[HN Gopher] Scientists glue two proteins together, driving cance...
       ___________________________________________________________________
        
       Scientists glue two proteins together, driving cancer cells to
       self-destruct
        
       Author : Jerry2
       Score  : 604 points
       Date   : 2024-11-04 00:42 UTC (22 hours ago)
        
 (HTM) web link (med.stanford.edu)
 (TXT) w3m dump (med.stanford.edu)
        
       | mountainriver wrote:
       | I feel like I've heard this before, is this something that is
       | actually novel?
        
         | staplung wrote:
         | Hard to tell. The cynical response is that the novelty is that
         | it's coming from Stanford. The perhaps more correct response is
         | that the novelty is the mechanism of triggering the apoptosis
         | and the specificity.
         | 
         | Here's a paper from 2018 that discusses the prospect of using
         | apoptosis for cancer treatment. They even talk about BCL-2.
         | 
         | https://pmc.ncbi.nlm.nih.gov/articles/PMC5855670/
        
         | SanjayMehta wrote:
         | It's due to the phrase "self destruct."
         | 
         | For some reason people who write headlines like using this in
         | the context of cancer cells.
         | 
         | First noticed it in 2010 when I was researching multiple
         | myeloma treatments for my father.
         | 
         | It's medical clickbait.
        
           | F-Lexx wrote:
           | Isn't the phrase "self destruct" just meant to be a popular
           | term of referring to apoptosis or programmed cell death in
           | general?
        
         | emporas wrote:
         | Triggering the automatic cell death on demand, instead of a
         | period of time, i.e. apoptosis, sounds pretty smart and novel.
         | 
         | After 7 years all of our cells die and regenerate, but using
         | biochemistry and some endogenous proteins glued together to
         | control that period of time, i haven't heard about it before.
         | 
         | Not a medical expert, but cancers have a vast number of
         | variations in the type of the cancer cell they create, but one
         | common characteristic of all cancers is that they are derived
         | from our own cells. So they should respond to some "commands"
         | our own cells follow.
         | 
         | Inducing apoptosis for cancer prevention and treatment is old
         | news though. Fasting, water fasting that is, causes apoptosis
         | of cells en mass and has proven to be very effective in
         | minimizing radiotherapy or chemotherapy sessions, and even a
         | total treatment. Instead of doing 20 chemotherapy sessions,
         | reducing it down to 1 or 2 and the cancer is gone.
         | 
         | Anyway, someone doing the same using a biochemical pathway and
         | light up gene expression, is pretty novel.
        
           | bglazer wrote:
           | I think you're overstating the "proven" effect of water
           | fasting. That said I'm surprised and happy to see that
           | several academic medical centers are running trials of
           | fastingin conjunction with chemotherapy.
           | 
           | https://www.cedars-sinai.org/discoveries/fasting-as-next-
           | ste...
        
             | emporas wrote:
             | I meant "proven" when done by the patients themselves, not
             | by the doctors necessarily.
             | 
             | Dr. Gundry has done an interview with a martial arts guy
             | who was diagnosed with cancer, and fasted for 20 days only
             | water, and 20 days a little meat and nothing else, and one
             | or two sessions of chemotherapy or radiotherapy later he
             | was clear of cancer. There are many people who talk about
             | same experiences, from the patient side.
             | 
             | If some doctors are seriously researching fasting and
             | cancer treatment, that's going to produce some measurements
             | instead of relying on anecdotes.
             | 
             | I cannot find Gundry's interview, it's 5 years old
             | something like that.
        
               | AuryGlenz wrote:
               | You'll find anecdotal "evidence" for all sorts of stuff
               | when it comes to cancer. Some of it is just woo, others
               | might just work for really specific genetic mutations,
               | etc.
               | 
               | Fasting in general has been known for quite a while but
               | (and I'm far from an expert) it only helps with certain
               | cancers. Hell, I had a friend die this year from stomach
               | cancer and he literally couldn't eat or drink. He only
               | went to the hospital when he was already skin and bones,
               | got a few chemo treatments, and then it was too late.
        
