The human body is a non-orthogonal system. Everything in it is interconnected and exists in interrelated dynamic tension. We're still finding new structures in living humans that went undetected in cadaver analysis [1].
If you've written any code at all, you know that a non-orthogonal system is incredibly complex. It isn't just a matter of complexity scaling linearly with the count of the individual parts. Complexity scales with the interactions between each component, and between the assemblages of those components that have emergent interactions. Change one line of code, and you get wildly different behavior in another part of the system, or seemingly nothing for a long time until the system deletes its own database suddenly one day.
Curing cancer is a dramatically broad statement, because each kind is different, interacts with a different part of the body, and has different ways of growing and sustaining itself. Each intervention causes a cluster of unintended side-effects, again, because the body is a non-orthogonal system. Even your simple statements fall flat. Most cancer cells disguise themselves as normal cells from the perspective of the body's immune system. It's why the cancer can grow at all. The other factor is that most things that would kill cancer cells would kill cells... in general. Pull one thread wrong, fix one bug the wrong way... you end up doing more harm than good.
Maybe we'll get to a point where we have combinations of nanotech and gene therapies that eliminate most cancers. But it won't be simple. Getting there in an ethical fashion makes it even harder. How do we experiment with this kind of nanotech (which is not even off the ground yet). How do we experiment with this kind of gene therapy (we have more traditional paths to tread here, but there are still some quandaries).
We're just not there yet, and I doubt it will ever be something as reductive as your two items.
> The other factor is that most things that would kill cancer cells would kill cells... in general. Pull one thread wrong, fix one bug the wrong way... you end up doing more harm than good.
Yep. It's like modifying an undocumented API where there are tens of thousands of endpoints and you know there are a few dozen services that rely on each endpoint, and probably a few dozen more that nobody knows about. You are only allowed test runs that are expected to succeed, since test failures = death. Your dev environment is a mouse. Every change gets pushed to prod with no option to revert.
Push to assure that as much people as possible are supplied with food and water that are clean of cancer triggering chemicals. Educate people about sunburns is useful also, but people will rarely get leukemia or pancreatic cancer by sun exposure alone.
The sad truth is that most people will not be grateful for --not having-- cancer or --not going-- into a fat accumulation spiral by chemicals breaking the body fat system. People just take this for granted, or expect somebody volunteering to do this work for free.
Is not a lack of will, is a lack of resources. Banners are still one of the most powerful tools against cancer and the most underrated one.
Pathologist here (doctor who diagnoses cancer), who happens to have a degree in physics and works on diagnostic ML problems, including cancer.
Cancer is not a simple anomaly detection problem. I mean, there's that, but so much more. These cells, each one of them, by their very nature, looks exactly like your normal healthy cells, on the outside. It's what's inside the cell that's going to kill you. The uncontrolled replication. There are 36 trillion cells in the human body. How are you going to monitor them all? Well, turns out we have several methods built in, collectively called the immune system. But again, they're mainly looking for "not self". Because if they were looking for "self" you'd have another problem, called auto-immunity.
The uncertainty is real. It's not a hypothetical uncertainty. Combinatorics is a bitch.
There are 3 billion base pairs per normal human cell. The difference between a normal cell and a cancer cell can be on a similar order (a cancer cell may have many billions or less than a billion base pairs). There are similar problems for the number of proteins, lipids, polysaccharides, metal ions etc, per cell.
Three billion times 36 trillion, oh, and many generations of many of those 36 trillion over time. So, let's casually say a billion billion cells in a human life time. Times 3 billion base pairs. If one of those cells gets out of control, you've got a problem. Shockingly, only one in six people die of cancer.
Only under the most austere circumstances can we partially characterize a single cancer cell, and even then we waste many, many other cancer cells to surface that one cell (e.g. single cell transcriptomics).
Other methods allow us to examine many cells, but we can't examine them as closely (histology, histochemistry, immunochemistry, in situ hybridization, flow cytometry, targeted genomics, shotgun sequencing, karyotyping, etc), and we still never see most of the cells.
