
Some Thoughts on Cancer from a Hacker - DanielBMarkham
http://www.whattofix.com/blog/archives/2011/06/some-thoughts-o.php
======
ryanmarsh
This is a great article and while Daniel may be on to something, the sad truth
is: It doesn't f __*ing matter. Here's why:

When my wife and I lost our two year old daughter to cancer we started a
nonprofit to raise money "for research" we thought. What we found when we got
very prominent doctors behind closed doors is a system of bureaucracy that has
led to the ineffective local maximums in research that have left heavily
funded diseases such as Neuroblastoma (MYC-N amplified) with an increase in
survival rate that amount to a rounding error.

I'll keep this short so it doesn't turn in to a tirade. 1\. Doctors tend to
want to study, and grant advisory committees tend to want to fund INCREMENTAL
research. Anything that is not incremental on something that is being done
prominently is considered "high risk". Good luck with your out of the box
thinking. You'll be labeled a hack and your career will end.

2\. Many doctors who apply for and receive grants from cancer research
foundations do so only because it is a good source of funding for their life's
work if they can construe it to in some way have an angle on cancer. A real
life example would be studying the immune systems of Zebra fish because: an
immunotherapy discovery in the similarly functioning immune systems of Zebra
fish might create a model that is applicable to humans. I've been told behind
closed doors that it's flat out bullshit, he probably has studied the immune
systems of fish his whole career.

I was flat out asked by the director of a major US cancer research center to
just give them money so that the could continue to keep certain researchers on
salary.

Lastly, we want to fund a study into using THC (yes, from Marijuana) as an
option for children with cancer because it positively affects three major
areas of children with cancer: pain, nausea, and appetite. Right now we pump
them full of IV nutrition, anti-nausea meds, and morphine. All of which is
very hard on their little bodies. Top cancer research doctors are horrified of
the light this kind of research will cast them in so good luck finding someone
who will do it, much less sit on your board.

I could go on forever but I'll leave you with this. My wife and I lived on
PubMed and Wikipedia while our daughter was sick. We wanted to understand
everything, and you know what we found? The very first question that every
single parent who has a child that is diagnosed with cancer asks: "What can I
feed my child?" They have to say "we don't know.". Search PubMed, you won't
find a single study related to nutrition and solid tumor cancers in pediatric
patients. That's fucked up, and its because of the bureaucracy and entropy in
the research community.

We'd like to break that mold, but first we'll need to raise a lot of money.
Shameless plug <http://laylagrace.org>

~~~
Mz
Sorry for your loss.

My sister has been battling cancer on and off for over 10 years. She has done
a lot of her own research (ie reading up on stuff) and used supplements and
nutrition to help keep her alive in addition to traditional therapies. She has
had four occurrences of cancer with at least 3 different "types" of cancer (I
don't recall the names, but various breast cancers basically). She has also
expressed her frustrations at these specific things: a) Cancer research is all
variations on a theme, with almost nothing really new/different. b) There is
no real solid information on nutrition and doctor's reply to inquiries about
nutrition with answers which essentially chalk up vitamins like they are
placebos whose sole value is psychological comfort.

My mom and dad have both had cancer twice. My mother's mother died of cancer
and she has several sisters who have had either breast or uterine cancer. So
it seriously runs in the family and my family has a high survival rate because
of the family tradition of looking to nutrition and the like and not just
putting things in the hands of doctors. My mother kept father alive when
doctors expected him to die. One of his doctor's interviewed her on tape for
two hours and changed some of the practices of his clinic based on what she
told him.

I've used nutrition, among other things, to effectively combat a different
"dread disease" for me and my oldest son. On the up side, nutritional
approaches do not require your doctor's permission. You don't need a
prescription from him. You don't need to run it past the FDA or some such. So
this is a space ripe for guerrilla warfare, so to speak. :-)

Good luck with your goal to get something meaningful done in this space.

~~~
palish
_So it seriously runs in the family and my family has a high survival rate
because of the family tradition of looking to nutrition and the like and not
just putting things in the hands of doctors._

Couldn't it be that your family's survival rate isn't due to nutrition?