       | lr0 wrote:
       | Same as mountainriver's comment. I really find strange how I've
       | been reading news lines over the past years about great
       | advancements in many incurable and chronic diseases (like
       | Alzheimer's, diabetes, and cancers) yet after all that time
       | people's treatment is not going any better. I'm not sure whether
       | scientific journalism somehow delivered some unintended messages
       | to me, or we're just supposed to experience these great
       | advancements after couple of decades from the announcement.
        
         | njtransit wrote:
         | Why do you think "people's treatment is not going any better"?
         | As far as I know, cancer outcomes have greatly improved.
        
           | bb88 wrote:
           | It's the articles that decry "Big discovery in X".
           | 
           | This could be because the researchers need funding so they
           | will hype the results as much as possible.
           | 
           | Then the articles need as much readership so the journalists
           | hype the results as much as possible.
           | 
           | Then the people suffering from the disease want as much help
           | as possible so they push the articles/papers to the doctors.
           | 
           | On the other hand, it's been my experience that GLP-1
           | agonsists weren't overhyped, I was completely surprised when
           | my doctor prescribed Mounjaro for weight loss. Even after
           | decades of articles about "NEW WEIGHT LOSS TREATMENT!" (See
           | also phen-phen)
        
             | markus92 wrote:
             | It's mostly the PR department of universities that boast
             | about those big discoveries. Researchers themselves usually
             | try to add some nuance to it.
        
           | SoftTalker wrote:
           | Cancer detection/testing has gotten a lot more attention.
           | Detected early, many victims are still alive after 5 years
           | and considered "cured." But it still gets you in the end. A
           | lot of expense and misery while under
           | medication/chemo/rad/surgical therapy and in the end you are
           | dead just the same.
        
             | fzeroracer wrote:
             | I'm not sure why this matters. In the end we're all going
             | to die, death is inescapable. The ultimate form of your
             | rationalization is that we should simply not treat anything
             | because we die all the same.
             | 
             | But for many cancers and other diseases not only has early
             | detection gotten better but so has treatment and prognosis.
             | Treatment isn't nearly as bad to go through and long term
             | survival rates are higher. People can live longer with
             | cancer while still being fully functioning.
        
             | Spooky23 wrote:
             | That's the measurement that a lot of Covid deniers liked to
             | roll out. Death isn't the only metric.
             | 
             | Life is a precious and personal thing. Those years mean
             | wishes fulfilled, graduations and weddings celebrated, life
             | lived.
        
           | ekianjo wrote:
           | > cancer outcomes have greatly improved.
           | 
           | If you stop believing the bullshit headlines you will see
           | that newer treatments simply increase OS by a few months and
           | that's sufficient to claim significant improvement. In terms
           | of patient outcomes, not a major difference, the cancer still
           | kills you in the end. it's just KPI hacking.
        
             | rowanG077 wrote:
             | What else is there? Are you saying immortality or bust?
        
               | ekianjo wrote:
               | What else is there? Long term remission for example. This
               | is hardly looked at because we don't see any difference.
        
               | rowanG077 wrote:
               | Long term remission is just a few months extra to live.
               | In the end you have people who die quickly and people
               | that live for years. That's why you get averages of a few
               | months extra.
        
           | adamredwoods wrote:
           | Depends. Early cancer? Yes, outlook is getting better.
           | Metastatic cancer? It's still very bad outcomes. (Personal
           | experience.)
        
         | lenerdenator wrote:
         | Well, let's see.
         | 
         | Some drug company or group of investors must think it's
         | potentially profitable to develop into a real treatment.
         | 
         | Then they have to move up the trials ladder, from mice to
         | humans and the steps in-between.
         | 
         | Then they have to get regulatory approval.
         | 
         | Finally, assuming the steps prior didn't fail horribly, they
         | need to set up the manufacturing for the drug.
         | 
         | All the meanwhile handing off money to a bunch of people who,
         | more likely than not, never worked for the company in the form
         | of earnings-per-share.
         | 
         | So, yeah, a couple decades.
        
         | echelon wrote:
         | Cancer deaths have been falling since the 90's. Detection and
         | treatments are improving.
         | 
         | We don't have a silver bullet because these diseases are so
         | incredibly complicated. "Cancer" is a particular type of
         | disease behavior, but is essentially a broad class of failure
         | states across different types of cells and tissues, with
         | different genetic, metabolic, biochemical, and molecular
         | dysfunctions.
        