To get a basic understanding, it's advisable to take the ground up approach used in statistical mechanics: in cancer, from the ground up, a single cell is the source of the initial problem. That cell and its progeny divide many times, let's say 30-40 times. Now you have a billion cells, maybe 10-100 billion cells. Every one of which is starting from an unmanaged state, highly vulnerable to additional mutations. And probably the cell of origin died 20 generations before you find the tumor. Even in a basic science research setting, it would be exceedingly challenging to demonstrate you had found "the cell of origin".
This is very similar to physics: there are things we can know at one energy level that we can't know at another energy level. You can't explore Bose-Einstein condensates with the LHC. You're off by 20 orders of magnitude. You can't do single cell transcriptomics on a 1 kg en bloc cancer resection specimen, you're off by 20 orders of magnitude.
Complicating matters, fission is actually pretty straight forward compared to biology. In fission, you've got a very small number of elements involved, at very high, specified purity. In biology, you can barely guess most of what the organism consumed in the last 24 hours, let alone what they've been exposed to over a lifetime.
Cancer, nuclear physics, internet-scale computation, most of the really interesting problems: you can't just "take pictures" of the whole thing. It would be like assuming you can "just understand" what's happening in an actual nuclear explosion using some cameras and a sound understanding of math. Or the proposal that we could just understand the global economy by examining the ledger of all transactions. It's ridiculously beyond the realm of possible.
Even in the Trinity explosion, a highly controlled, intensively studied nuclear explosion, we can't even be sure how many neutrons the beryllium-polonium initiator produced. 8? 10? Not really sure which atoms produced them, for sure. And how many got produced in each succeeding fission generation? Meh? I mean, we can do some statistics, but that's it. That's roughly the scale of the problem we're dealing with in cancer research: where'd the thing come from? And where's it going? Statistically, we can make some guesses, but no one understands the whole thing.
I also appreciate the details response but unfortunately did not refute my argument or even provide me with additional knowledge.
Obviously we all know how many base pairs there are and how many cells are in the human body. The comparisons to many of the fields in physics are invalid since cells are microscopic objects that dont have relativistic energies.
You should start a blog... or maybe not - pursue the battle in academia/work and occasionally drop nuggets of wisdom like this somewhere. But do not delete them.
A biopsy is predicated on the idea that you can identify good from bad. You might not be able to identify the origin cell but you would be able to pick out metastasization.
You certainly can take pictures. And not to be too reductive: cells are visible in a light microscope. The point is that the scale that cells are at is not really at the quantum level. People have been interacting with individual cells for decades: https://www.youtube.com/watch?v=GTiKFCkPaUE
I also have a degree in physics but in addition I have a degree in computer science. 36 Trillion is not a very large number for modern computers anymore. I am sure even today we could build machines that would filter the cells in your blood by images and do it at 10s of millions per second.
Imagine thinking you're teaching a pathologist anything about evaluating neoplastic cells.... Like even as a doctor who's not a pathologist I wouldn't dare because I know just how much I don't know compared to them. A CS grad thinking they can jump in on that is peak tech-centric hubris.
We get pretty arrogant for sure, but from an outsider point of view at least this looks more like somebody pitching a perpetual motion machine to physicists, rather than typical tech-centric hubris.
Appeals to authority tend not to fly in a hacker community which is all about questioning authority and the status quo. It is usually much better to respond with logic and refutation.
I really can't tell if you're trolling at this point but in the chance you aren't, I'll bite.
Appealing to the authority of a pathologist is safe in my book given the subject matter and the education of the counterparty. There is a lower bound of requisite knowledge beneath which it's not worth even trying to entertain your claims about just "find and destroy rogue cells". You can't even begin to respond with logic and refutation if you haven't achieved anything close to the level of expertise required to be certified as a pathologist. Coming in here trying to play the angle of "well just model with supercomputers" isn't the winning ticket. Contrary to stereotypes of computer-illiterate doctors, there are some wicked smart people working in medicine (I've met and befriended many) and I guarantee your genius approach was considered and abandoned decades ago.
Looking through his comments, I think he's young and, as tends to go with youth, frustrated. This comment elsewhere in thread suggests he may be coming around: https://hackernews.hn/item?id=40895503
I am not that young. If you go back far enough in the comments you will see that I completed my physics degree 15 years ago. I studied quite a bit of biology and I personally know multiple doctors. I am more bored than frustrated.
i truly hope you never have to experience cancer treatments for a loved one where the treatments end up not working in the end. it is humbling and eye opening.
