  

Also - do you have any good book recommendations for those interested in learning more about cancer research? The book I mentioned before (whilst good) was a general overview covering 150 years worth of medical history over 400 pages. So - it didn't get too indepth with the science.

Yo Cardguy check this one out, should be right up your alley:

http://www.amazon.com/The-Secret-History...0465015689

It was well reviewed and takes a perspective on cancer that I believe is sorely missing these days...

[EasyMoney]

The only way to avoid cancer is to eat a very healthy diet, avoid refined sugars and grains as much as you can, avoid exposure to heavy metals and known carcinogens as much as you can, and pray that your genetics don't fuck you over.

Nutrition is the basis of health for most of the population. Some people get genetically fucked over. My best friends baby sister died of a cancer that effects 1 in several million people a year - but that's an extreme.

[cardguy]

Just came across this graph. Seems to me quite an arbitrary and 'cherry picking' way of trying to maximise the number of lives 'saved' from cancer.



http://www.cancerresearchuk.org/cancer-i...o-research

The graph doesn't make sense since it logically implies that the line would have kept rising until eventually everyone in the world would have died of cancer - had the efforts of the charity not been funded. I call bullshit.

[Tigre]

Really interesting recent article on cancer research. Plenty of scope for optimism in the material presented:

Quote:

IF cancer researchers ever HAD a collective “STAND-with-your-MOUTH-WIDE-OPEN in SHOCK” moment, it is RIGHT NOW.

http://robbwolf.com/2013/09/19/origin-ca...ign=Buffer

[cardguy]

I would be interested to see what Nassim Taleb thinks about cancer research. He briefly touches on the subject here:

http://nassimtaleb.org/tag/cancer/

Taleb is a non-smoker who developed throat cancer. And happily overcame it. So I am sure it is a subject he is interested in.

Does anyone know if he covers medicine in his new book - 'Antifragility'? He was making some disparaging remarks about doctors in an interview a few years ago. But I got the impression he might tackle the subject exclusively in a future book.

[cardguy]

I have being meaning to mention this for awhile. But I will just dump it here...

Doctors are no different to businessmen.

Let me explain - and I don't mean that statement in the way you think I might.

You see - your average businessman is a smart guy who wants to be rich. So - he starts up a business and is happy with a ten percent chance (let's say?) of making a couple million bucks.

Now - what about doctors? They have similar desires - but are happy to take the path of settling for the 100% chance of making 200,000 dollars. Which thanks to 'expected value' amounts to the same thing.

Essentially - they have the same goals as the businessman - but dress it up in bullshit about wanting to help others.

For many people - they would rather guarantee a smaller amount - than take a risk at shooting for a larger amount.

It is an obvious point. But I just want to stress that doctors are not your friends. They are in the business they are in (medicine) because it is the easiest way for them to achieve the lifestyle they want. Just like a businessman.

Indeed - the doctor's approach is more rational than the businessman's since (according to research) the marginal utility of money starts to dramatically fall off after the first 70,000 dollars or so.

Sorry for the sidetrack - but it is a point I have being meaning to make for awhile!

[Cyr]

(11-11-2013 05:11 PM)cardguy Wrote:  

I have being meaning to mention this for awhile. But I will just dump it here...

Doctors are no different to businessmen.

Let me explain - and I don't mean that statement in the way you think I might.

You see - your average businessman is a smart guy who wants to be rich. So - he starts up a business and is happy with a ten percent chance (let's say?) of making a couple million bucks.

Now - what about doctors? They have similar desires - but are happy to take the path of settling for the 100% chance of making 200,000 dollars. Which thanks to 'expected value' amounts to the same thing.

Essentially - they have the same goals as the businessman - but dress it up in bullshit about wanting to help others.

For many people - they would rather guarantee a smaller amount - than take a risk at shooting for a larger amount.

It is an obvious point. But I just want to stress that doctors are not your friends. They are in the business they are in (medicine) because it is the easiest way for them to achieve the lifestyle they want. Just like a businessman.

Indeed - the doctor's approach is more rational than the businessman's since (according to research) the marginal utility of money starts to dramatically fall off after the first 70,000 dollars or so.

Sorry for the sidetrack - but it is a point I have being meaning to make for awhile!

Thats too strong a generalisation. I know a lot of people who are in the process of applying for medical school, and for most of them, helping people/ providing pastoral care is their main motivation to go into medicine.

[cardguy]

Maybe - maybe not.

I think everyone makes risk/reward calculation before undergoing a difficult degree such as medicine.

I might be wrong. I often am! But - my understanding of human nature tells me that people say one thing - whilst being motivated by something else.

The easiest person to lie to is yourself.

[OkStudies]

The assertion of the OP that cancer is biologically unavoidable is not exactly true. Not only do a significant chunk of humans never get cancer (such as most members of my family), but there are animals with a 0% cancer rate, such as the naked mole rat http://www.nature.com/news/simple-molecu...r-1.13236.

Cancer *is* curable we will find a cure for it. Hopefully the Federal Death Administration will not bungle it when it does come.

[rottenapple]

Isn't cancer mostly affecting western world? Or is that because detection in third world is much worse?

Also what do you guys think about influence of radiation? From what I heard, numerous sources are claiming cellphones, wifi, etc. are detrimental, yet others the opposites, very ambiguous. It can be similar as to how people taught smoking or asbest was harmless.

It would also love to see the difference in cancer numbers from people living in big cities opposed to people living in small villages with less polution.