
New Research Suggests Cancer Can't Be Eradicated - ca98am79
http://www.npr.org/2014/08/21/342012360/an-unstoppable-killer-new-research-suggests-cancer-cant-be-cured
======
jboy
The sensationalist assertions made in this article (particularly in the
headline) don't follow from the results that the article describes.

Part of the blame for this sensationalism seems to fall at the feet of the
original scientist himself (Bosch). He makes an unfounded leap from the
biological result that cancer seems to be an intrinsic property of genetic
processes in cells (and the statements "You have to interfere with fundamental
pathways", "It's a web of interactions" and "It's very difficult to do") to
the assertion "will probably never be completely eradicated". Difficult is not
the same as impossible.

He follows with more sensationalism: "You carry a time bomb in your body when
you're born," he said. "It can explode early in life, or middle age or later."

I suppose it's understandable; he's probably just trying to get some publicity
for his team's long-running research on hydra. And even he admits "that
doesn't mean that, with a patient who develops cancer, there's nothing you can
do."

But then the hedging of "probably" and "completely" was discarded by the
article writers for a more sensationalist article and headline.

~~~
idlewords
I'm not sure why you see these claims as sensationalist. The lifetime risk of
cancer is 1 in 2 (for men), and both the rate of incidence and the mortality
rate are about the same today as they were in 1975. This despite the massive
increase in our understanding of the phenomenon.

The claim that cancer probably never will be eradicated seems pretty
defensible. Notice how it's the people who study it who are the least sanguine
in their predictions. It's perfectly possible for us to have a complete
understanding of cancer and find that we still can't eliminate it.

~~~
possibilistic
> Notice how it's the people who study it who are the least sanguine in their
> predictions.

I love this quote, and I'm totally going to steal it.

There's just something about the futurists and singularity folks that mimics
the Dunning-Kruger effect. The more you learn, the more you recognize that
we're still operating on Cro-Magnon brains. All of our magnificent toys are
merely low-hanging fruit in deference to the problems that seem to really
matter.

~~~
adventured
I don't consider the microprocessor in my smart phone with its billions of
transistors, and the ever-faster global internet and wireless systems that
enable nearly instant (certainly to human perception it's nearly instant)
global communication to billions of people at any time, to be low hanging
fruit.

I consider that extraordinary, and the exact opposite of low hanging fruit.
It's hundreds of years of incremental progress across dozens of fields,
resulting in reaching very high hanging fruit in the form of an iPhone and
everything that goes with it.

I consider such amazing communication technology to be every bit as valuable
to social beings such as humans, and to our general societal structures, as
curing cancer is.

~~~
possibilistic
Humor me here a little here.

Search and traversal become increasingly difficult as any graph grows in size.
It's not hard to generalize this to the graph of scientific and engineering
knowledge. To maintain the connectedness of our ideas, we must either leave
amazing literature and documentation or we must constantly seek to foster
connections between those of separate, heterogenous fields and disciplines.
Unless there is movement of ideas through collective human consciousness, key
insights cannot percolate through to the point where they have the greatest
impact. (For instance, not long ago biologists were still using Perl. :P) At
some point, the time it takes for certain information to spread across the
graph grows substantial enough that discoveries are simply repeated over.

Science and technology require ever-increasing levels of specialization. The
network topology isn't going to get easier for the human mind to traverse.
Imagine what kind of information lies just beyond your reach--the kind of
insights that might truly propel you ahead, to reach your Eureka. If only you
knew what you were missing out on. On the flip side, do you ever think about
the places where your contributions would be the most impactful?

These problems are somewhat symptomatic of the fact that we haven't breached
the complexity threshold of what our brains are capable of performing. We may
have computer-aided tools to get us beyond some classes of problem--search and
mathematical modeling come to mind. Still, our mastering of breadth at depth,
our powers of abstraction and of reasoning, all have a hard limit. Everything
we've ever done falls neatly within defined lines. Nothing being done today is
substantially harder than what the previous generation did with its much more
limited set of knowledge. (Have we discovered our generation's calculus or
quantum mechanics? Advancements like that are special, truly rare, set apart
by hundreds of years.)

