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Medicine Biotech

Why a Cure For Cancer Is So Elusive 366

Posted by samzenpus
from the still-looking dept.
Hugh Pickens DOT Com writes "George Johnson writes in the NYT that cancer is on the verge of overtaking heart disease as the No. 1 cause of death and although cancer mortality has actually been decreasing bit by bit in recent decades, the decline has been modest compared with other threats. The diseases that once killed earlier in life — bubonic plague, smallpox, influenza, tuberculosis — were easier obstacles. For each there was a single infectious agent, a precise cause that could be confronted. But there are reasons to believe that cancer will remain much more resistant because it is not so much a disease as a phenomenon, the result of a basic evolutionary compromise. As a body lives and grows, its cells are constantly dividing, copying their DNA — this vast genetic library — and bequeathing it to the daughter cells. They in turn pass it to their own progeny: copies of copies of copies. Along the way, errors inevitably occur. Some are caused by carcinogens but most are random misprints. Mutations are the engine of evolution. Without them we never would have evolved. The trade-off is that every so often a certain combination will give an individual cell too much power. It begins to evolve independently of the rest of the body and like a new species thriving in an ecosystem, it grows into a cancerous tumor. 'Given a long enough life, cancer will eventually kill you — unless you die first of something else (PDF). That would be true even in a world free from carcinogens and equipped with the most powerful medical technology,' concludes Johnson. 'Maybe someday some of us will live to be 200. But barring an elixir for immortality, a body will come to a point where it has outwitted every peril life has thrown at it. And for each added year, more mutations will have accumulated. If the heart holds out, then waiting at the end will be cancer.'"
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Why a Cure For Cancer Is So Elusive

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  • by kumanopuusan (698669) <goughnourc@NoSpAm.gmail.com> on Sunday January 05, 2014 @06:38PM (#45873601)

    Cancer is a whole spectrum of diseases with different causes, effects, mortality rates, etc. This question is only a little less silly than asking why we haven't cured all disease yet.

  • Bollocks (Score:2, Insightful)

    by TechyImmigrant (175943) on Sunday January 05, 2014 @06:47PM (#45873687) Journal

    This hypothesis (that cancer is inevitable, just masked by other diseases that get you first) is wrong.

    There are populations where recorded cancer rates are essentially 0. Some pacific islanders, African populations before westernization of their diets (I.E. eating grain) etc. This simple fact undermines the above hypothesis.

    There is also evidence that people get cancer all the time and the body deals with it.

    The medical research on cancer is primarily focused on identifying the mutations and chemical pathways that cause cancer to occur and then developing chemicals to block those pathways.

    So a productive approach may be to find what it is that is causing people's bodies to fail to continue to detect and correct cancers in the body. Unfortunately, that has more to do with diet than drugs and so there isn't a strong profit motive to take that vector seriously.

  • by Anonymous Coward on Sunday January 05, 2014 @06:53PM (#45873725)

    Cancer is a generic term for a large group of diseases that can affect any part of the body.

    - World Health Organisation

    Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues.

    - National Cancer Institute (@NIH)

    Where should he get his definition from?

  • Re:Bollocks (Score:5, Insightful)

    by wonkey_monkey (2592601) on Sunday January 05, 2014 @06:56PM (#45873759) Homepage

    This simple fact undermines the above hypothesis.

    Not if they all used to die of sleeping sickness before the age of 30.

    Without knowing what did kill them and at what age, the existence of these populations might equally well support the hypothesis, might it not?

    What was the life expectancy of these Pacific island or pre-Western diet African populations? Did they have anything approaching "Western" medicine for coping with all their other ailments?

  • by Anonymous Coward on Sunday January 05, 2014 @06:58PM (#45873779)

    The simple reason is that the people who fund the research feel there is more profit in treating cancer than there ever would be in curing it.