It might be, but it might not be. Our ignorance is just as likely to kill us.
For example, perhaps your family does have some natural survival mechanism
activated by certain foods, but maybe it has the opposite effect for someone
else.

This isn't just hypothetical speculation. When the Black Plague hit, some
people were convinced that cats were contributing to the problem, so they
killed them. But the _rats_ were the carriers, not the cats. And so by killing
the cats, the rat population ran rampant, which seriously deteriorated the
overall situation.

They had the right idea --- "some animal is carrying the disease, therefore we
should kill that animal". But they didn't _know_ , so it wound up killing them
instead of helping them.

Maybe you have the right idea about nutrition, but you don't _know_ \--- so
you're gambling with people's lives by telling them things that may only make
the situation worse.

On the other hand, your family is basically conducting research. You should
document and publish your methods and observed results. Maybe you're onto
something.

~~~
Mz
_This isn't just hypothetical speculation. When the Black Plague hit, some
people were convinced that cats were contributing to the problem, so they
killed them. But the rats were the carriers, not the cats. And so by killing
the cats, the rat population ran rampant, which seriously deteriorated the
overall situation._

My sons and I have talked about that and have wondered if killing the cats
ultimately helped. As I understand it, ultimately some other rat population
crowded out the rats that were carrying the vermin. Perhaps that was more
effective (and perhaps indirectly supported by reducing the cat population). I
don't have the answer, I am just saying I have wondered if a different
conclusion is in order.

 _Couldn't it be that your family's survival rate isn't due to nutrition?_

Sure. It could also be that I got well with cystic fibrosis by sheer luck and
happenstance. However 10+ years of steady forward progress seems to imply
otherwise. :-)

FWIW: When my dad had colon cancer at the age of 69 and wasn't diagnosed until
after he lost half his body weight, my parents focused heavily on hydration.
They calculated how much fluids he needed daily and anything containing
caffeine did not count. (Alcohol would not count either but my dad gave up
drinking many years earlier.) When he was really nauseous from chemo, she made
him homemade "slushies"/milkshake-like drinks. She used ice cream, milk, and
fresh or frozen fruit...not sure what else. When he was too sick to tolerate
that, she used ice, frozen fruit and fruit juice. On bad days, he got this
twice a day in place of meals. She was putting so much weight on him at a time
when most patients are losing weight that his doctor basically yelled at her
for it. He has a long-standing heart condition and the doctor was concerned
that regaining so much weight so quickly would put too much strain on his
heart.

My mother also came up with some excuse for him to miss one radiation
treatment a week. She watched her mother die from cancer in her teens and she
is convinced that the radiation killed her. I have been told she came up with
excuses even though she kept his skin in such good shape that he never had
radiation burns, which is apparently a common reason (especially with older
people) for delaying treatment. She used Penaten cream (a German product for
treating diaper rash) to keep his skin in such good shape. My understanding is
this product was adopted by two different cancer clinics because of her use of
it on him. She also used it to help his 13 inch surgical scar heal better.

I also used adequate food and hydration to break my sister's fever the first
twenty four hours after she was home from the hospital following her first
mastectomy. I have always put more emphasis on hydration with my sons and my
own health issues than on eating. It takes 2 to 3 weeks to starve to death (or
more in some cases). You can die from lack of fluids in as little as 2 days.
Dehydration can be misinterpreted as hunger and this probably contributes to
obesity and is probably why drinking a great deal of water is a dieting
technique that helps some people lose weight.

 _Maybe you have the right idea about nutrition, but you don't know --- so
you're gambling with people's lives by telling them things that may only make
the situation worse._

I do wrestle with such questions. I have a website where I try to share
information about how I got well. I often wonder if it should come down.
Though I worry more about people misunderstanding it and thus misusing it and
getting into trouble that way. The approach itself is very conservative, much
more so than conventional medicine. And we all impact our body chemistry every
single minute of every single day with myriad small choices, starting with
every single thing we eat or drink. Study after study after study indicates
that diet and lifestyle play major roles in every major deadly disease but
then when you come down with something doctors have no idea what to tell you
about nutrition. The state of the art nutritional advice for my condition --
where having a dietitian on staff is common for CF clinics -- is to recommend
a "high fat, high calorie, high salt" diet. In practice, this means they
actively encourage people with my condition to load up on junk food. This runs
counter to my experience of what works. It also is the opposite of what most
folks with my condition are doing who have better than average success in the
face of this problem. So I am hardly the only one, my example is just more
dramatic.

So, for now, I leave the website up and struggle with how to better convey
what I understand. Because I think it is clear and well established, even in
"conventional" mental models for health, that diet and lifestyle do make a big
impact and since no one can stop eating entirely or cease to have a lifestyle,
it seems to me the only sane thing to do is try to encourage and support
better education and mental models for those pieces of the puzzle.

