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Medicine Biotech

Why a Cure For Cancer Is So Elusive 366

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@gma[ ]com ['il.' in gap]> 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.

    • This question is only a little less silly than asking why we haven't cured all disease yet.

      It's even more silly because it asks no new questions, nor gives any new answers. The prevalence of cancer today is precisely because of improvements in the treatments of other diseases. The fact that it has been more difficult to cure is not an argument that it is never curable. In fact there are some very promising candidates even today.

      Just as you say, however: there are different kinds, and as a result there will likely be many different treatments.

    • by Kjella ( 173770 )

      True that there's many different causes and the type of cells causing the problems lead to many forms of cancer, but the basic problem with it is still the same - uncontrolled cell growth. And that is per se the problem, over time many of your cells probably go defective but as long as it's <1% of your liver and the other 99% work fine that's not really a big problem. So if you're looking to eradicate the causes that's a vast subject, but if you're just trying to find a cure then it's really one catch-al

    • That's basically what the summery said " But there are reasons to believe that cancer will remain much more resistant because it is not so much a disease as a phenomenon"

      How then is this insightful?

    • That makes it harder to deal with.

      What some people seem to forget is that we dealt with the easy stuff in medicine already. We are getting to tougher and tougher problems to tackle, hence why it takes longer and more research to deal with.

      Cancer is very tricky. As you note it is a type of issue, not a single disease (much like the flu is a type of viral infection, not a single virus) and it really is the body turning against itself, it isn't an outside pathogen that can be dealt with.

  • is old age. So as other diseases are solved we have cancer moving up the list.

  • Mere flesh? (Score:5, Funny)

    by blackiner ( 2787381 ) on Sunday January 05, 2014 @06:47PM (#45873685)

    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.'"

    Pffft, I plan on being 100% robot by then. I'd like to see cancer bite my shiny metal ass.

    • I'd like to see cancer bite my shiny metal ass.

      Just wait until your nanotech self-repair mechanisms get a bit hinkey and mix up "break down" with "build up".

    • by DarkOx ( 621550 )

      Rust

    • " I'd like to see cancer bite my shiny metal ass."

      Welcome to wear, corrosion, stress cracking, and your Windows 2080 operating system.

  • Bollocks (Score:2, Insightful)

    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 pathw

    • by blueg3 ( 192743 )

      African populations before westernization of their diets (I.E. eating grain) etc.

      The civilization of their diets, you mean. Modern civilization is built on the agriculture of cereal plants. This is true of both Eastern and Western civilization (and, in fact, probably started in northern Africa).

      • So what? Intensive agriculture is more efficient at producing dense human populations than hunting and gathering is, but that doesn't mean that it's healthier.
        • by blueg3 ( 192743 )

          I didn't say it was. I said there was nothing Western about grain-based diets -- it's civilization in general.

    • 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?

    • Re: (Score:3, Interesting)

      by Fools Gold ( 3486579 )
      Death certificates are a very poor indicator of cause of death. The battle between Cancer and Apoptosis is one theory. It has some merit to it, but it also seems that tumors can be viewed as a fundamental form of life similar to a fetus having its own blood supply and largely anaerobic environment. We keep finding various pathogens in tumors and declare them to be likely causes but are probably a result not a cause. We treat "tumor burden" by lowering the number and size of tumors but we have no idea if th
    • The point was that if one lives long enough cancer is a certainty. Obviously we do not know what the cancer rates would look like for people over 140 years old. However it also seems to me that changing the immune system or altering ones genes to combat disease is becoming more of a reality these days. So if we must complain or be in fear perhaps the real issue is not a cure but a fast and easy cure or arrest of cancer that does not involve pain, fear, loss of teeth or hair or causing on
    • 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.

      There is plenty of research trying to determine why a person doesn't see the cancer, and plenty of research to train the immune system on how to fight the cancer.
      See: http://www.mayo.edu/research/discoverys-edge/training-immune-system-fight-cancer [mayo.edu]
      http://www.newscientist.com/article/mg22029442.800-cancer-meets-its-nemesis-in-reprogrammed-blood-cells.html [newscientist.com]

      Diet has an effect on cancer but it's not how you state it. Drugs are all very powerful ally in the fight against cancer.