           | derektank wrote:
           | The decline in cancer deaths can almost entirely be explained
           | by the decline in smoking. Getting from 40% of people smoking
           | to 15% was probably the biggest public health victory of the
           | latter half of the 20th century
        
             | bb88 wrote:
             | similar arguments have been made about lead and leaded
             | gasoline being made illegal in the 70s.
        
             | bglazer wrote:
             | This is true in the large sense but it obscures that 5 year
             | survival rates have been steadily extending for many people
             | who _already_ have cancer. Treatments are in fact improving
        
             | cyberax wrote:
             | That's not true. Survival rates in most cancers went up,
             | not only in lung cancers.
        
               | derektank wrote:
               | It's true that there has been some progress in treating
               | most cancers and particular success in treating some
               | specific cancers e.g. with checkpoint inhibitors. But
               | lung cancer is both one of the most common forms of
               | cancer (it's still third even with the massive decline in
               | smoking) and has a much lower 5 year survival rate than
               | the other most common cancers, breast and prostate. The
               | massive decline in smoking has played an outsized impact
               | on the improvement in reducing both cancer rates and
               | deaths from cancer generally
        
         | treflop wrote:
         | I'm not sure I agree. We now have techniques like immunotherapy
         | for some cancers. Cancer rates still continue to fall.
         | 
         | We have a drug now that you can take so you won't catch HIV, as
         | well as another drug for HIV+ that keeps it at bay.
         | 
         | We haven't found a cure-all. Rather, now we have a lot more
         | treatment options nowadays depending on your specific cancer or
         | illness.
        
           | andkenneth wrote:
           | And as always, when problems get solved, other problems get
           | revealed. We didn't even really know about cancer until life
           | expectancies got to the point where dying in your 30s is a
           | tragedy instead of being fairly normal.
        
             | xp84 wrote:
             | I don't think dying in your 30s has been normal in the
             | Western world anytime In the last 500 years. Remember all
             | those life expectancy mean statistics were heavily dragged
             | down by the huge infant mortality stats.
             | 
             | If your comment was more talking about the Stone Age or
             | something, I apologize for misinterpreting :)
        
               | radicalbyte wrote:
               | Infant and mother mortality stats.
        
             | anonym29 wrote:
             | The idea that most people more than ~120 years ago died in
             | their 30s or 40s is a popular misconception. LEAB (Life
             | expectancy at birth) used to be in the mid-30s, but this
             | was largely due to a bimodal distribution of deaths: a
             | large number dying during childbirth, infancy, or early
             | childhood, and a lot at more typical old age (60-70, still
             | a bit lower than is common in much of the west today, but
             | you get the idea). If you made it past puberty, there were
             | pretty good odds of you making it to old age.
        
               | mlyle wrote:
               | Aside from infant morality, don't forget the massive
               | death load from things like accidental death, famine, and
               | maternal mortality.
               | 
               | E.g. from Wikipedia, female life expectancy from age 15
               | in Britain in the 1400-1500s century was 33 years (so
               | reaching 48 years of age).
        
               | thomassmith65 wrote:
               | ...and also bubonic plague.
        
               | dahart wrote:
               | 100%. I carried this misconception after high school and
               | college and was surprised to learn it's completely wrong.
               | There's a name for the old-age end of the bimodal
               | distribution: longevity. Longevity is the natural
               | lifespan of people who don't die of any early mortality
               | factors. Most people who have the misconception are
               | accidentally conflating life expectancy with longevity. A
               | few unscrupulous peddlers of false hope, like Ray
               | Kurzweil for example, intentionally conflate life
               | expectancy with longevity to reinforce the misconception.
               | As I was learning about longevity I started talking to my
               | anthropologist brother about it, and he was like, oh
               | yeah, people who don't die from war or disease or
               | infection have always lived to be about 80 years old for
               | all of known history. He mentioned there's plenty of
               | written evidence from, e.g. Socrates' day, and also lots
               | of human remains that support it from ten thousand years
               | ago.
        
               | wbl wrote:
               | Well we have a lot less disease and infection now!
        
