Cancer Moonshot initiative restarted by NIH
cancer.gov
cancer.gov
But as far as bang for the healthcare buck goes, why not advocate a serious national physical fitness campaign? Many people have gained weight and lost their fitness during the last 2 years, and we're doubling down on doing counterproductive things in cities like introducing friction and barriers for people to get to the gym in the name of defending them from Covid which is completely backwards. Losing weight is probably the single best thing the nation could do for not only better Covid outcomes, but also improving a bunch of other health issues from diabetes to heart disease and possibly cancer as well, if I remember right.
Culture is incredibly difficult to intentionally shift. People actively resist when they feel they are being manipulated even if it is supposed to be for their own good.
Don't forget that in the US they named their anti-drugs policy in schools: DARE!! lol!
That's some twisted reverse psychology stuff..
Also, it makes sense to publicly do one thing and privately do another.
DARE campaign was Reagan era, when they were importing cocaine by the plane load.
Don't bother pointing out facts or using logic. Any time someone mentions drugs on HN, the usual group of addicts-in-denial show up parroting the same tired and disproven talking points that High Times magazine has been flogging for the last 40 years.
In the US, dependent on location, a person may be living under several different governments.
Governments recognize and/or create holidays, and holidays can go on to be cultural events.
Governments organize and finance festivals and events, which can and do become culture of a place or people.
They built statues, museums, parks, libraries, theatres, etc; all with several different levels and layers of culture.
You'd need to start defining parameters of what is a government, what is a culture shift, etc.
That doesn't mean they can't, won't, and don't, shift cultures in many other ways.
DARE is a program to increase public positive image of, deference to, and political support for the arbitrary action of police. (And t it's only demonstrated effect is on attitudes toward police; it doesn't have any effect on drug use.)
How that advances the cause of marginalizing minority groups is left as an exercise for the reader.
The claim is keeping kids off drugs was probably never the real goal, and even if it was the program continued to expand to new places and be funded in existing places long after it was proven ineffective as anything but pro-police propaganda, which wasn't an accident by decision-makers.
Which reveals that even if keeping kids off drugs was once part of the motivation, it wasn't what sustained the program.
But losing weight? Endless amounts of effort is already spent towards this goal, it is deeply embedded in our culture(for ex. Fat shaming).
I don't some large ad campaign would change that much.
I think being able to have healthcare discriminate based on smoking has been hugely impactful in cutting US smoking rates, I think the same should be done for being overweight.
Fat anxiety is driven by food industry propagandists (more marketers than lobbyists.) Most weight-loss companies are basically high-priced subscription food services with add-on food marketing and a hook that gets people to pay for that as a service. While they've become a big enough business too often be standalone, it's not telling that Weight Watches spent a couple decades as a subsidiary of HJ Heinz.
> I think being able to have healthcare discriminate based on smoking has been hugely impactful in cutting US smoking rates
Health insurance was never prevented from discriminating on that basis, even while smoking rates went through the roof. There's plenty of policies for which there is evidence of utility in cutting smoking rates, health insurance price discrimination isn't one of them.
The government can educate on and encourage healthy eating and fitness. The goal is not weight loss. Weight loss is just a side effect.
In part thanks to that advert, my entire life whenever I can pinch an inch I simply stop drinking my calories. Admittedly it is harder to eat healthy when you are time constrained and poor. But could there be anything faster and cheaper than pouring a glass of filtered tap water ? Can we advise that first before developing more PSAs about nutrition, exercise routines, etc.
https://www.globalissues.org/article/532/media-manipulation
(note: this is not an endorsement of these sites, but took me 30 seconds to locate online, and verify at least glancingly.)
Getting people to eat less, not so much.
The idea that we cannot make substantial improvements to people’s decision-making context and instead should spend all this money trying to hack the genome is obviously ridiculous.
Except piles of cash per year ARE spend trying to change people's habits for the healthier, and it's obviously falling in the US.
You're idea of, "Don't throw a pile cash at medical research, that's stupid! No, spend it on advertising, but healthy stuff!" seems like the obviously ridiculous idea.
There is very little funding of behavioral science research compared to pharmacological.
Look how much culture has changed in the last few years, in a direction that closely matches the intentions of some powerful people.
Look at changes around public health, smoking for example.
> People actively resist when they feel they are being manipulated
The only way to change things is to manipulate people?
> It’s a worthy goal but I doubt the government could move the needle with any amount of money
If you are talking about promoting exercise, here I agree: More money isn't always needed.
It’s a genuine effort to put something positive on the table for the administration as the mid-term elections ramp up. Biden, like his predecessor, is historically unpopular. The administration is desperate to do anything to maintain control of the house and senate.