    Nonsense. The underlying causes of the uncontrolled cellular growth simply vary dramatically depending on the individual type of cancer. It is extremely complicated to even detect many cancers, yet alone come up with targeted treatments which don't adversely effect another part of a persons body. This is before you even start to factor in the cost of research, development and testing... ;)

  • Re:Money (Score:1, Insightful)

    by rudy_wayne (414635) on Sunday January 05, 2014 @07:08PM (#45873847)

    In the 80s I read an article which claimed that cancer researchers were being overly conservative and rejecting many ideas because there was too much money to be made from private/government grants for cancer research. At the time I dismissed it as conspiracy theory. But 25 years later it appears that they may have been right.

    As someone who has had cancer, I have learned a lot. Most importantly, all the various cancer charities are complete frauds. Despite taking in untold Billions of dollars, the number of people dying from cancer has increased, not decreased over the last 20 years. And nobody has ever had their cancer cured because someone wore a pink ribbon or yellow wristband or walked 10 kilometers.

    If you are lucky, like I was, and the entire tumor can be removed surgically before it has a chance to metastasise, you'll be OK. But if the tumor is in an area where surgery is impossible, or if the cancer metastasises, in most cases you are fucked. And all the pink ribbons, yellow wristbands and 10k walks in the world won't save you.

  • Re:True fact: (Score:5, Insightful)

    by Anonymous Coward on Sunday January 05, 2014 @07:12PM (#45873871)

    "It's more lucrative to treat a disease than it is to cure it."

    While true at face value, the implication here is that a "cancer cabal" profits as a whole when cures are withheld and it collectively decides to release only incrementally improved treatments. But there is no such cabal, quite the opposite, there is intense competition among researchers and pharma companies and no collective decision, only individuals more than willing to "break the ranks".

    Heck, curing a single type of cancer say prostate or leukemia will guarantee you a Nobel prize and a life time of doing whatever you want whenever you want both from a professional and personal point of view - regardless if the cure is monetizable (patentable) or not. And you expect us to believe researchers are actively hiding cures for the sake of the pharma industry ? Please, not even the Mafia can command such allegiance.

  • Hugh Pickens Blog (Score:5, Insightful)

    by Luthair (847766) on Sunday January 05, 2014 @07:18PM (#45873915)
    Seriously, how many articles per day is Slashdot going to feature from this guy? Recently it feels at least 3 per day.
  • by Press2ToContinue (2424598) * on Sunday January 05, 2014 @07:20PM (#45873927)

    A strong immune system keeps cancer at bay - this is a duh.
    But our lifestyles are increasingly focused on pathogen and stressor avoidance instead of encountering and overcoming them. Most people look at me as if I'm crazy when I say I like going out in the cold because it's good for me, and as many think I'm a kook when I ask them if they have ever drank water from a stream. Activities in the outside world boost our immunity, and we perform them less and less, and de-germ our environments more and more. I, for one, think there is a correlation.

  • Re:Money (Score:5, Insightful)

    by Sique (173459) on Sunday January 05, 2014 @07:24PM (#45873949) Homepage

    As someone who has had cancer, I have learned a lot. Most importantly, all the various cancer charities are complete frauds. Despite taking in untold Billions of dollars, the number of people dying from cancer has increased, not decreased over the last 20 years. And nobody has ever had their cancer cured because someone wore a pink ribbon or yellow wristband or walked 10 kilometers.

    If you had bothered to actually read even the slashdot article (you don't even need the links), you would understand why the number of people dying of cancer increases. Everyone who has died so far has died of something. Many of the causes people were dying of, we have minimalized or fully eliminated in the last 150 years, Nearly no one dies of the bubonic plague anymore for instance, and most of the other infections are in retreat. With every cause we eliminate, all the remaining causes get a bigger share. And in the end, there are two main causes remaining: coronary diseases and cancer. Everyone of us, given that he dies not of anything else before, will in the end die of either coronary diseases or cancer, which means that they will increase their share, if we further eliminate the other causes for an premature death.

