Kind of wish they would try something different. The book "Tripping Over the Truth" was a good expose of the failed approaches to cancer research over the years.
Our immune system is probably strong enough to whack most cancers before they become a macroscopic problem. Most hopeful treatments of today are in direction of engaging the immune system against cancer cells.
If I had to guess, the ultimate solution would be resolving immunosenescence. Our immune systems are getting worse over time, so the chance of a runaway malignity grows with age. But we might be able to prevent or reverse this loss of function.
Cancer cells are your cells. And this is the heart of the problem, the majority of the time the immune system is a-ok with what cancer cells are doing. It's not rare at all to find cancers so big that they have had a major effect on the bloodflow to healthy cells around them simply because they consume that much in terms of resources. They can get so large that they will quite literally rearrange your organs and disrupt their functioning. And all the while not a peep from your immune system. Of course this doesn't hold for all cancers, in all situations, your immune system can and does detect certain types of cancer, sometimes in an early enough stage that it is able to eliminate the threat.
Good read (a bit old, 2002):
https://jlb.onlinelibrary.wiley.com/doi/10.1189/jlb.71.6.907
Ok, no. The majority of the time the immune system prevents tumor formation. Immune surveillance is not really debated [1]. Animals where the immune system is shut down and immunosuppressed patients have a much higher chance to develop cancer.
The paper you cite even underlines the point that immune evasion is a failure and not the rule.
Obviously, we are within the 'war on cancer' talking about the remainder, not the ones that the immune system dealt with successfully.
Our immune systems are much worse in our 70s than in our 20s, and we suffer from many more cancers in our old age. This correlation probably isn't completely random.
I am cautiously optimistic about potential rejuvenation of immune systems in older adults. There already were successful experiments (google TRIIM and TRIIM-X by Dr. Greg Fahy) that restored function of the thymus in older people (people, not mice!).
Active thymus likely translates into a better function of T-lymphocytes, vital soldiers in the immune army.
> I am cautiously optimistic about potential rejuvenation of immune systems in older adults.
That's a worthy goal.
It is interesting that short-lived animals like mice tend to suffer from cancer a lot, while huge, long-lived beasts such as whales and elephants seem to be very resistant to cancer, even though they have a lot of cells that can go wrong. Their anticancer mechanisms are obviously much better than ours.
We might yet learn something from them.
Similar with viruses: small viruses are typically RNA because they don't need that error correction as much as their larger counterparts which are typically DNA based giving much better resilience against mutation (and hence a much lower mutation rate).
This is survivorship bias. Of course we do not detect cancers that were killed early on, much like we aren't aware of all the pathogens that were neutralized before they could cause visible symptoms. We only know about those that escaped the immune system patrol.
The good news is that the immune system can be augmented/instructed from the outside, and new cancer therapies do precisely that.
For example, BioNTech was actually founded as a cancer vaccine research lab, its Covid vaccine is "only" a (very welcome) serendipity.
https://pulitzercenter.org/stories/cuba-has-lung-cancer-vacc...
It is impossible to treat cancer without killing cancer cells, so I'm not sure why this is troubling to see
Diet change, for example, is generally undervalued I’m told.
My understanding is that dietary effects on treatment have small effects on the margin. They might bump your survival a few percent, but are not going to reverse your stage 4 cancer.
Dietary research is probably good ROI, but is unlikely to yield groundbreaking treatments or silver bullets, like you mentioned in the OP.
best treatment would be to find root cause and prevent cancer cells from growing in the first place, I'd imagine gene therapy will one day be used to help with this.
Early detection would also drastically improve outcomes
[1] - https://www.youtube.com/watch?v=06e-PwhmSq8 [video]