This “plan” is a retread of Biden’s 2012 scheme that went nowhere.
As for corruption, probably just run-of-the-mill NIH feudalism. Even Joe Biden isn’t so brazenly corrupt that he’d directly pay his bag men while he’s the sitting President.
It’s good to see cancer get more money & attention, regardless of the motive.
Now, if you would be advocating banning advertisements for fast food, candy and other junk , you might be on to something.
https://en.wikipedia.org/wiki/The_President%27s_Challenge
It does not seem to have been effective.
The power of government PSA campaigns is also well known. On average, they enrich advertising agencies and produce no change in the public's behaviour.
It's not well known at all to me. What is the basis of that?
Most of the really pointless and counterproductive Covid restrictions were implemented at the state and local levels where the NIH has no real authority.
It didn't fix everything, but what were its aims and what were the outcomes?
ParticipACTION!
Unfortunately, although it gets high marks for awareness, trust, and organizational capacity, it doesn’t seem to have been very effective: Canadian kids are at the bottom of the rankings for fitness and activities.
Years later a Solzhenitsyn fan who worked for the NIH recreated the shaman’s recipe and long and behold it was a cocktail of the most promising cancer fighting chemicals the NIH was investigating at the correct dose!
[1] https://undark.org/2016/03/31/did-solzhenitsyn-cure-his-own-...
But start with “A day in the life of Ivan Denisovich”, short and to the point and skip the Gulag.
The Gulag is brilliant, but its too long and depressing (Ive never made it past half way through the first book).
Also, keep in mind the fundamental difficulty of Russian novels: each character has a half dozen names, nicknames or variations of their name. Keep the wikipedia page open so you can look up the characters!
What you should skip, as I read the recommendation, is The Gulag Archipelago, a separate multi-volume (at least a trilogy, maybe much more) epic about the Gulag system in general and, I gather (but may be wrong) more explicitly based on Solzhenitsyn's own life therein. FWIW, I agree with this recommendation.
Well look at that, common ground! I've always been a compulsive reader -- up until I was about forty, forty-five, an obsessive-compulsive one: if I'd started a book, I'd finish it.
Except for a very few works. Weirdly, come to think of it, all three (that I can recall now) of them were recommendations from my best friend since lower-middle school, whose taste I still trust and whose recommendations I'd still follow -- but whose literary stamina I apparently lack.
We were assigned to read Denisovich in or just before our lower teens, and I found it quite good and interesting. After that, he read The Gulag Archipelago and said it was good, so I tried... That's the first book I can recall giving up on.
Sometime in our teens we read TLOTR, which he followed up with The Silmarillion. Strike two. Then, sometime in our twenties or thirties, he recommended Proust's In Search of Lost Time. Strike three (and you're out?).
I'm tempted by -- but dreading! -- Stephen King's The Dark Tower... OTOH, lots of other people also seem to be recommending that. And I've gotten past "my gotta finish it" fixation. So maybe, after all.
I’d love it if also included large amount of effort into reducing exposure to chemicals that cause cancer.
Seems reasonable, especially given the rate technology advances these days.
Where does it say endless treatment? Most cancer treatments aren't endless.
I feel like this should have a height or bmi attached to be more general.
Overall people get very weird or think you have an eating disorder if you fast for any length of time. Luckily that is changing, but is still an issue for my partner who is in a much more traditional field and often skips meals.
But by far the most useful tool I’ve come across to precisely control body composition is the skill of counting and estimating calories and macros. Once you know your TDEE, it is super easy to control body weight with precision this way.
This should be taught in schools imo. It is surprising how wildly off the layman is when it comes to estimating calories.
Is there any empirically successful way for governments to use resources to fight obesity?
All I can think of is "The Maduro Diet" in Venezuela, where the average venezuelan has lost over 10kg due to food shortages...
My mother says this is related to "blood sugar" but I'm unsure if there's any deeper meaning to it.
Treating, let alone curing, advanced cancer is very difficult. Just look at the numbers - a human has about 6 trillion nucleated cells. A cancer 1cm3 in size has a hundred million cells in it or thereabouts. Therefore in advanced cancer you are looking at billions of cancer cells in the person. This is a very large amount of disease biomass. And the task is to make it all go away.
Yes, there are some patients who have favourable disease biology who are otherwise healthy, not too old, relatively wealthy and have access to incredibly sophisticated and expensive cancer care who can be cured from advanced cancer. But this number is very small compared to the deaths, especially for the common cancers (Breast, Prostate, Colon). And there is no general strategy to extend these occasional wins/miracles to everybody. We can't wait to cure cancer one Nobel prize at a time. Furthermore, we are seeing large waves of ageing populations colliding with poorly resourced healthcare systems around the world, and these systems just can't deliver what one would call optimal cancer care which requires specialist surgeons, oncologists, nurses, radiologists, PET scanners, MRIs, sophisticated radiation equipment, supportive care and very, very expensive drugs.