    What is actually increasing is the average age humans die because of coronary diseases or cancer. That means, we are able to push the time further away, when cancer or coronary diseases will get us.

  • by Anonymous Coward on Sunday January 05, 2014 @07:29PM (#45873973)

    " if it's anything at all, is a bunch of very different diseases that are characterized by the cells in the body multiplying faster than they should"

    That's a contradictory statement.

    If one guy breaks his leg falling from a ladder, and another breaks his leg in a car accident, does the doctor treat that broken leg differently? Preventative measures for those broken legs may be different, but the result is the same. Likewise, a broken arm and broken leg might be be susceptible to different treatments, but they're both fundamentally broken bones, and it's worthwhile to categorize them as such.

    Cancer can absolutely be categorized as one disease. As you say, it's the pathological replication of a cell. Yes, different types of cells may have different behaviors, although they also all have a litany of identical behaviors. Yes, it's a fruitful avenue of research to treat different cancer types with different methods. But that doesn't mean we should stop looking for broader methods than can treat multiple different kinds of cancers based on their numerous shared characteristics.

    The meme that "cancer is a whole spectrum of diseases" is just that, a meme. Researchers who recite that meme don't believe it literally. They do have a much more nuanced perspective on cancer. But they use that meme in an attempt to deflate journalists' and lay people's expectations about cancer research. And then people echo that meme in an attempt to sound knowledgable and up-to-date.

    Study any topic deeply enough and almost any label will come up short. That doesn't mean the label is wrong. Labels are meant to simplify and aggregate. They sacrifice accuracy for the necessary convenience of relating complex topics in rational discourse.

  • by Anonymous Coward on Sunday January 05, 2014 @07:34PM (#45874007)

    Err...you have a point, but 'morons'?
    Perhaps the (man/woman)|(men/women) writing on this (is an)|(are) eminent scientist(s). Maybe this is more about how the New York Times gets science wrong rather than what's going on in medicine itself.
    And maybe...just maybe, since there are logical or reasoning problems within the theory of evolution itself, this is about how people could miss the very obvious point that if cancer is a side-effect of evolution/mutation then all biological life must be capable of getting it, which is where your naked mole rat comes in. Jerry Fodor and others have pointed out some of the problems with evolution/natural selection, I believe. For example, it's circularity.
    But allow me to recommend that you never study economics. If you think morons are prevalent in scientific circles, you won't believe just how bad things can get in what's laughingly called the Queen of social "science".

  • Re:Money (Score:5, Insightful)

    by Kjella (173770) on Sunday January 05, 2014 @07:39PM (#45874029) Homepage

    As someone who has had cancer, I have learned a lot. Most importantly, all the various cancer charities are complete frauds. Despite taking in untold Billions of dollars, the number of people dying from cancer has increased, not decreased over the last 20 years.

    That is a statistical fallacy, if we're getting better at treating cancer but even better at treating non-cancer diseases and injuries the relative share of cancer deaths may go up. Most of the people diagnosed with cancer are quite old and while we're getting better at emulating the body's "functions" with artificial hearts, artificial lungs, dialysis machines and so on we're not making the same kind of progress on cancer. I've had several ill and frail relatives but modern medicine kept them alive until the cancer got them, I consider it more of a success than a failure of the medical system. Eventually everybody dies from something.

  • Re:Money (Score:4, Insightful)

    by dmr001 (103373) on Sunday January 05, 2014 @07:39PM (#45874031)
    It's an interesting claim that apparently all cancer researchers feel there is so much money to be made in grants, they are careful to reject novel ideas that might lead to cure for cancer so they can securely remain on the gravy train. By interesting, I mean for what it reveals about how people think. Hanging around the parking lots of university-based research facilities did not yield a surfeit of expensive cars. And while a good argument can be made for the plodding progress of research despite all the pink ribbons, breast cancer mortality [cancer.gov] is in fact steadily decreasing - even for women with tumor that's spread to lymph nodes. From the same website, you'll see even more impressive progress in colon cancer mortality, lung, and prostate cancer, which rounds out the list of the most common fatal cancers.

