
A technique for alleviating pain may help disable nerves that spread cancer - rbanffy
https://www.newscientist.com/article/mg23631480-200-how-hitting-our-nervous-system-could-let-us-defeat-cancer/
======
peterlk
Reading articles like this reminds me how little we know. Before we had a
theory of germs (viruses and bacteria), we believed that sickness came from
phlogiston. This did a decent job of explaining how disease spread, but didn't
do a very good job of how explaining how it originated. If you were sick, you
were enveloped in a cloud of invisible nastiness, and staying away was a good
way to remain healthy. Certain things, like carcasses and stinky puddles, were
thought to be carriers of phlogiston.

The thing that I find most interesting about the theory of phlogiston is how
close it is. It's almost right, but humanity needed a fundamental shift in the
way we thought about disease to actually start to solve the problems of
disease. I feel like cancer is the modern form of phlogiston. It's close, but
cancer is slippery enough that it's got to be wrong; I want to be clear,
though, that the theory may still be useful.

Now, perhaps breaking down cancer into it's distinct forms (breast cancer,
skin cancer, etc.) will get us there - this approach may have led us to the
discovery af germs as different types of phlogiston. But I can't help but
think that our mental model for cancer is wrong.

~~~
toufka
I don't think it's our model of 'cancer' that is wrong - we can recreate it in
lab, we know quite a bit about it, even though it's extraordinarily
disingenuous to call it a single thing.

Our model for developing drugs is stuck. Small molecules were unbelievably
(literally) useful against invaders of our bodies. They can discriminate and
interupt vital processes of one biology without effecting another's biology.
This made the development of small molecule drugs in the 20th century against
bacteria, fungi, and even some viruses verry effective. Cancer _is_ you. There
is no biologically 'other' one can use as a discriminant that doesn't apply
equally somewhere else in you. Socially we've built an entire pharmaceutical
industry whose talents are focused entirely on a methodology for finding
'interruptors' of foreign disease. And again, that is not cancer.

Look the the new CAR-T therapies for cures to cancer. They disrupt the
pharmaceutical industry's methodologies in thier development. There can't be a
tox test or a primate study. They are fundamentally customizable, cheap, and
curative, but they are the injection of genetically modified immune cells
containing invented and designed protein tools - _not_ small molecules. There
is literally not yet a vocabulary to distinguish these new therapies from the
drugs of the 20th century. They are as distinct from drugs as vaccines - but
have literally only been tested on a few hundred people, being approved by the
FDA only in the past two months.

~~~
L_Rahman
Hi /u/toufka, do you have any papers or summaries of CAR-T you'd recommend?

The first-level Google results are all PR-heavy so I'm hoping you can share
something more granular and explanatory.

~~~
toufka
/u/pas has some good links below.

The primer is that a CAR is an engineered protein that is inserted into your
immune cells with a kind of 'cellular surgery'. Here proteins are the actual
machines that accomplish life's tasks within a cell - where small molecules
are the fuel, building blocks, and modulators _of_ proteins. From inside the
linked reddit post, here's a kind of diagram of the designed CAR from a high-
level abstraction layer:
[https://serotiny.bio/notes/proteins/car19/](https://serotiny.bio/notes/proteins/car19/)

These proteins can have additive functions in precisely the way small
molecules cannot; they can provide new capabilities to cells - whereas small
molecule drugs are almost only capable of disrupting an existing capability.

The reason these engineered proteins are useful _now_ is that we now have not
only have arbitrary read access to genomic information, but with recent
advances, we also have arbitrary (and economical) _write_ access to DNA that
is long enough to encode an entire protein's blueprint (chemical DNA
synthesis). And with those capabilities we've rapidly developed the first
novel biological tools to deliver that DNA in a biological way (CRISPR). Until
recently we could read an entire blueprint, but we could only make copy/paste
changes. We can now design them de novo - and to interesting effect. There is
a gene for human hemoglobin out there that is v1.1 - it is actually an
intelligent improvement upon our existing human 1.0 version of hemoglobin, in
that it can not only not aggregate in a way that causes sickle cell disease,
but it can disaggregate mal-formed hemoglobin, inhibiting the disease. We can
now start to program those new tools into biology in well-designed ways.

Further, with a decade of read-access to life's various genomes, we have
started to actually be able to inspect well-written code in other organisms
for inspiration.

And combining a few of these technologies, we can now start to think about
attacking cancer and the like from first principles rather than simply
repurposing our small-molecule hammer... And in their preliminary results they
have performed remarkably well.

Some more discussion:

[http://www.onclive.com/web-exclusives/expert-discusses-
appro...](http://www.onclive.com/web-exclusives/expert-discusses-approval-of-
first-car-tcell-therapy)

[https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/u...](https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm581216.htm)

~~~
L_Rahman
Thanks for putting the links together.

If I understand this correctly (my biomedical engineering undergrad finally
coming to use!):

1\. Cancer cells present antigens that are specific to cancer cells and do not
occur in healthy cells.

2\. CRISPR allows us to genetically engineer someone's existing T cells to
target those antigens.

3\. When re-introduced, these T-cells target the cancer cells and destroy the
tumor.

4\. Because they are T-cells, they're effectively distributed through blood to
the entire body and are able to affect cancerous cells that may be too small
to observe or detect.

5\. They become inactive and stowaway in the lymphatic system but if the
cancer comes out of remission, an "immunity" type response brings them back.

This is amazing. This feels like science fiction from my childhood and the
life changing possibilities unlocked by CRISPR that I was taught in my
undergrad classes.

------
has2k1
> People who regularly took medication, such as beta-blockers, which impede
> parts of the nervous system, often had lower rates of cancer

This is not far away from backing up the link between long term stress and
cancer.

~~~
travmatt
You may also be interested in Dr. Bruce Ame’s “Triage Theory of Nutrtion” -
basically, chronic deficiencies of nutrients makes your body prioritize short
term survival over long term, and these trade offs bear consequences in the
long run:

Ames had become well aware that many micronutrient (vitamins and minerals)
deficiencies are associated with chromosome breaks and cancer in humans, such
deficiencies having caused DNA damage in rodents or human cells in culture. It
had also been established that chromosomal breaks cause early aging. As a
result Professor Ames proposed that DNA damage and late onset disease are
consequences of a ‘triage allocation mechanism’ developed during evolution to
cope with periods of micronutrient shortage.

~~~
dpatrick86
Here's a video in which Dr. Ames discusses his Triage Theory...
[https://www.youtube.com/watch?v=wrfxdtXjXHs](https://www.youtube.com/watch?v=wrfxdtXjXHs)

------
oprah
Do I understand it correctly? If you can block the nerves then the tumour
losses one of its ways to interact with the host's organism. It does
intuitively make sense.

~~~
agumonkey
That's my understanding too. I'm shocked it never occured to me that the
nervous system had its role in tumors even though we see nerves around and
these are still .. well cells.

