[HN Gopher] The roots of the National Cancer Act
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The roots of the National Cancer Act
Author : noodlesUK
Score : 51 points
Date : 2021-12-23 20:16 UTC (2 hours ago)
(HTM) web link (www.npr.org)
(TXT) w3m dump (www.npr.org)
| TulliusCicero wrote:
| Amazing to me how many commenters here are looking at a
| successful government initiative that's massively improved
| survival rates for a number of diseases, and the takeaway they
| can't wait to share with the world is, _but the name is dumb_.
| avgcorrection wrote:
| It's a general attitude. Not restricted to some agency or
| initiative.
| johnebgd wrote:
| Ken Burns documentary "Cancer: Emperor of Maladies" does an
| incredible job opening with some of this history.
|
| It aired on PBS 6 years ago: https://www.pbs.org/show/story-
| cancer-emperor-all-maladies/
|
| For those interested it's still on Amazon:
| https://www.amazon.com/Cancer-Emperor-All-Maladies/dp/B00UGD...
| GhostVII wrote:
| The book that documentary is based on is one of my favorites,
| second only to the making of the atomic bomb.
| [deleted]
| melling wrote:
| https://www.amazon.com/Making-Atomic-Bomb-Richard-
| Rhodes/dp/...
|
| Richard Rhodes
|
| He has a new book on EO Wilson
|
| https://www.amazon.com/Scientist-Wilson-Life-
| Nature/dp/03855...
| dang wrote:
| All: _Please don 't pick the most provocative thing in an article
| and rush to the thread to complain about it. Find something
| interesting to comment about instead._
|
| That's a new addition to the site guidelines and highly relevant
| in a case like this. I've changed the title (to the first
| sentence of the article) to try to cut down on the flamebait, but
| it shouldn't be appearing here in the first place. It's not what
| this site is supposed to be for.
| civil_engineer wrote:
| Jim Allison - Breakthrough:
| https://www.youtube.com/watch?v=MapggZMbCaI
|
| Dr. Allison recently was awarded the Nobel Prize in Medicine for
| his persistent decades-long pursuit of using our own immune
| system to combat cancer. I was diagnosed with Stage 4 melanoma in
| early 2017, and I have been cancer-free for almost five years.
| Thank you, Jim.
| akoluthic wrote:
| Only about 10% of cancer patients respond to immunotherapy at
| the moment. While it's great when it works, we have a very long
| way to go in improving outcomes.
| sungam wrote:
| Whilst this might be true in general melanoma does respond
| particularly well to immunotherapy with 5 year survival rates
| in excess of 50% for advanced (metastatic) disease and a
| subset of patients effectively cured.
| sorenn111 wrote:
| I wonder how much of this rate is affected by patients who
| try immunotherapies have failed frontline treatments and then
| try an immunotherapy later.
| jcims wrote:
| I'm just a layperson in this and could be wrong here, but my
| understanding is that cancer tends to survive by accumulating
| complementary pathogenic properties that individually are of
| little threat to the body. One of these properties is
| increased expression of 'programmed death ligand 1' (PD-L1),
| a surface protein on the cancer cell that binds with
| 'programmed death protein 1', a person on the surface of
| T-cells that, when bound, inhibit the T-cell response. I
| could be wrong here as well, but most immunotherapies today
| are of the 'checkpoint inhibitor' variety, which interfere
| with this binding process in one way or another.
|
| To me this is similar to removing an invisibility cloak from
| the cancer cells. Now the immune system gets a shot at these
| cells b/c there's nothing indicating otherwise. In the case
| of some cancers, like melanomas and some lung cancers they
| may look sufficiently broken that the immune system just
| kills them naturally. But if the cancer cells still resemble
| healthy tissue, it's not super clear to me what is going to
| provoke a kill response.
|
| I do think it's likely we will ultimately have customized
| therapies in which cancer cells are extracted, unique
| features are identified and custom mRNA packages created to
| emulate those features sufficiently to provoke the immune
| system to kill them. That, in combination with checkpoint
| inhibitors, would likely create an effective response.
| robbiep wrote:
| The treatment of melanoma is a true 21st century medical
| miracle.
|
| When I was going through med school 2010-2013 metastatic
| melanoma had a 5 year survival of basically 0%. By the time I
| graduated, it was a chronic disease for a proportion of
| patients and getting better.
