
A radiologist applying evolutionary principles to cancer research - jonbaer
https://www.wired.com/story/cancer-treatment-darwin-evolution/
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pazimzadeh
Summary: Cancer cells are competing against each other as much as they are
competing against healthy cells. If you use a high treatment dose you select
for the drug-resistant cells and long term it can be worse. If you lower the
dose of the drug you slow down the rate of evolution of the cancer, even if
you don’t kill as many cells. Overall it suggests it may be better to try to
“coexist’ with the cancer rather than try to kill every cell.

By the same logic you should not take the entire bottle of antibiotics after
an infection, because you're more likely to select for resistant bacteria.

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cannonedhamster
What's interesting is that nearly all current research shows that combinations
of drugs is the most effective solution for eliminating cancers. So it would
be nearly the opposite effect. If you let it grow slow you're potentially
causing organ damage, letting it spread further which makes it harder to kill,
and prolonging side effects of chemo which can be super severe for many
people.

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1_over_n
"makes it harder to kill" Unfortunately, this is still thinking in terms of
the "cure" mindset as opposed to co-existing with cancer. Maybe you just can't
kill cancer. Try not to think about "let it grow" vs "managing the growth". If
aggressive treatment leads to hardier cells forming, which can then break off
and lead to metastasis. There are other chronic conditions which we can live
with such as diabetes and HIV that were previously thought of as early death
sentences, it is not inconceivable we can get there with cancer.

~~~
cannonedhamster
So we might get there, but realistically the methodology is really flawed.
Cancer is, for all cancers, a failure of our own immune system to recognize
cells that have gained a genetic defect that doesn't cause proper cell
apoptosis. This isn't a foreign invader, this is our own cells with a flaw.
While it's cute to think about just living with it, if you're not completely
preventing the growth in some cancers you're not really doing much.

We can cure most cancers nowadays through surgery, radiation, and chemo...if
we catch them early enough and they don't spread. If you're talking about
coexisting with cancer, you're already past the point of worrying about it
spreading. It's already metastasized. Coexistence only makes sense if it's
something you _could_ live with. If you want to see how well this works out
ask Steve Jobs how co-existing with his cancer worked out, because this
essentially amounts to letting the cancer spread further and more aggressively
which will damage even more organs. The hardier cells will already exist, your
body will just have to fight off more cancer cells.

The only, and I mean only, way to live long term with cancer is to allow the
immune system to fight off the cancer and keep it at bay by removing the
inhibitors that prevent recognition and reaction. I hope the day that cancer
becomes chronic is today, but realistically I'm probably not going to live to
see the day that it does. This article is just another drop in the bucket of
false cures and pseudo-scientific nonsense that exist for cancer that aims to
provide hope and to take advantage of already desperate people, who often
don't have the financial means to cover the costs of chemo, infusion pumps, CT
Scans, PET Scans, ports, rides, medications, etc.

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1_over_n
link to paper discussing new classification scheme based around evolution of
cancers

[https://www.nature.com/articles/nrc.2017.69.pdf](https://www.nature.com/articles/nrc.2017.69.pdf)

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1_over_n
we are working in a similar space, the challenges of getting this to something
that is beneficial to patients are immense. Getting the science working is one
thing, regulation & reimbursement strategies for this are equally as
intimidating. Complexity in tackling cancer is not just at a cellular level,
it is also at a healthcare system and social level.