    • And other animals where cancer rarely, if ever occurs.

    • 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.

      So what do they die of instead?

  • remember way back when (before bacteria was the bad guy)?: "For many, many years, ulcers within the stomach were thought to be caused entirely by emotional stress". http://people.ku.edu/~jbrown/ulcer.html [ku.edu] well, cancer, for many, many years was thought to be non-contagious. until it's not. this is the next breakthrough for the courageous researcher.
    • by PaddyM ( 45763 )

      http://en.wikipedia.org/wiki/Devil_facial_tumour_disease [wikipedia.org]
      Cancer is contagious right there.

      Also, note that Gardasil, the vaccine which prevents HPV, is being legislated ostensibly to prevent cervical cancer.

      So yes, there are contagious causes of cancer, but there are other non-contagious causes as well. And the trouble is that once it occurs, it is difficult to selectively remove those particular cells when they look mostly like any other cell.

  • Old age... True enough, but this doesn't say much about testicular or breast cancers, who hit people in their 20s and up.
    Understanding why testicular cancer, for example, can be diagnosed in kids as young as 15 might be an interesting venture, me thinks.
    • by Sique ( 173459 )
      Because the testicles are places of intensive cell division and thus prone to errors?
  • If you live to see 200 you will likely find yourself at some point with the option to abandon biology as we know it and its limitations. At the very least replace DNA with something more resilient: http://io9.com/5903221/meet-xna-the-first-synthetic-dna-that-evolves-like-the-real-thing [io9.com]
  • ... and volunteers exist I'm sure the problem will be eventually solved, look at the latest (and ingenious) solution for leukemia [ems1.com].

  • Oh, cancer is an evolutionary compromise of multi-cellular life? Yeah, right. It's a product of mutation, but it runs counter to reproductive fitness, and it's not like our bodies don't have immune systems which reject other foreign (differently mutated) cells, so, Checkmate, moron.

    If cancer is so damn inherent in the very fabric of complex life then we probably wouldn't find any species on the planet that doesn't get cancer... Like Naked Mole Rats. [sciencemag.org] Some studies I've seen suggest cancer has less to do wit

    • "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)

      Cancer usually doesn't affect people until well after the age at which they would have reproduced, and as a result wouldn't be filtered-out by natural selection.

      A better example of this is sickle cell anemia, a hereditary mutation that eventually kills the person who has it. However, this mutat

      • "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)
        That is complete nonsense.
        Males can father children up to age of 70, if not longer. Females till 40 / 45. The more children you have the higher is the chance your genes get distributed and stay "alive".
        There is no magical "natural selection" stopping just because you are over age of 25.

      • Re: (Score:2, Insightful)

        "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.

      • "Reproductive fitness" ends at about age 25 as far as evolution is concerned.

        Please explain how natural selection cares not about those born as my little brother to a 35 year old mother and a 45 year old father. So, are you saying that longevity and quantity of offspring have nothing to do with breeding. Are you seriously presenting that once you hit 25 or so evolution doesn't care about how long you can viably produce children for? And for the record, you idiot, evolution doesn't care about fucking one bit. Evolution cares about the quantity an SURVIVABILITY of OFFSPRING -- I

    • by wisnoskij ( 1206448 ) on Sunday January 05, 2014 @10:09PM (#45875055) Homepage

      "runs counter to reproductive fitness"

      Wrong. There is a huge reproductive fitness bonus for getting old useless people out of the way as quickly as possible, and more specifically a huge natural selection bonus for death after some maximum amount of years. Death is one of the major pillars of natural selection, and cancer, in many species plays a big part to ensure that we do not too many people living to 80-100+ or comparable.

  • by gmhowell ( 26755 ) <gmhowell@gmail.com> on Sunday January 05, 2014 @07:12PM (#45873869) Homepage Journal

    I guess Heather did, but why did she never disclose what the Kergan did?