Take your smartphone, for instance. You can't look at the following block
diagrams and tell me they're too difficult to reason about:

* [http://eda360insider.files.wordpress.com/2012/08/samsung-exy...](http://eda360insider.files.wordpress.com/2012/08/samsung-exynos-5-dual-mobile-processor-block-diagram.gif)

* [http://www.arm.com/images/Cortex-A15-chip-diagram-LG.png](http://www.arm.com/images/Cortex-A15-chip-diagram-LG.png)

* [http://www.wired.com/wp-content/uploads/blogs/insights/wp-co...](http://www.wired.com/wp-content/uploads/blogs/insights/wp-content/uploads/2011/10/arma15-blockdiagram.png)

(Yes, I know the implementation details go much deeper and that these diagrams
are meant for ease of conveying knowledge. You still understand them. And
given time, a diligent student can learn to contribute to processor design
using the pre-existing domain knowledge.)

Do you have a sense or appreciation for how complex the physical and chemical
reality is by contrast? We can only partially understand minute samples taken
from real systems. It's not especially owing to our primitive equipment or
tooling; it's the sheer complexity that baffles us. There are things like
helium atoms--we don't understand them. There's Hartree-Fock, but that's an
approximation.

I find it hard to be beholden to the majesty of a phone when no one can stand
up and explain a helium atom. I mean, don't you find it a little bit amusing
we're still caking onto SGML, shoveling it onto handsets, and yet we don't
understand the interstitial gas between us and the cell tower? The stuff we're
breathing.

Anecdotes from the early days of AI research suggest that we didn't think we'd
still be writing code imperatively, yet here we are writing Javascript module
frameworks and the like. We have a stunningly powerful ability to
underestimate how long and difficult things are. We are also often satisfied
in rediscovery.

We're concerned with how to perform delivery in San Francisco, yet... can you
imagine the vast number of computations the universe is performing every time
a protein isomerizes? I wager it outweighs all of the computing power we have
available to us through modern technology today. The modern smartphone could
never compete in this arena; we would be comparing something not even at the
level of a bacteria to the most omnipotent of gods. I'm not saying that one
day we'll design computers out of polymers in solution. I don't even know if
we'll survive as a species long enough to care. I'm just asking you to wonder.

Look to nature. Can you sense how incredibly infinitesimal and primitive we
are as a species when you look up at the night sky? We've been feeding off of
the cosmologically low hanging fruit, and we're still in the nursery. We spend
on average 20 years learning what we need to begin making our cornerstone
contributions to society. At that point, how much longer do we remain
productive? It's a limited window with which we have to collapse all the
reverse salients. Damn shortness of human productive lifetimes, and all of
that. Oh well, there's always a new generation with which to start fresh.
Rinse, repeat. Stand on a few more shoulders, see a little more of the
picture.

Fill your mind with what might be possible. Let it be dissatisfied when you
cannot reach a conclusion to a problem. Don't ever put a bound on the type of
problems you're curious about. You'll scoff at press releases. Everything in
our generation is transient, scaffolding for the next one gestating.

(Sorry for rambling. And also--I still hold that my flappy bird machine not
even in the same galaxy when it comes to being as cool as science. It's a toy
for which there will always be one better. How could it ever be so magnificent
as the universe I get a few short years to experience firsthand?)

~~~
gmarx
I created an account just to tell you how wonderful your rambling is. When I
think about similar issues, my mind wonders towards evolution. If you believe
that our brains evolved to solve problems we faced way back when, you must
accept the unlikelihood that they are capable of understanding cosmic truths
(not sure what the real phrase should be for that, but you get it).

------
deciplex
"These ancient creatures also get cancer, therefore there is no cure for
cancer". What nonsense. Naked mole rats do not get cancer, what about that?
This only points out that cancer has been around for a long while - which I
don't think is a contentious issue anyway - not that cancer can't be
eradicated.

~~~
coldtea
> _" These ancient creatures also get cancer, therefore there is no cure for
> cancer". What nonsense._

Yeah, because a scientific study can summarized from a couple of lines from a
NPR article (and even those strawman-quoted in your comment).