    In some sense, increasing cancer mortality likely results from people in industrialized nations being killed less often by other stuff (cars, emphysema, smallpox, contaminated water). And walking 10 km [cancer.gov] (on a regular basis) probably has significantly decreased cancer mortality, probably by changes in hormone balance and metabolism. Cancer research may not always be flashy, but they do seem to dig up useful stuff over time.

  • No Profit In Cures (Score:2, Insightful)

    by some old guy (674482) on Sunday January 05, 2014 @08:07PM (#45874245)

    In case you haven't noticed, medical science (which is primarily undertaken in the US by pharmaceutical companies and universities receiving large corporate endowments), is primarily concerned with treatments, not cures.

    A cured patient is no longer a paying customer. A patient under treatment (and his/her insurer) can be milked indefinitely.

  • by MickLinux (579158) on Sunday January 05, 2014 @08:10PM (#45874261) Journal

    Okay, it isn't nonsense; it is one of many factors. Yes, cheap cures get removed from the market (mebendazole, anyone?), new cures get challenged before the FDA by johnny-come-latelies until the developers go out of business (angiostatins?), cancers that should remain untreated and monitored instead get invasive surgery (prostate cancer)... yes, chmpanies like to ure the sick and hurting as ATMs.

    That said, it is also correct to say that there is no single cure for cancer.

  • by lgw (121541) on Sunday January 05, 2014 @08:12PM (#45874275) Journal

    Well, it all comes down to: are your trying to stop it from happening in the first place (in which case it's a broad spectrum of causes), or to cure it after the fact (in which case they all have the same mechanism). Which way you see it likely depends on which part of the problem you're concerned with.

    Genes just need a digital checksum - get on it!

  • by Michael Woodhams (112247) on Sunday January 05, 2014 @08:39PM (#45874449) Journal

    An argument about the world is interesting. An argument about a word is not.

    This is an argument about a word. What is "a disease" versus "a spectrum of diseases"?

    Cancers have some common features, and some very important differences. This is the "world", and you agree on it. Stop arguing about the word.

  • by interkin3tic (1469267) on Sunday January 05, 2014 @08:54PM (#45874541)

    If one guy breaks his leg falling from a ladder, and another breaks his leg in a car accident, does the doctor treat that broken leg differently? Preventative measures for those broken legs may be different, but the result is the same.

    Not really. If you land on your leg from a ladder and get a compound fracture, that's probably your bone being compressed. If you get your leg crushed in a car accident, that's probably going to break a different way. The bone will likely need to be set differently. With crushing, I think there's a greater chance of internal bleeding, can't remember where I heard that. The specific insult will lead to a different type of injury that necessarily affects the treatment, even if they both are very similar overall (like they both require casts).

    Yes, it's a fruitful avenue of research to treat different cancer types with different methods. But that doesn't mean we should stop looking for broader methods than can treat multiple different kinds of cancers based on their numerous shared characteristics.

    Uh, I'm pretty sure no cancer researcher in the world is giving up on curing ALL cancers if they can. I mean, you automaticaly win the nobel prize for sure, get assured to be put on a stamp, and free drinks for the rest of your life if you "cure cancer." If you cure "just" one subtype of cancer, you probably get tenure or plenty of grant money, but you probably won't get automatically laid by saying "I'm the guy who cured multiple myeloma!" in a bar.

    They're focusing on specific types because that seems far more likely than any one treatment curing all types of cancer. For instance multiple myeloma cells appear to be more on the verge of auto-cannibalizing themselves [nih.gov], moreso than other cancers. Researchers got them to undergo unrestrained autophagy and die, that probably won't be the case for other cancers. If it even works in patients for multiple myeloma.