    And I guess maybe Freddie Mercury did, but he was doing it wrong.

  • 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.
  • Some are caused by carcinogens but most are random misprints.

    It seems there is some research pointing to the contrary [cbsnews.com].

    The /. summary also mentions that cancer is about to overtake heart disease as the number 1 cause of death. Accordingly, can we deduce that increase of lifespan is increasing relatively faster than the increase of environmental causes of cancer? I would sincerely like to believe that, but the ./ summary is not enough for me to adopt such an optimistic view.

    Can anyone here please pr
  • 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.

  • Is the cure elusive because they're digging in the wrong place?

    This article seems wedded to the somatic (gene) theory of cancer.

    What if it's a metabolic disease (Warburg, Seyfried)?
    Seyfried has a 2012 textbook, but here's a concise summary:
    http://ajp.amjpathol.org/article/S0002-9440%2813%2900653-6/fulltext

    If so, the top treatment, calorie-restricted ketogenic diet, is something that sufferers can try at home. I suspect many are, and I would expect anecdotes to become data in a few years.

    Of course, many peop

  • The error rate in DNA replication probably is the result of some amount of evolutionary pressure that trades off cancer against the ability of a species to adapt to new conditions. The "optimum" may not be what we want it to be. It is conceivable that we could modify the DNA replication process to reduce the error rate and thereby reduce the cancer rate.

    I'm NOT saying its easy, or even possible, but cancer may not be absolutely inevitable.

  • 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.

    • Well, if that were the case we would have drugs that arrested the progress of cancer, but didn't cure it.

      But we don't.

    • by ewieling ( 90662 )
      I have a couple of counter arguments. 1) Shareholders and the markets put strong pressure on corporations to take short term profits at the expense of long term profits. 2) The larger a conspiracy the harder it is to maintain. I don't believe for a moment it is possible to maintain a conspiracy large enough to prevent cures from being developed. 3) Cures are being developed, but they are very expensive. The drug sofosbuvir, a recently developed cure for Hepatitis C will cost $1,000 per pill. A typical
  • Cancer is a symptom not a cause, so it is tricky to fight it. Removing symptoms does not stop more symptoms from coming along. The other reality is that we help more people to survive that would normally would not, which was how natural selection cleaned out the gene pool. So we use technology to make up for it, but it is a battle with a negative feedback loop.
  • ...is to improve on the built-in error correction.

    This is actually very, very hard. Some, but not all, "jumping genes" and relocated genes need to be able to move freely. But not to just anywhere - some places are good, some places will trigger genetic disease. And it's not possible to be 100% sure if those places are fixed or vary according to some other state of some other mechanism.

    So cancers caused by gene relocation aren't preventable at this time.

    Mutations within a gene are easier. There are no (curre

  • He's thinking about it all backwards. The person is not the left hand or the right hand. Not the feet, not the legs. You aren't your earlobe or your eye. Replace all the cells, everything, with new, better programmed, cells. Transfer the person into the new body. Bingo - cancer is cured.

  • 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.

    Finally, an explanation for all those dupes here on Slashdot! It's somehow the price we pay for evolution.

  • I have a feeling that one day in the distant future people will read our current understanding of cancer as laid out in the summary and shake their heads that our understanding was ever so limited the same way we do when reading how bleeding patients out was the cure for just about everything in ancient times.

    Also, agreed with a Cold Fjord post and if I have learned anything from the /. is that is an unforgivable use of mod points (or something like that)

  • The article says that errors in the DNA copying mechanism are eventually degrading the DNA to the point where cells become cancerous. So what if the solution is to improve the copying mechanism? After all, there are people who live well into their 100s and there are populations that have very little cancer. So why not examine the copy mechanism of those people to figure out why theirs works better?

    But on the other hand, there are already way too many people around as it is and far too many Ship B people.

  • We all get cancer many times in our lives, but our immune system normally eliminates it without our awareness of the close call. The problem with most cancers is that they are not cause by something present, a mutagenic virus, for example. Instead they result from something absent, a healthy, raring-to-go immune system. Therefore the focus should be on boosting the immune system.

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