> _This only points out that cancer has been around for a long while - which I
> don 't think is a contentious issue anyway - not that cancer can't be
> eradicated_

At a basic level, this points out that cancer can emerge even with the very
barest forms of life/DNA -- so it's something more inherent than something we
acquired after several degress of evolution.

~~~
deciplex
>Yeah, because a scientific study can summarized from a couple of lines from a
NPR article (and even those strawman-quoted in your comment).

If you couldn't tell, I don't think the article is well-written and is
probably an incomplete summary of the research being done. However, I think
the statement I made there is an accurate summary of what the article - if not
the research - is trying to claim. I.e. it is not a strawman.

------
Gatsky
Two salient points:

1\. Hydra are apparently immortal. They do not appear to age. It is likely
that there is some biological trade off between immortality and cancer
predisposition. Therefore they are not a good model for concluding that cancer
everywhere in everything is incurable

2\. Hydra don't have an adaptive immune system. This is a huge flaw in an
experimental system for studying the 'roots' of cancer development.

The main point of the journal article is that maybe we should use metazoans to
study cancer. The journalist here is way off the mark.

------
danieltillett
Of course this whole story is a typical media beat-up. We know that cancer can
be eradicated - it happens every day. Even in the absence of medical treatment
seeming terminal cancers can go into complete remission and never return (as a
bit of an aside if anyone has any desire to become a saint the easiest way to
achieve this is to go around blessing cancer patients. As long as you bless
enough you will get the required two “miracles” you need from spontaneous
remissions alone).

Since cancer is the consequence of the loss of the regulation of cell division
it is axiomatic that in any cellular system given enough time and mutations
the regulation will be lost in at least one cell of an individual. We don’t
need to prevent disruption of the regulatory system, although this is good, we
just need to be better able to identify and destroy those cells that are not
regulated.

~~~
codexjourneys
Do you really think spontaneous remission is a random miracle? A scientist
actually looked at the data and wrote this book:
[http://www.amazon.com/Radical-Remission-Surviving-Cancer-
Aga...](http://www.amazon.com/Radical-Remission-Surviving-Cancer-Against-
ebook/dp/B00DB3A1UC/ref=sr_1_1?ie=UTF8&qid=1408706096&sr=8-1&keywords=radical+remission)

Typically there is a lot of work involved in "spontaneous" remission.

But yes, it's likely we can't eliminate cells' mistakes, just prevent, detect
and fix them better in the future.

------
melling
$90 billion dollars since 1971 doesn't sound like much. The interest on the US
national debt is a couple hundred billion a year, for example.

[http://money.cnn.com/2014/02/04/news/economy/budget-
outlook-...](http://money.cnn.com/2014/02/04/news/economy/budget-outlook-
interest-on-debt/)

~~~
graeme
At that scale, money isn't fungible. You couldn't double cancer research by
making the total $180 billion. At least, not in the same way that you could
double the number of televisions you own.

There are only so many biologists, labs, etc. You can certainly entice more
into the field with money, but I expect costs increase non-linearly with the
number of scientists.

(I am not saying we can't do it. I'm saying it would cost much more than we
expect from a linear extrapolation, especially in the near term. Imagine
trying to use money to double, say, world food production – it couldn't be
done, at least not in the short term.)

~~~
melling
I didn't say that if you doubled the money that you would double the research.

In a $15 trillion economy, you'd think it would be possible to spend 10x on
research. More private funding?

~~~
adventured
Isn't it likely that the big problem is having enough highly capable leaders
and researchers, and then knowing what directions to actually go in terms of
spending vastly increased amounts of money (without simply wasting it
foolishly)? It can take a lot of time just to find the path you should go
down, and then to have the qualified people in place to go, and then to keep
them in place long-term to sustain the effort. Very challenging stuff.

How many top notch leaders can you cultivate to lead big research teams.
People that have a comprehensive understanding of what targets to have for the
research, people able to recruit the best brains to the cause.

This seems to not be primarily a monetary bottleneck, but rather the
inherently limited resource of how many really great people you can find to
work on something at one time.

It strikes me that humans also can only move so quickly, and that perhaps
automated / machine learning, testing and solving is the long-term solution to
speed of progress. I know a lot of progress is actively being made on this, I
expect it'll drastically accelerate the pace of breakthroughs in curing
illness. I think of it this way in premise: the current approach is the NIH
trying to sequence the human genome; the future approach is Venter'ized.

------
api
Cancer is not one disease. It's one symptom of multiple genetic regulatory
failure modes.