~~~
palish
Thanks. For what it's worth, I think you're doing the right thing and are
acting responsibly, and making the best of bad situations.

Also, that's an interesting hypothesis about the Black Plague. I hadn't heard
that before. Thanks for sharing.

Best of luck to you, and I'm glad we have the chance to learn from your hard-
earned wisdom.

------
reasonattlm
You want to fix cancer, don't wait for the scientists. They are hobbled by
regulation. Be an engineer: get out there and make one of the viable solutions
work, and make it work outside the US, because you'll never get approval from
the FDA for a reasonable amount of money - money that could to towards making
something work rather than the normal nonsense.

The best present tack for dealing with cancer is granulocyte therapy. It works
very, very well, but because researchers can't yet say why it works it's
pretty hard to get trials going in the US. I think there's only one right now.
But somewhere out there, for as far as we can see near every cancer, there's
someone with an immune system that can kill it.

[http://www.fightaging.org/archives/2010/04/the-state-of-
leuk...](http://www.fightaging.org/archives/2010/04/the-state-of-leukocyte-or-
granulocyte-transplants-to-kill-cancer.php)

But at a cost of $100k per patient in a formal trial, and with researchers
willing to go to bat on this one, getting something going in Asia shouldn't be
out of the possibility for a few million dollars.

The philosophy of all new medical development should be "get it done outside
the US". Seriously. See:

[http://hplusmagazine.com/2011/05/31/open-cures-an-
initiative...](http://hplusmagazine.com/2011/05/31/open-cures-an-initiative-
to-speed-clinical-development-of-longevity-science/)

[http://www.fightaging.org/archives/2008/05/envisaging-a-
worl...](http://www.fightaging.org/archives/2008/05/envisaging-a-world-
without-the-fda.php)

[http://www.fightaging.org/archives/2007/03/whose-life-is-
it-...](http://www.fightaging.org/archives/2007/03/whose-life-is-it-
anyway.php)

~~~
carbocation
> because researchers can't yet say why it works it's pretty hard to get
> trials going in the US

That can't be right. We use plenty of drugs with unknown mechanisms of action.
Here's a list:

    
    
      4-Aminosalicylic acid 
      Alendronate 
      Ambroxol 
      Arsenic trioxide 
      Becaplermin 
      Bexarotene 
      Chloral hydrate 
      Clofazimine 
      Dactinomycin (RNA synthesis inhibitor) 
      Dapsone (folic acid synthesis inhibitor) 
      Diethyl carbamazine 
      Diethyl ether 
      Diloxanide 
      Dinitric oxide 
      Ethambutol 
      Gentian violet 
      Ginkgolides 
      Griseofulvin 
      Halofantrine 
      Halothane 
      Hydrazinophthalazine 
      Limefantrine (antimalarial; prevents haem polymerization) 
      Levetiracetam 
      Mebendazole 
      Methyl-(5-amino-4-oxopentanoate) 
      Niclosamide 
      Pentamidine 
      Podophyllotoxin 
      Procarbazine 
      Selenium sulphide

Source: <http://www.nature.com/nrd/journal/v5/n10/full/nrd2132.html>

~~~
reasonattlm
Per Zheng Cui, the chief obstacle to fundraising for development was that he
didn't have a molecular mechanism of operation in hand and explained. I have
no reference to hand for that; it might have been in email.

The funded work looking into this, where it exists at all, is presently
largely focused on finding that mechanism and thus doing away with the need
for donor cells. e.g.