| nikkinana wrote:
| narrator wrote:
| I read a lot of medical research. A lot has something to do with
| cancer and the research can be summed up as "We found a new way
| to kill cells. This may work better on cancer cells than normal
| cells. Hooray! More study is needed." or "This gene or habit or
| whatever may have some correlation to cancer."
|
| 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.
| inglor_cz wrote:
| What else would you do with those cells? Keep them alive?
|
| 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.
| jacquesm wrote:
| > Our immune system is probably strong enough to whack most
| cancers before they become a macroscopic problem.
|
| 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
| monocasa wrote:
| The majority of the time, it seems that the immune system
| does it's job. 'The majority of the time _that it has
| already become a macroscopic problem_ the immune system
| didn't do it's job' is sort of a tautology.
| jacquesm wrote:
| That's a fair criticism, but those are the cases that
| people are worried about, not the ones where the immune
| system generates the appropriate response. Just like we
| don't really care about regular moderate rain but we do
| care about rain that overwhelms our ability to deal with
| it. I'm not even sure what the stats are on the cases
| where a cancer got nipped in the bud at the single or
| just a few cells stage, but now I'm interested and I'm
| going to try to find out if this has been researched or
| not, that has to be a tricky problem to determine the
| answer to.
| inglor_cz wrote:
| "the majority of the time the immune system is a-ok with
| what cancer cells are doing"
|
| 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.
| jacquesm wrote:
| If cancer cells didn't occasionally manage to evade
| detection by the immune system then we wouldn't be having
| this conversation in the first place so _those_ are the
| cancers that are in focus because they are the ones that
| people end up dying from (or needing treatment or surgery
| with all of the associated risks).
| inglor_cz wrote:
| True, but as I already mentioned, immune systems can be
| trained against those cancers as well, they only need
| external help.
|
| For example, BioNTech was actually founded as a cancer
| vaccine research lab, its Covid vaccine is "only" a (very
| welcome) serendipity.
| monocasa wrote:
| There's also Cuba's lung cancer vaccine that's
| unfortunately illegal here in the states because of the
| embargo.
|
| https://pulitzercenter.org/stories/cuba-has-lung-cancer-
| vacc...
| jacquesm wrote:
| That's a very weird thing that Cuban embargo, I never
| really got what's so terrible about Cuba that you
| couldn't travel there. And in this context it is terrible
| assuming that that stuff really works.
| folli wrote:
| > the majority of the time the immune system is a-ok with
| what cancer cells are doing
|
| 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.
|
| [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1857231/
| jacquesm wrote:
| That's the third comment that says the exact same thing.
|
| Obviously, we are within the 'war on cancer' talking
| about the remainder, not the ones that the immune system
| dealt with successfully.
| inglor_cz wrote:
| This is a shifting standard, though.
|
| 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.
| jacquesm wrote:
| Part of that is simply that the cumulative copy errors of
| cells several generations old incurs a higher chance of
| cancer as well as the higher chance of those cancers not
| being detected by the aging immune system. So there is
| degradation on multiple axis at once (and probably others
| that I'm not even aware of).
|
| > I am cautiously optimistic about potential rejuvenation
| of immune systems in older adults.
|
| That's a worthy goal.
| inglor_cz wrote:
| Random errors in DNA are part of the picture, but we have
| error-correction mechanisms as well. It is possible that
| those mechanisms go haywire as we age, too.
|
| 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.
| folli wrote:
| Sorry, I was getting riled up about the "majority" part
| of your statement and trying to find some references with
| quantitative estimates (which you were also wondering
| about in your response to a sibling comment). The other
| comments snuck in meanwhile...
| jacquesm wrote:
| Yes, I should have been more careful in wording that,
| obviously if the early stage stuff gets snuffed out we
| won't know about it. But the numerical angle is an
| interesting one and the ratio between the cancers that
| are caught versus the ones that aren't (and maybe per age
| cohort) could be quite insightful.
| s1artibartfast wrote:
| There is a lot of money to be made if someone comes up with a
| game changing cancer treatment - so the incentive is there.
|
| It is impossible to treat cancer without killing cancer cells,
| so I'm not sure why this is troubling to see
| williamtrask wrote:
| Not all treatments are equally profitable. I'm close
| colleagues with the cancer research dept here in Oxford and
| there's more than a little cynicism about what types of
| pursuits get funding amongst grad students.
|
| Diet change, for example, is generally undervalued I'm told.
| alphaoverlord wrote:
| Not all treatments are equally likely as well. Given how
| good dietary science is outside of cancer, less optimistic
| at rigorous studies in this area.