Unlike almost any other disease, cancers start from a single cell. The endgame has to be prevention. We should be preventing as much cancer as possible. And for most common cancers, we don't even understand why it happens with sufficient detail to think about how to prevent it. Detecting cancers earlier with tests like the one from Grail is a good thing to aim for, but trust me, being told you have cancer, and the inevitable surgery plus whatever else still sucks a lot even if the chances of cure are very good.
Stress is similarly complicated and not well defined or easy to measure. There are different types of stress of course. It seems like moderate to severe stress isn't necessarily harmful, based on studies of I think it was Dutch women in WWII who were definitely stressed but not in Auschwitz or open combat. There is some poorly controlled data from concentration camps that extreme stress coupled with malnutrition and everything else that went on does result in more cancers, but this doesn't really help us today.
Sugar is another complicated one. Any nutritional factor has different effects in different people. There is evidence that what sort of sugar you have, and even how you eat it matters (drinking sugars, especially fructose seems esepcially bad). Here it may be more relevant to consider the result of sugar intake, such as insulin resistance and high insulin levels.
But we do successfully treat cancer in many people, and prolong life in many others.
Prolonging life in advanced incurable disease is important but it isn't getting us to where we want to be. Having advanced cancer is a state associated with immense suffering, as much psychological and spiritual as it is physical, even when things are under control. We can pat ourselves on the back for saying on average we have given this person an extra 6 months of life, but when you are administering these treatments or recieving them it does not feel like a win. Also, young people get cancer - eg the most common cause of non-accidental non-suicide death in women aged 25 - 40 is breast cancer. An extra year isn't enough for a woman with advanced breast cancer in that phase of life, especially as it is spent running back and forth from hospital and in various states of ill health either from the disease or treatment side-effects. Almost all of them would rather be alive and having the treatment of course, but taking a step back, I feel very strongly that we need to do better than this and we need to offer more than this, and what is the best of all is if as few people as possible ever meet an Oncologist. It's important not to lose sight of that.
The other point I was making is that successful cancer treatment is difficult and expensive, and if you are mentally ill or poor or homeless or in the wrong country or in a warzone etc then you will miss out.
That is certainly not the experience of a great many people whose lives are prolonged. Many experience lots of healthy, productive years that they woulnd't get otherwise.
You can chose an example of a slow growing low volume malignancy like a neuroendocrine tumour, but that isn't representative of the majority by any means.
It worries my a bit that this moonshot effort is still listing the generation of cancer atlases as a priority. I hope these atlases will be used for the selection of epitopes towards developing cancer immunotherapies.
Previous atlas efforts made no sense, and it was very frustrating to see other great initiatives to obtain much less funding, like CAR-T cells. Research politics I guess...
Question - why does the US Gov have to create and register a 'Service Mark'?
There are some cancer types where this is more prominent. But even then, it's hard to disrupt this without causing a lot of collateral damage, because normal cells also need to ferment.
https://www.npr.org/sections/health-shots/2016/03/05/4682855...
“Despite the Herculean effort and enormous expense, only a few drugs for the treatment of cancer were found through NCI’s centrally directed, targeted program. Over a twenty-year period of screening more than 144,000 plant extracts, representing about 15,000 species, not a single plant-based anticancer drug reached approved status. This failure stands in stark contrast to the discovery in the late 1950s of a major group of plant-derived cancer drugs, the Vinca Alcaloids -a discovery that came about by chance, not through directed research.” — Happy Accidents: Serendipity in Modern Medical Breakthroughs.
CRISPR-9 was discovered by accident while trying to understand how bacteria fight the flu. (CRISPR-9 is the acronym for gene editing brouhaha).
Penicillin was discovered via Alexander Fleming’s random mold observation.
Roentgen discovered X-ray tech by accident when he shot electric current through a special gass in a glass tube. Roentgen found out that he’d made a ray that passed through light elements, but interacted with heavy ones; the X-ray.
Vaccines were accidental too. (Edward Jenner — cowpox)
Directed effort seems to be a not-good bet in biotech.
Lesson: Let scientists advanced things in accordance with the invisible hand of scientific discovery and observation as opposed to subsidizing bridges to nowhere. Think more Ioannidis than Kurzweil.*
But there are plenty of examples of research with directed effort leading to cures and treatments. You just choose not include any.