[http://www.fightaging.org/archives/2009/12/seeking-
funding-t...](http://www.fightaging.org/archives/2009/12/seeking-funding-to-
explain-granulocyte-cancer-therapy.php)

~~~
timr
_"Per Zheng Cui, the chief obstacle to fundraising for development was that he
didn't have a molecular mechanism of operation in hand and explained."_

When you hear people complaining about this, it's a good sign that they're on
the extreme margins of whatever field of study they're in, or that they're
getting too far ahead of themselves (i.e. trying to pursue clinical studies
before basic scientific facts are known). The "mechanism of action" becomes
much more important to reviewers when your evidence for efficacy is weak
and/or the thing you're advocating tends to go against established scientific
theory.

Sometimes the medical establishment is conservative, but this is a _feature_ ,
not a bug.

------
thisisnotmyname
Some thoughts on cancer from a computation biologist working in the field of
proteomics:

The author of the article mentions "a million different proteins" - The human
genome contains about 20,000 genes, each coding for a different protein. Some
small fraction of these genes would be involved in cancer, although the exact
proportion is an interesting question which we're not entirely sure of.
Perhaps with splice variants we're getting into the millions, but obviously
you can't consider splice variants to be unique proteins. In any case, the
problem is at least 2 orders of magnitude smaller than the author is thinking.
Currently, there are 10s of thousands of cancer researchers worldwide, and
hundreds of millions of patients, so the studies he talks about are quite
feasible.

More troubling is the fact that with the huge amounts of money available,
cancer biology attracts a gigantic number of researchers, many of whom are not
doing especially great science. There are many, many different pathways in the
body that can drive cancer generation, so you can study almost any of them and
call yourself a cancer researcher, even though the chances are that most of
that work won't lead directly to a cure.

My opinion: cancer is impossible to cure - people will always get cancer.
There are deep, fundamental connections between our ability to evolve and
adapt to our environment and the inevitability of getting cancer. My opinion
on how to beat the disease: genomic profiling of an individual's propensity to
develop cancer, early detection, anti-metastasis drugs and improved surgical
procedures.

For anyone interested, there is a fantastic review called "The Hallmarks of
Cancer", published in Cell that you should check out.

~~~
mrvc
Someone once argued here that cancer is now just a business. With so many
interests vested in keeping the money flowing, their is a significant
disincentive to move towards a solution. Instead, it is better to murk the
waters and hinder progress, as that will keep the tap flowing for longer,
allowing those researches to continue paying their mortgages.

It was suggested a better model would be massively rewarding those who create
progress in the field (such as yourself) rather than offering large lucrative
grants for research irrespective of result.

------
eps
I wonder how the cervical cancer fits in, because it was ultimately traced to
a virus as a trigger and then they developed a vaccine for it. The same may
apply to other types of cancer, in which case "debugging" the condition
without removing the root cause does not make much sense.

~~~
Mz
I have come to think that (or at least wonder if) maybe all cancers are
viral/have a viral component: 1) Human papilloma virus causes cervical cancer
(which is why women get annual "Pap smears") 2) Cancer causes tumors, ie odd
growths, much the way warts and fever blisters cause growths on the body. Both
warts and fever blisters are caused by virii and I don't know of any other
pathogen which causes growths of that sort, by taking over the cell like that.
3) Virii are made of the same stuff as genes: RNA. This is precisely why some
of them can get inserted into a cell and take it over, which is the way warts
operate.

~~~
RK
The book mentioned by the OP discusses the "virus theory" of cancer, which was
very popular for a while.

What people eventually realized was that cancer is the result of genetic
mutations and there are many potential causes of the mutations, viruses being
one of them. E.g. HPV can lead to cervical, anal, throat cancer, etc.

An interesting book. The books feels a little bit narrowly focused on medical
oncology, but the author is a medical oncologist, so you'd expect that.

~~~
pradocchia
I'm in the middle of the book myself, and I half-suspect the/a common thread
will turn out to be chronic inflammation. Bacteria causing ulcers causing
stomach cancer seems a case in point. Also, tobacco & lung cancer: sure, the
smoke contains carcinogens, but you're also looking at decades of chronic
inflammation in the lungs.

Likewise, the recent WHO announcement re: cell phones & brain cancer was
poopooed, since _everybody knows_ the radiation is not powerful enough to
damage DNA, but! it could certainly cause some low-grade inflammation of brain
tissue. Low-grade inflammation + daily use -> chronic inflammation -> cancer?

No, I don't know how something like leukemia would fit under this rubric.