| ren_engineer wrote:
| >It is impossible to treat cancer without killing cancer
| cells
|
| 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
| folli wrote:
| That's the problem: there's no single root cause to cancer.
| Every cancer type has an additional dozen subtypes with
| different causes. It's a mess.
| LinuxBender wrote:
| I find this video [1] interesting as it pertains to the
| root cause of cancer. Compelling theories anyway.
|
| [1] - https://www.youtube.com/watch?v=06e-PwhmSq8 [video]
| avgcorrection wrote:
| Americans are always going to proverbial war on stuff. It seems
| bad enough that something inanimate is trying to kill you. To
| imagine an enemy with malign intent on top of that doesn't seem
| very helpful to me.
| dang wrote:
| Ok, but please don't take HN threads on predictable generic
| tangents. Especially not nationalistic ones. We're interested
| in the diffs (i.e. the new information) in a story--not the old
| saws.
|
| https://news.ycombinator.com/newsguidelines.html
| C19is20 wrote:
| ...not forgetting that some other countries do the same.
| Allies/ sheep? Sometimes it's a fine line.
| forgotmypw17 wrote:
| Fifty years of loudly covering up for profitable carcinogens.
| CoastalCoder wrote:
| I share your concern that we (as a society) seem more focused
| on treating cancer than in addressing whatever environmental
| factors increase the risk.
|
| I'm curious about how much this stems from the U.S. legal
| system's approach to liability.
|
| IIUC, a company can contaminate the air/land/water to shocking
| degrees, but will only be held liable if the _government_
| chooses to enforce environmental regulations or an individual
| can prove that _that particular source of contamination_ caused
| a particular harm to that individual.
|
| So, for example, if I were to dump 1000 gallons of dioxin in
| some aquifer, and a few more people got prostate cancer than
| one would statistically expect, I may end up paying only the
| cost of defending a law suit. Despite the myriad of evidence
| that I should have known that it was taking a major gamble with
| the lives of current and future people.
|
| And if I or my company _was_ found guilty, in all likelihood I
| 'd only have to pay for the harm to the particular persons who
| sued me. Which, with "proper" incorporation, I could walk away
| from with most of my personal wealth intact.
|
| If I'm correct about this, it seems very far from true justice
| to me. Nor does it seem like an effective deterrent. My current
| view (which I hold lightly) is that a _more_ just policy would
| be that (1) such crimes carry the same legal penalties as
| attempted mass murder or attempted terrorism; (2) all corporate
| veils are ignored; and (3) there is no limitation of liability
| for stockholders, even for publicly traded stocks.
| elmomle wrote:
| Is (3) either implementable or necessary (for the former
| case, are you liable the if you hold stock the moment the
| decision is made? What if the decision is kept secret from
| public stockholders?)?
|
| Agreed, though, that quality of life would be higher if
| decisions that materially degrade the quality of life for
| members of a society were judged as crimes against society,
| with antediluvian punishments (lifetime imprisonment at
| least, and stripping of all assets from the family) for all
| culpable corporate officers. Of course this also runs into
| problems, chief of which is: when does something materially
| degrade quality of life? How many tons of carbon emissions is
| permissible, for example? Once something is known to be bad,
| does a public oversight panel determine how much is to be
| allowed for a given company? And if so, how do you avoid (1)
| dramatically slowing innovation (which would be fine except
| we're still in competition with other countries) and (2)
| corruption of such processes over time?
| koprulusector wrote:
| Well, if it's had anywhere near the success as the "War on Drugs"
| ...
| VWWHFSfQ wrote:
| great comment. super smart.
| photochemsyn wrote:
| It's a bit odd to see an article on the efforts to reduce cancer
| incidence that doesn't include the terms 'carcinogen' or
| 'mutagen' anywhere in its body, or that doesn't reference Rachel
| Carson's significant role in the understanding that many
| pesticides and herbicides have carcinogenic properties, and
| doesn't even reference the well-studied linkages between tobacco
| and lung cancer.