"find and destroy rogue cells" is an attempt to ask the right question. Sometimes, when stuck, questions from ignorance are useful even if it is just as inspiration.
My ignorance has a model like: If you keep putting sugar in the gas tank, how do you fix the car? How do I stay healthy if I eat only crap? How do I stay fit if I never get out of my chair?
Shit, would it be one of those cause and effect things?
I mean I kind of get it: if the problem is tumours, just "laser" all the tumours out and problem solved right?
Which feels like it should be true for a sufficiently targetable "laser" right?
Metastatic cancer is defined by essentially there being too many things to hit though, but therein lies the entire detail: you can't treat someone faster than they die of either the cancer or the treatment.
Google paraneoplastic syndromes. Cancer is rarely a problem of just tumors.
> just "laser" all the tumours out and problem solved right?
No. The tumors don't just evaporate. The treatment causes tissue necrosis. Your laser causes inflammation. Even the high tech IMRT you're picturing has those problems.
>Metastatic cancer is defined by essentially there being too many things to hit though,
Metastasis as a concept is fairly meaningless in how you're using it. There are so many more factors in treatment of various cancers that have nothing to do with the distribution. There's a lot that clinpath looks at and frankly I care much more about what's on those reports than playing where's Waldo with nodules. Frequently we assume micrometastasis just based on the cell line or other characteristics.
> therein lies the entire detail
So no.
> you can't treat someone faster than they die of either the cancer or the treatment.
Again far more consideration goes into it but I'm losing my desire to debate these contrived simplistic takes.
I dont get it. The first hit there says it is a rare disorder due to cancer; so this is already not the more common case. Second it is still due to the presence although not local of the tumor. If you destroy the tumor you may have a chance of resolving the condition.
I am aware of necrosis. You need to either completely break down the cell or remove the material. Radiation of course does not do this but surgery of course does.
My appeal to you would be to allow more disruption in this space. Software and Hardware are (mostly) unregulated which allowed for the explosion of progress.
> My appeal to you would be to allow more disruption in this space
No. There is far too much disruption that we don't want/need. If you want to help, go put yourself through medical school first, and then bring your CS knowledge to supplement it.
Jumping in when you haven't learned the basics wastes everyone's time like you have here.
But you have not actually been able to point out the basics that I am missing. You mention a specific condition which is listed as rare via a google search [0]. This condition is also caused by tumors so again perhaps a subset of these cases are completely resolved just by destroying the cells.
The fact of the matter is that I think any kind of refutation is actually pretty difficult for you (perhaps due to the medical training). It likely would have been easier had you just agreed and said "Yes if you can destroy the cancer cells you can treat >90% of all cancer."
Tell you what, if you're bored and want to learn about this world, I recommend newcomers read Robert Weinberg, The Biology of Cancer, (2nd Edition): https://www.amazon.com/dp/0815342195
I'm assuming you realize that the cancer community has been inundated by people from other domains for decades, right? If only those cancer researchers could think of this one idea that'd solve everything. And yet, somehow it persists.
Yes. There are regimented silos within medicine that allow hacking in ways that attempt to minimize patient harm. Attempting to circumvent them is a good way to land in court.
The information you can get from light miscroscope images is quite limited though.
On the other hand, maybe it would be enough to filter out every cell that is not identified as a blood cell. This should be an easier task.
Probably we could direct only a small part of blood into this filtering machine at a time. Sounds like it would be still more like a machine detecting if there are cancer cells present in the bloodsteam rather than a machine eliminating metastasization.
I think the "cure cancer without biology" approach makes somewhat sense (I assume you would still need some biology :) ). Don't many surgeries already fall into this category? Let's say we made an automated colonoscopic machine that scanned the whole intestine and destroyed all abnormal colonic crypts. Now if this machine worked well, you would essentially cure at least those colon cancers that go through some aberrant crypt stage.
1. Identify rogue cells 2. Destroy the rogue cells.
You can use technology to do both and pretty much ignore biology.