~~~
Mz
FWIW: Inflammation is known to promote infection. For example, it is well
established that reducing inflammation in cystic fibrosis patients reduces
incidence of infection. Reducing inflammation via diet is one of the things
that helped me get off multiple drugs, most of which had anti-inflammatory
properties as their primary or secondary purpose.

------
smharris65
Cancer thrives in an environment that allows it to flourish. Dr. David Servan-
Schreiber has written a great book that talks about his two successful battles
against cancer and how our "modern" western lifestyle and diet(for example,
too much sugar as @aneth mentions in another comment) may set the stage for
rise in cancer occurrences: <http://www.youtube.com/watch?v=XaDt3AJQ98c>

------
rsheridan6
There's nothing stopping docs from using customized therapies that haven't
been through clinical trials. Once a drug is approved, doctors can pretty much
do whatever they want with them. If there is an approved drug with the
mechanism that the computer program wants, the doc can prescribe it.

But bear in mind that the doc may have trouble with malpractice liability, and
insurance probably won't pay for it.

~~~
ryanmarsh
"There's nothing stopping docs..." Oh yes there is, the strongest entropy I've
ever witnessed in any field of science.

------
giardini
The medical establishment has promised a cancer cure for more than 50 years
and has nothing significant to show for it. "Cancer centers" will stop at
nothing to get money from cancer victims who apparently will spend their last
dime in futile attempts to "survive". "Children's" cancer centers are absolute
pits of despair and hypocricy.

We should terminate federal funding of cancer research (its a government
white-collar jobs program for the medical field) and face the fact that we all
die someday.

Simultaneously significant effort should be spent ensuring that death from
cancer is not painful. That is, give cancer patients the drugs necessary to
relieve their pain. For some reason I am reluctant to watch yet another cancer
victim writhing and sweating in pain as he/she slips into a 3-week coma and
imminent death.

~~~
derefr
Or, just as validly in my mind, go the other way, and shunt all the money
people are spending on _managing_ cancer into trying to _cure_ it.

------
ericb
What about the equivalent of find and replace (delete) based on pattern
matching? Something along the lines of, extract a sample of the cancer, create
a virus that binds to it with high specificity and kills it, then deploy.

~~~
Palomides
I would observe that both cancers and viruses evolve very rapidly in the human
body; in many cancer patients, a particular treatment grows less effective
over time because the cancer evolves to be less susceptible. Adding a virus
that may just quickly evolve to infect all the cells in the body to the mix
seems rather risky.

~~~
Mz
This is basically the plot for the movie "I am Legend", starring Will Smith.
In that movie, yeah, things go terribly wrong with this approach. (EDIT: And I
mention the movie to say that as a thought experiment this has been done
before and drew the same conclusion: This has potential to go very, very
wrong.)

~~~
rvkennedy
It's a general law in fiction, going back to Frankenstein, that any
development that challenges the status quo will prove harmful. Mary Shelley
didn't call it "The Modern Prometheus" for nothing - the implication is that
to challenge our limitations offends the gods, or God, or Nature. It's a great
way to make people feel OK about mortality or failure. And a guaranteed trope
- when a TV episode or movie starts with a new development in science with
great promise you know 100% by the closing credits that the scientist will
have been punished and the status quo ante restored.

I would guess that when the first crazy experimentalist tried putting seeds in
the ground instead of foraging for fruit, there was a cave painting about how
the Spirits would punish the whole tribe for its arrogance.

~~~
Mz
Well, I'm kind of familiar with that firsthand since my hobbies include
getting myself well when doctors claim it cannot be done. So I get called a
liar, charlatan, and snake-oil salesman...blah blah blah... by folks who think
it just cannot be done. Still, the idea of intentionally introducing a virus
to cure cancer doesn't sit well with me. :-)

------
tintin
Some thoughts of another hacker: The story is about a cure, not about the
sources of cancer.

