Why James Watson Has Become Optimistic about Curing Cancer
cancer.nautil.us
cancer.nautil.us
I will say re: optimism that science for me is always both exciting in that there are always new questions, new answers and new possible treatment, but can also be very disappointing if you expect any one answer to be without very real and confining limitations.
The headline "Why [scientist] Has Become Optimistic about Curing Cancer" could have been written a million times about a million emerging or maturing field in cancer research (see: DNA repair, angiogensis, immunotherapy, onco-viruses).
We make progress everyday, but my brain usually goes to hibernate when somebody says they're "optimistic about curing cancer". If that time ever comes, I don't imagine it'll explode on the seen, but be a victory of iterations that creeps up on us.
I often think of how AIDS is now a treatable chronic illness instead of terminal one, and how that was a success that nearly goes unnoticed since treatments simply got incrementally better over time.
Aren't there numerous famous examples of medical breakthroughs exploding into the scene? Penicillin and vaccines coming to mind. (at least I don't think those slowly crept up on us?)
I don't think a miracle cure is around the corner, but I can see why the layperson may feel like it's plausible, when you look at the miracle cures we have learned about growing up.
My perspective is that there are numerous awful diseases that we have sent into oblivion with medical science done by people with far fewer resources than our scientists have today.
We prevented Y2K from becoming an Apocalypse. People now remember Y2K with derision, like "Those fools ever thought it was a threat. Ha!" When oil wells were set on fire as Saddam Hussein departed Kuwait, it was predicted they would burn for years and be a global environmental catastrophe. When it was resolved in six months, it was a footnote in stories with more human drama. It was not celebrated with the degree of fervor that the potential catastrophe was loudly decried.
People have a way of sweeping good news under the rug, forgetting it was ever a serious problem and finding something new to loudly bellyache about.
"But if all life, including cancer cells, continues to exploit niches, no solutions from technologists will be final.
Cancer cells are not simply a disorder or breakdown in a mechanism, but an organism going on a full-tilt offensive, using multiple, often shifting strategies to produce and use molecular fuel, win resources, and evade the immune system. If so, then the rules of the game may change—these insights suggest that the war on cancer may be endless. Still, we can get better at treating it as an evolving entity within the context on its ecology, through the idea of “living drugs,” such as engineering the body’s own immune cells to sense and mobilize an attack on cancer."
http://cancer.nautil.us/article/186/cancer-isnt-a-logic-prob...
It's plausible that we may eventually have such a good understanding of biological processes, and such powerful technology, that it'll be straightforwards for us to adapt treatments to new exploits.
Obviously no one can know for sure if this will or won't be possible, nor, if it will be possible, how far in the future it will be.
(Note: just because some technological ability seems really distant from our current capabilities does not make it valid to assume that it could only be something possible really distant in the future. We only need to look at the history of technology to see such assumptions can't be made).
Speculation from a non-expert: maybe what is going on is ancient programs preserved in our dna from before multi-cellular life are getting activated, so the cell is treating the body as its competitive environment.
So this is just an incremental update of the old strategy of trying to find a better chemotherapeutic for each cancer. It isn't going to work fast enough and well enough. There are not enough researchers and isn't enough funding to tackle every one of the hundreds of cancers and their subtypes in any reasonable about of time via the one project per cancer approach.
The only viable approach to a sweeping cure for cancer is to identify commonalities shared by very large fractions of all cancers. The chimeric antigen receptor strategies are a step in this direction, producing a technology base that has a much lower cost of adaptation to each new cancer in the class that they can target, rather than needing a whole new project from scratch. But is only a modest step.
The best way forward appears to me to be blockade of telomere extension: sabotaging telomerase [1] and alternative lengthening of telomeres [2], a small collection of mechanisms. If developed, it can be applied to all cancers, as all cancers depend absolutely on telomere lengthening. They can't evolve their way around it, as is the case for many existing methods of targeting particular mechanisms in a type of cancer. It is too fundamental a part of cellular biology. Blockade of telomere lengthening would be absolutely and determinedly the full stop at the end of all cancers - and would cost no more to develop than any one or two existing therapies that can treat only one subtype of cancer.
[1]: https://www.eurekalert.org/pub_releases/2015-01/usmc-rtt1231...
[2]: https://www.lifespan.io/campaigns/sens-control-alt-delete-ca...
Its partly the way the problem is framed. Perhaps we wrongly assumed that cancer is one disease with a distinct root cause / cure purely based on similarities in symptoms. If so, talking of "curing cancer" is like "curing inflammation" - its much too general a symptom to cure, even though doctors are able to treat many cases of it by narrowing down the cause of inflammation, or treat it partially etc. Maybe cancer will be cured piecewise over the years rather than all at once, and people will laugh at how humanity thought there was a disease called cancer.
Its a weird semantic point admittedly..
The most interesting fact about his genome that he had twenty genetic defects for disease that had not expressed themselves for unknown reasons. This helped lead to a moratorium on public genetic disease diagnosis from places like 23andMe, just lifted last week. Because you cant really tell the client they will get sick or not for many of the defects.