    The meme that "cancer is a whole spectrum of diseases" is just that, a meme. Researchers who recite that meme don't believe it literally.

    I, for one, do actually believe it. And I think it's more than a meme. I think researchers who pursue a grand cure might be modern day alchemists: trying very hard to achieve a goal which is far beyond the current technology. Modern chemistry came about from alchemists. Likewise, researchers who are attemtping to cure ALL cancers can definitely make important contributions even if they don't cure all cancers, so I'm not knocking them. But I do think we'll probably cure individual cancer subtypes before theres a big overall cure.

  • by cold fjord (826450) on Sunday January 05, 2014 @09:20PM (#45874723)

    No, what we were presented with is a conspiracy theory for which no evidence was given. If you want people to believe such an extraordinary claim, which would require a massive world-wide conspiracy lasting decades among all manner of countries, governments, and people of varying socio-political-religious orientations, you need to present some actual evidence instead of simply making a bare allegation. In short you are whining because a crank allegation with no supporting evidence was dismissed as such.

  • by gargleblast (683147) on Sunday January 05, 2014 @09:28PM (#45874755)

    If one guy breaks his leg falling from a ladder, and another breaks his leg in a car accident, does the doctor treat that broken leg differently?

    Actually a doctor most likely will treat those injuries differently. An impact with torn metal will probably be more serious than an impact with soil. For instance, it is more likely to result in a compound fracture. In general, different accidents cause different injuries.

    Cancer can absolutely be categorized as one disease.

    OMG.

    You are going to need to know a heck of a lot more about a disease than "it is cancer" before you can even start considering treatment. In what type of tissue did the cancer originate? What organ is the cancer in now? What oncogenes / suppressor genes were affected by the mutation? Is it one of:

    • Breast cancer due to tumor suppressor gene BRCA1 mutation, metastasized to the lung
    • Prostate cancer due do mutation in Hereditary Prostate Cancer gene 1 (HPC1), unmetastasized

    In other words, what is the disease really?

  • "Reproductive fitness" ends at about age 25 as far as evolution is concerned. Natural selection doesn't care one bit about what happens to you after you procreate (the male preying mantis is a perfect example of this)

    Hey, dipshit. The mutation of cells replicating in the body has fuck all to do with the reproductive cell mutations that evolution is concerned with. What a nitwit.

  • by ugen (93902) on Sunday January 05, 2014 @10:43PM (#45875255)

    Whoa, that's news to me. I was under impression that we had virtually no treatment, other than symptomatic support, for viral illnesses such as influenza, common cold, mononucleosis and many others. We do have immunizations that provide a small measure of protection against acquiring some of these, and public health measures (like hand washing and wearing masks in Asian countries) that slow down their spread. But once a person gets one of those viruses - all modern medicine can do is say "there-there". I just spent 3 weeks fighting off a most miserable flu (it still isn't quite gone) and all doctors could do is recommend "bed rest". I think we are overstating our disease fighting abilities here, never mind cancer.

  • by Alsee (515537) on Sunday January 05, 2014 @11:18PM (#45875409) Homepage

    Genes just need a digital checksum - get on it!

    That would indeed be an effective means to stop cancers and some other diseases, but comes with a rather noteworthy side effect. It also brings human evolution to a halt.

    In the medium term (many generations) the percentages for the various existing checksummed genes will shift, but no new genes will enter the gene pool. And in the long term it becomes a statistical certainty that one particular variant of each gene will eventually reach 100% in the population. At that point the entire human population would be genetically identical, identical "clones". The only remaining variation is that there would be male-clones and female-clones.

    (For this discussion I am setting aside the potential matter of human genetic engineering creating babies with experimental new genes. That's a rather thorny issue, and it doesn't contradict my original point that natural evolution of humans would halt.)

    -

IF I HAD A MINE SHAFT, I don't think I would just abandon it. There's got to be a better way. -- Jack Handley, The New Mexican, 1988.

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