~~~
danieltillett
Cancer is certainly not one disease, but it in not the symptom of multiple
genetic regulatory failure modes - it the consequence of the failure of one
regulatory system, the system that controls cell division. The complication
comes about since there are multiple pathways involved in this one system.

~~~
possibilistic
Name the final edge in the transduction graph of a proliferation, apoptosis,
or cell cycle regulation pathway.

I _suppose_ you can do this for a cell in a terminally differentiated state of
your choosing. (But as you know, pre-cancerous cells are typically in fuzzy
states that break our tidy little metabolic models.)

~~~
danieltillett
Cell division is by nature binary. Of course the process of division is
probabilistic so that a regulated cell is unlikely to divide unless the
conditions in the niche are favourable, while a unregulated cell is much more
likely to divide even when division is not favourable.

~~~
possibilistic
You didn't directly answer my question, but now I'm just going to be pedantic
:P

[http://en.wikipedia.org/wiki/Budding](http://en.wikipedia.org/wiki/Budding)

Even with normal binary fission, there is never an equal distribution of
products between cells. Metabolite concentration, organelle distribution, etc.
will vary. (If you think about it, it's kind of an interesting period of rough
perturbation made to an extremely high-order dynamical system.)

At a kind of base level, though, the genome itself regularly experiences
abnormal partitioning that leads to certain interesting states.

It's not _strictly_ binary...

But back to the previous topic. Epithelia and endothelia are regularly
dividing cell types. (It's interesting that most cancers arise from these
lineages, right?) Blood cells are another lineage that undergo pretty frequent
proliferation.

(On an entirely unrelated note, I can't wait for an HN discussion pertaining
to quantum effects on biological systems--it's a topic I really want to learn
more about. The absorption spectra discussions in the retinal thread has
awoken my curiosity. For instance: though it's kind of a controversial, maybe
even a pseudo-scientific topic, the quantum effects on microtubules are fun to
think about and are still actively researched.)

------
blueskin_
There's a reason knowledgeable people don't talk about 'curing' cancer. Cancer
is what happens when cells fail (specifically, when they don't self-terminate
when they should), so it can't be vaccinated against in the same way as a
disease (much as you can't catch it in conventional terms). It can be treated,
the success rate of which is increasing all the time, but people will always
be diagnosed with cancer if they are unlucky. For that reason, even if
treatment becomes 99.99% successful with little to no side effects, it will
never be eliminated in the same way diseases such as smallpox or plague were.

------
dave_sullivan
The only thing more prone to error than predicting what will happen in the
future is predicting what _won 't_ happen in the future.

It's hard to measure progress in something like cancer research, but in
general, it hasn't been great. But the same might be said of the invention of
flight. Flight had clearly been a goal across a variety of cultures for many
years.

I suspect that a "cure for cancer" will not come at once, it will be more
gradual (owing to the fact that cancer is actually many different diseases).
Our knowledge of biology is improving at an exponential rate though, I
wouldn't discount that entirely.

------
jeroen94704
It should be noted that "cannot be eradicated" is something different than
"cannot be cured". I've read other articles that seem to point in the
direction that cancer is simply an intrinsic side-effect of the way our cells
work. So while it may very well be impossible to prevent cancer from
developing in people at all, that doesn't mean it is impossible to cure once
it develops.

------
cel1ne
A chemist friend once told me:

Cancer/dna-mutations happen all the time. They're triggered by the energy from
cosmic rays, free radicals etc.

A lot of those reactions involve the oxygen we inhale, so one of the reasons
for cancer and death is actually that we're slowly being burned in our
hazardous atmosphere.

------
conductr
I believe cancer is incurable based on intuition alone. Same way my childhood
self knew cigarettes were unhealthy; before ever hearing the research (putting
smoke in your body just doesn't make sense). Cancer just seems to be a side
effect of evolution, or perhaps a catalyst of evolution. I have basically no
scientific proof of course, that's just what I think.

That said, there is obviously ways to prevent and treat but that's a different
topic.