|
| Obviously, the industries involved in producing agricultural and
| industrial chemicals have an interest in suppressing this aspect
| of the cancer story, but entirely ignoring it is pretty
| ridiculous on the part of NPR. Clearly there are a wide variety
| of both naturally occurring and synthetic chemicals that can
| damage DNA and otherwise cause the cell cycle to go out of
| control, which is thought to be the fundamental process leading
| to cancers. A major part of the reduction in the incidence of
| cancer has been the removal of such substances from the water and
| food supply, right? The recent judgment against Bayer/Monstanto
| over the carcinogenic properties of their Roundup-Ready
| formulation wrt non-Hodgkins Lymphoma is one such example. (Note
| there that it's the surfactants causing the problem most likely,
| not the glyphosate itself, although without the surfactants the
| plants don't absorb the glyphosate).
|
| As far as the 'war on cancer' theme, one of the most curious
| books on the topic is about the German 'war on cancer' in the
| Nazi era, a period when the science of carcinogens (and
| toxicology in general) was making a lot of advances. It's a bit
| disturbing as well [1]
|
| [1]
| https://press.princeton.edu/books/paperback/9780691070513/th...
|
| I can't help thinking that NPR's silence on this rather
| fundamental feature of cancer, i.e. the role of environmental
| carcinogens, is in some way related to the money they take from
| their advertisers in the fossil fuel / pharmaceutical sector.
| DrScump wrote:
| "After adjusting for cancer stage, the mortality improvement in
| expansion states from the periods before and after expansion was
| _no longer evident_ (HR, 1.00; 95% CI, 0.98-1.02; P = .94), _nor_
| was the difference between expansion vs nonexpansion states (DID
| HR, 1.00; 95% CI, 0.98-1.02; P = .84). "
| sadfev wrote:
| All these "War on" political grandstanding does is kill a lot of
| people, increase a lot of taxes and inflate the poor into
| destitution.
|
| War on Drugs. War on Terror. War on Cancer.
|
| Same pig but different shades of lipstick.
|
| US govt has become unbelievably bloated and overreaches every
| aspect of life today.
|
| Slogans like these help them keep expanding and hurting the
| people.
| dang wrote:
| Please don't take HN threads on generic ideological tangents.
| They're repetitive and tedious. More here:
| https://news.ycombinator.com/item?id=29666852.
|
| https://news.ycombinator.com/newsguidelines.html
|
| Edit: you've unfortunately been posting a ton like this
| (unsubstantive flamebait and name-calling). Please don't! We're
| trying for a different sort of forum.
| sadfev wrote:
| It's not a tangent. It's how these things turn out.
|
| If you want to silence people speaking their minds and
| instead of humming along and cheer your neo-communist vision
| of the future.
|
| Then by all means go ahead and cancel me.
|
| Keep your precious silicon valley socialist/totalitarian club
| to yourself.
| sadfev wrote:
| Oh BTW, you people already banned/cancelled the guy who
| created this website. (PG)
|
| You think you are the guardians of truth but you are just
| exploiters and thought police.
|
| KGB of the internet.
| vimy wrote:
| PG is banned? That's the first I'm hearing of that.
| TulliusCicero wrote:
| > War on Drugs. War on Terror. War on Cancer.
|
| One of these is not like the others.
| Krasnol wrote:
| I wonder if the Americans "war on X"-phrase washed out the word
| "war". Is it still as powerful as it should be?
| tzfld wrote:
| As empty as "renewable revolution" or "space race"
| JasonFruit wrote:
| I think you're onto something there. We've come to think of war
| -- endless war -- as a normal part of life in the US. Even our
| actual wars are now the War on Terror, not the war in
| Afghanistan or Iraq. We may defeat one enemy (or more likely
| declare victory and ditch), but there's no expectation that
| we'll defeat Terror, or Obesity, or Hate.
| phendrenad2 wrote:
| It would be hard to tell, since it goes back over 100 years:
| https://www.uky.edu/~eushe2/Pajares/moral.html
| cblconfederate wrote:
| I suggest a different name next time. The US is not known for
| winning wars
|
| (edit: whoa didn't realize this was flamebait, i think it is a
| common journalistic trope, e.g.
| https://www.theatlantic.com/international/archive/2015/06/am...
|
| https://www.vox.com/2018/2/15/17007678/syria-trump-war-win-i...
|
| https://www.americanprogress.org/article/real-reasons-u-s-ca...
|
| nothing to do with nationalism)
| EarlKing wrote:
| Actually, that suggests an even better idea: Abandon our bodies
| and let someone else clean up the mess. I mean... it's worked
| before. :D
| dang wrote:
| Flamebait will get you banned here. No more of this, please.
|
| https://news.ycombinator.com/newsguidelines.html
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(page generated 2021-12-23 23:00 UTC)