When a program runs slow on a device you could add memory as the cure, but you
could also start with the source.

Skin cancer as example: You can find a cure for skin cancer but you could also
tell people not to stay in the hot sun for too long.

------
aneth
There are two diet changes the best doctors in the world will give you the day
you are diagnosed with cancer:

1) Eliminate sugar from your diet 2) Eliminate red meat from your diet

This improves survival rates by orders of magnitude.

The sugar cancer link is becoming increasingly apparent, and is the elephant
in the room. Excessive red meat can be a problem as well, but from everything
I gather, sugar is the real culprit. Sugar raises insulin levels, promoting
cancer growth, causing metabolic problems, and inhibiting apoptosis, then
feeds that cancer with excessive glucose in the bloodstream.

Want to avoid or treat cancer with your diet (along with diabetes, heart
disease, and autoimmune diseases)? Stop ingesting sugar!

~~~
pfedor
Citation needed. Google seems inconclusive, e.g.,

[http://www.caring4cancer.com/go/cancer/nutrition/questions/s...](http://www.caring4cancer.com/go/cancer/nutrition/questions/sugar-
and-cancer-is-there-a-connection.htm)

[http://www.mayoclinic.com/health/cancer-
causes/CA00085/NSECT...](http://www.mayoclinic.com/health/cancer-
causes/CA00085/NSECTIONGROUP=2)

[http://junkfoodscience.blogspot.com/2008/03/do-you-fear-
suga...](http://junkfoodscience.blogspot.com/2008/03/do-you-fear-sugar-might-
cause-cancer.html)

~~~
aneth
There is evidence of a sugar link on almost every cancer study - but nobody
wants to call this out because of the terribly obvious implications for the
modern diet. The fact is, your doctors have been telling you that low-fat
diets cause disease, pushing people to eat high sugar low-fat foods, thereby
killing them.

Here's just a few references I found in about 30 minutes. I don't keep track
as I probably should, but the link is painfully obvious.

\- [ ] [http://www.msnbc.msn.com/id/6813992/ns/health-
diabetes/t/stu...](http://www.msnbc.msn.com/id/6813992/ns/health-
diabetes/t/study-links-diabetes-cancer-risk/)
<[http://www.msnbc.msn.com/id/6813992/ns/health-
diabetes/t/stu...](http://www.msnbc.msn.com/id/6813992/ns/health-
diabetes/t/study-links-diabetes-cancer-risk/>); \- [ ] the researchers think
high blood sugar levels — another hallmark of diabetes — might also be
involved. \- [ ] "The highest risks for developing cancer and dying from it
were found in people with the highest blood sugar levels" \- [ ] insulin may
influence cell growth \- [ ]
[http://articles.timesofindia.indiatimes.com/2011-05-30/healt...](http://articles.timesofindia.indiatimes.com/2011-05-30/health/29379588_1_prostate-
cancer-cancer-risk-endometrial-cancers)
<[http://articles.timesofindia.indiatimes.com/2011-05-30/healt...](http://articles.timesofindia.indiatimes.com/2011-05-30/health/29379588_1_prostate-
cancer-cancer-risk-endometrial-cancers>); \- [ ] "Our results provide further
evidence that abnormal insulin and glucose signaling may contribute to cancer
initiation and development," said Gabriel Lai, a cancer prevention fellow at
the US National Cancer Institute. \- [ ]
<http://care.diabetesjournals.org/content/30/3/561.full>
<[http://care.diabetesjournals.org/content/30/3/561.full>](http://care.diabetesjournals.org/content/30/3/561.full>);
\- [ ] The association of hyperglycemia with total cancer risk in women and in
women and men combined for several cancer sites, independently of obesity,
provides further evidence for an association between abnormal glucose
metabolism and cancer. Type 2 diabetes, an extreme state of glucose
intolerance, is associated with elevated plasma levels of glucose and insulin,
both before and after its diagnosis, and is associated with an increased risk
of cancers of the liver, pancreas, colon, endometrium, kidney, and breast
(1,2). Less is known, however, about the effect on cancer risk of moderately
elevated glucose levels among nondiabetic subjects.

