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.
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.
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.
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.
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.
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.
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.
Thank you for the link, but it doesn't say "viral origin" it says "infection associated" and lists liver flukes (a parasite) as one of the known associated infectious agents. But great info nonetheless.
> Human papilloma virus causes cervical cancer (which is why women get annual "Pap smears")
If you meant to say the test was called after the Pap-illoma virus, then it's not correct. Pap test checks for abnormally shaped cervix liner cells rather than a virus. And it is named "Pap" after a person who invented it, not a virus.
No, I didn't mean to specifically say that. I think I was vaguely aware it was named after a person. Is anything in that line factually incorrect?
(EDIT: I am guessing you are reading it that way due to the quotation marks? If you check my comment history, I think you will find I am prone to overuse of quotations. I stick them in to make it clearer it is a phrase and those words belong together. I often feel English doesn't do a good job of making such distinctions. I suspect this has something to do with growing up in a bilingual household. In German, lots of words get run together into a megaword, which makes it clear it's basically a phrase. We do not have a similar mechanism in English. I often feel that leaves too much room for misinterpretation. So it's an odd personal quirk. Sorry for the confusion.)
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
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
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.
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.
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.
There's a website (listed in my profile) where I talk a bit about what I've done for my condition (which is atypical cystic fibrosis). There is nothing on the site specific to cancer. I did take care of my sister briefly following her first mastectomy, but I have not written about that on the site.
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.
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.
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.
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.
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.)
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.
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. :-)
My mother was working for a (now extinct) biotech company that was developing a cancer 'vaccine' using a retrovirus to do targeted removal of cancer cells. One of the big problems they ran into was that the patient's immune system had a tendency to kill off all of their cancer-killer viruses.
So for a while there, they were seriously working on making a virus that would be completely invisible to your immune system- and this was maybe eight years ago. I'm sure there are dozens of little biotech companies in the bay area alone trying to do the same thing now.
The state of targeted cell killers in the lab and early trials is pretty promising at this time: either viruses, nanoparticles like dendrimers, or enlisting the components of the immune system that already do that job. Even bacteria have been drafted.
The trouble with cancers is that they are basically just you, with a bit of a mutation somewhere. It's hard to find anything that "targets" cancer without targeting your normal cells as well.
I would argue that as soon as we understand how to put "logic" into a virus or delivery mechanism, we will be able to target cancer, and a host of other problems. I would also argue that this will happen.
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.
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:
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.
"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.
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!
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/stu...;
- [ ] 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/healt...;
- [ ] "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>;
- [ ] 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.
The efficacy of Gerson Therapy not supported by the evidence and it can be harmful to patients. Coffee enemas can damage the large intestine. Foregoing demonstrably effective traditional treatments can lead to reductions in life span and quality of life.
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.