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Comment by hwillis | Hacker News Reader

Squeeze her hand for a stranger. Every person who has lost someone to cancer, and everyone who has survived it, and all of the people who watched that fight- all of us have her back and stand with her. She's fighting one of the hardest battles put to a person, and she has our respect and awe. I saw my friend at his weakest, and also when he was stronger than anyone I've ever known. It's been years but still, I'm crying. Cancer is personal. Once it touches you, and you see the enemy, you see how everyone is fighting your enemy. I'm grateful to her. We'll be cheering when the bell rings for her- all of us.

Fuck cancer.

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Thanks so much for this heartfelt comment. The personification of cancer as an enemy didn't really click with me until my family was directly threatened by it. Reading through the drugs in her chemo cocktail, I come across bevacizumab. A little bit of googling and:

  A cancer needs a good blood supply to provide itself 
  with food and oxygen and to remove waste products. When
  it has reached 1 to 2mm across, a tumour needs to grow
  its own blood vessels in order to continue to get
  bigger.

  Some cancer cells make a protein called vascular
  endothelial growth factor (VEGF). The VEGF protein
  attaches to receptors on cells that line the walls of
  blood vessels within the tumour. The cells are called
  endothelial cells. *This triggers the blood vessels to
  grow so the cancer can then grow.*

Wait...what?!?!

OK, what about this trial...atezzolblablblah.. What's it do?

  Programmed cell death protein 1 is a cell surface
  receptor that plays an important role in down-
  regulating the immune system and promoting self
  tolerance by suppressing T cell inflammatory activity. 
  PD-1 is an immune checkpoint and guards against
  autoimmunity through a dual mechanism of promoting
  programmed cell death in   T-cells in lymph nodes while
  simultaneously reducing cell death in regulatory T
  cells.

  ...

  PD-L1, the ligand for PD1, is highly expressed in
  several cancers *and hence the role of PD1 in cancer
  immune evasion is well established*.

Seriously?

This thing isn't just some dumb pathogen floating around that just DoSes your body. It's digging tunnels and cutting phone lines. It has strategy.

This cancer is being evolutionarily selected for proliferation and resistance to regulation. It is being constantly engineered to destroy.

See also epithelial to mesenchymal (ETM) transition, in which cells lose their anchors and become an entirely different kind of cell so that it can better infiltrate other parts of the body.

It's pernicious and highly specialized because that's why it survives. And that's why everyone will die of cancer if something else doesn't kill you first.

Are you saying that cancers that are particularly good at their job are more likely to be passed on to the next generation in other people? By what mechanism does a cancer or a cancer mutation spread to the next person?

EDIT: OK I've done some reading about cancer and evolution. Clearly there is an evolutionary process happening inside each person's body that "selects" for cancers that are good at their "job". However even the most successful of those have no hope of passing beyond their host unless they also mutate a transmission mechanism for themselves, which happens much less often (but the Internet tells me it has been known to happen in dogs).

There's at least a couple mechanisms. The most obvious is heredity—certain alleles of a particular gene that normally controls growth, or expresses some surface protein, mutate, leaving descendants with a greater risk of cancer. BRCA4, for example, has some variations that all but guarantee breast cancer. Mutation can happen in both somatic (body) cells and in germ-line cells; when it happens in the latter, the mutation can be passed on to offspring.

Oncoviruses are another transmission vector. HPV, or human papillomavirus, is a virus that causes warts (of all kinds) in humans, and also causes several kinds of cancer, including cervical and esophageal cancers.

A third way would be a pretty rare thing in humans, but is thought to be behind some of the canine cancers you mentioned: direct transplantation of cells. The tasmanian devil is on the edge of extinction thanks to a facial cancer they get from each other through this mechanism.

There are a few diseases that started as cancer: https://en.wikipedia.org/wiki/Devil_facial_tumour_disease

Generally, infectious cancer is a result from a population that either regularly has open wound contact, and or is very closely related genetically.

Given enough time cancer can even start to survive on it's own: https://en.wikipedia.org/wiki/HeLa It's actually become somewhat difficult to avoid cross contaminating samples with this cell line.

You are right, I was referring to the fact that cancer cells are rewarded as being "more fit" in the body than their neighbors. By gorging themselves on resources and disabling the body's mechanisms for slowing growth, they are rewarded with proliferation.

To be fair, most of that strategy is inherited from healthy cell function. As your body grows and cells become further removed from blood supply, they have to send out a demand signal to encourage vascularization of the under supplied region.

Cancer cells simply lack the trigger to stop growing.

Indeed - the theory, that cancer is in fact the primordial default (grow and keep growing) and ordered growth is something that came later springs to mind.

If you like reading, I highly recommend Siddhartha Mukherjee's The Emperor of Maladies. It's a catholic overview of the history of cancer research and the modern understanding of cancer as of around 2010. I read it when my Mum was struggling with cancer.

> This thing isn't just some dumb pathogen floating around that just DoSes your body. It's digging tunnels and cutting phone lines. It has strategy.

The cancers that haven't mutated to emit VEGF don't survive to grow and kill you.

It's natural selection, not intelligence.

Of course, but it doesn’t feel that way.

Natural selection is a form of intelligence (aka directed goal-seeking).

This was very interresting https://www.youtube.com/watch?v=OjkzfeJz66o

esp. in combination with studies r intermittent fasts/food in general. Neven Orhel's (fiction) books are also in the line with intermittent extremes / how healthy cells can cope with them and cancer cells can not, which is well in-line with the finish saying(was something like "if sauna doesnt cure you no doctor will" - pls correct me here)

Thanks for this. My beloved aunt was diagnosed with cancer years ago, and has been fighting an awe inspiring battle against it the whole time. She was given bad news last week -- a short and definite time scale. It was hard news for me and more so for her husband, children and grandchildren, but everyone is keeping close in support of her through the hardest part of the fight so far. These battles are so hard to watch, but at the same time just as inspiring. Anyhow, that's the back story, I really just wanted to thank you for posting these words. <3

+1, Fuck cancer.

I understand the need to use some martial metaphor but not everybody is born to see through that lens. The friends I have lost to cancer did not loose a battle. They were strong, they did everything they could, they had a "grandeur d'être" that inspires me until today. But sure, they didn't fail/loose the battle. They were just unfortunate. And their ghosts are still with me.

I don't normally respond to messages like this, but this one touched me. Nearly a decade ago I had to battle a Sarcoma in my leg. It changed the entire course of my life, but has made me stronger as a result. It is an experience I don't wish on anyone, and remembering the impact that it had on my family chokes me up a bit.

Your comment made me cry.

"Squeeze her hand for a stranger."

OP, I will keep your wife in my thoughts.

- Squeeze her hand for a stranger -

I'm crying, my Mom passed away almost 3 years ago, but that sentence got me. Godspeed to the Scientists and best of luck OP's wife.

(squeeze delivered btw, thanks again)

Fuck cancer.

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