from Hacker News

A Pointless Cancer ‘Moonshot’

by BGyss on 5/27/16, 8:24 PM with 47 comments

• by openasocket on 5/27/16, 10:49 PM

  It is entirely possible that we can completely cure cancer. Not just a treatment, but actually prevent anyone from ever getting cancer in the first place. It would be super duper difficult, but we know it is possible because of the naked mole rat. Naked mole rats are essentially immune to cancer (I say essentially because this February scientists dicovered two individuals that had cancer, the only two documented cases). It is thus possible that genetic therapy could create a population of humans with no (or almost no) incidence of cancer.

• by yaakov34 on 5/27/16, 11:02 PM

  I am going to go against the grain of the usual sympathetic responses to this type of articles, and I am going to say that this is a case of pernicious and pointless casuistry. Apparently, this now passes for some kind of deep thought on the human condition.

  Well of course any medical treatment for anything just leads to more medical treatment in the future; that's not a profound statement, not as long as people are mortal. And it's not limited to cancer. It used to be, in the bad old days, that some people became almost completely bedridden as their joints gave out, and then either died early or wished they did; now we have arthritis medications and joint replacement surgeries that let many of them (not all, but very many) enjoy decades of their retirements. Does this lessen the need for future orthopedic treatment? Obviously not, since it extends their lives and keeps them on their feet long enough to develop other joint problems. Does that make orthopedics and rheumatology pointless? As someone who needed the intervention of rheumatologists, I assure you that it doesn't.

  In the case of cancer, nobody believes that one can make people live forever by curing their cancers; of course, they will live long enough to die of something, maybe even another cancer. Still, I personally know people in their 70s and 80s who would have been dead and buried 20 years ago if it wasn't for cancer treatment; and the idea of the "cancer moonshot" is to give the same chance to a lot more people. I came home today after visiting a very dear friend whose cancer is, with the current level of medicine, close to untreatable. Will she live forever if some treatment is developed for it? Well of course not. Would it be worthwhile to change the several months that she has left to live into several years? Of course, and yes, it would mean that she would require more cancer treatment, not less.

  We can debate if the "moonshot" model is right for cancer (personally, I think it has merits), but these pseudo-profound dismissals of medicine are simply vulgar and annoying.

• by joss82 on 5/27/16, 10:04 PM

  We are essentially temporary cell colonies evolved to relay life to the next generation, and as long as we are human, there will always be another cancer.

  That sentence made that great article awesome.

• by funkysquid on 5/27/16, 11:01 PM

  I'm not sure how you get from, "this is a difficult problem that won't be solved soon", to, "throwing money at this problem is pointless". It seems like the best way to solve problems is not to give up, but to keep the people who are trying to fix it well funded.

  Does he just want a more dourer PR campaign? I suppose "We probably won't cure cancer, but, I guess this is better than nothing" would be more realistic.

• by reasonattlm on 5/27/16, 10:35 PM

  There is a verge that is going to be crossed for cancer soon. The reason that cancer research and development is a slow, expensive, ugly morass is that 99% of the people involved are targeting biochemistry peculiar to a very small number of the thousands of relevant varieties and subtypes of cancer. A year of lab time is much the same ballpark of cost whatever you happen to be doing, give or take. So if it takes a thousand distinct cures to defeat cancer, it'll never get done.

  BUT.

  There are range of new approaches to cancer that are not particular and specialized to a very small number of cancers, or that can in principle be adapted with comparatively little work to target different cancer types from a common core platform.

  This is what will produce meaningful control of cancer: attacking the commonalities present in many or all cancer types.

  The best and most promising approach here is interdiction of telomere lengthening. All cancers must lengthen telomeres. They have to. If they can't, they wither. So block telomerase, block ALT, and cancer goes away. You can either block these mechanisms globally for a while, long enough to kill the cancer, but not long enough to kill the patient due to stem cell depletion, or combine this with any of the targeted delivery mechanisms under development to turn it off only in cancer tissue.

  There are a few labs working on aspects of this, more on the telomerase side ( e.g. http://www.eurekalert.org/pub_releases/2015-05/cndi-csa05111... ) than the ALT side, because ALT cancers are only about 10% of the total, and ALT is still not completely cataloged. ( See: http://www.the-scientist.com/?articles.view/articleNo/42444/... )

  SO.

  It is foolish to talk about cancer as a thing that medical science cannot get to the bottom of. There are very clear approaches to get to the bottom of cancer and fix it.

• by thetruthseeker1 on 5/28/16, 1:10 AM

  I am not cynical about humans living longer etc as this article seems to claim. However I am cynical about the approach of calling everything a moonshot. For Moonshot, there were clearly measure-able goals before you were able to land on moon in say 10 yrs. Now in Cancer research or any research is not executed in the same paradigm as planning a voyage to moon.

  Yeah my point maybe a minor one, but I dislike the dumbing down of things or appealing to past glory.

• by ck2 on 5/27/16, 9:55 PM

  the better we get at keeping people alive, the older they will get

  I'm generally not a fan of people either but there are kids with cancer that I feel should get some time to enjoy their lives outside of dying in a hospital if at all possible, someday.

  Besides, there are still many, many millions of people in the USA who can't get insurance so even if there was a "cure" or life extension, they couldn't afford it. Don't worry, they will die for you because emergency rooms don't treat cancer. For example if I got cancer, I'd be screwed.

• by MistahKoala on 5/28/16, 1:34 PM

  Well that was a lot more pessimistically fatalist than I was anticipating.

• by xupybd on 5/27/16, 11:51 PM

  With the rise of antibiotic resistance, cancer will become less relevant.