               | dahart wrote:
               | This is why life expectancy has gone up, while longevity
               | has mostly remained unchanged (for at least thousands of
               | years). Longevity represents the best we can do, and life
               | expectancy can't exceed longevity. Life expectancy will
               | asymptotically approach longevity as medicine improves.
        
             | jezzamon wrote:
             | Cancer was first documented around 3000 BC, and has been
             | studied for a long time. https://acsjournals.onlinelibrary.
             | wiley.com/doi/10.1002/cncr...
        
           | d_tr wrote:
           | Cancer mRNA vaccines for solid tumors are administered to
           | real patients in clinical trials right now.
        
             | hanniabu wrote:
             | So you'd rather she them before you get cancer?
        
               | mschuster91 wrote:
               | As far as I understand it these immunotherapies are
               | tailor-made to the very specific cancer and its genetics
               | that a patient has, which is also why the stuff is so
               | darn expensive. So you can't have a vaccine until you
               | already have the cancer.
        
         | weaksauce wrote:
         | mrna vaccine had big "breakthroughs" during the 80s and 90s and
         | yet it took quite a while for it to be a viable thing. some
         | things take time and some things never pan out past the in a
         | pitri dish stage.
        
         | melling wrote:
         | I don't think we've made any progress in Alzheimer's. Where did
         | you read that we have?
        
           | zdragnar wrote:
           | There have been a fair number of announcements about possible
           | progress, and even several recently related drugs. The
           | research and drugs continue to focus entirely on beta amyloid
           | buildup in the brain:
           | 
           | https://www.science.org/content/article/new-alzheimer-s-
           | drug...
           | 
           | There's not a shortage of debate on whether they are
           | effective, ought to have gotten any approval, or if beta
           | amyloid buildup is even a cause or contributor to Alzheimer's
           | disease, so whether we've actually made progress remains
           | debatable for the short term until results on these drugs are
           | in.
        
             | throwawaymaths wrote:
             | Wasn't a lot of the beta amyloid buildup hypothesis based
             | of of results from Marc tessier Levine who left Stanford
             | under a cloud of accusations of results fakery and is now
             | the CEO of the ai startup xaira?
        
               | ekianjo wrote:
               | Yes it was mostly a bad hypothesis on which the industry
               | wasted billions and 20 years.
        
             | melling wrote:
             | Well, which is it "great advancements" or "possible
             | progress "?
             | 
             | You're both saying two different things.
        
         | kemmishtree wrote:
         | Robust biomarker monitoring in toilets would lead to a 95%
         | reduction in cancer deaths.
         | 
         | Robust biomarker _discovery_ in toilets would let us take care
         | of most of the other 5%.
         | 
         | That's the main obvious humanitarian purpose of our project
         | www.molecularReality.com
        
           | 8n4vidtmkvmk wrote:
           | How do I buy an anticancer toilet?
        
             | esperent wrote:
             | Post I spotted earlier today on reddit:
             | 
             | > TIL that scientists at Stanford University have developed
             | a smart toilet that reads your anus like a fingerprint and
             | monitors the health of your poop and pee. The lead
             | researcher said, "We know it seems weird, but as it turns
             | out, your anal print is unique."
             | 
             | https://old.reddit.com/over18?dest=https%3A%2F%2Fold.reddit
             | ....
        
               | NemoNobody wrote:
               | I had a tech startup back in the day and I always had a
               | hard time getting people to understand the significance
               | of data and ended up often explaining how incredibly
               | valuable the data is about when we simply take a sh*t
               | is/would be. Most people couldn't seem to grasp that
               | either.
        
         | uoaei wrote:
         | The missing ingredient that makes it make sense is the profit
         | motive.
        
         | Spooky23 wrote:
         | Two things. If you follow the news closely, but lack specific
         | expertise or knowledge, you develop this nihilistic sense of
         | doom to some degree. The narrative of our age is that
         | everything is in decline. It pulls clicks.
         | 
         | The other thing is that cancers are not created equal, not all
         | treatments are evolving quickly. Your loved one may be
         | suffering, and that's your world.
         | 
         | I will say that I lost my beautiful wife a little over a year
         | ago. She had an aggressive cancer, for which the 10-year
         | survival rate was zero. Thanks to the miracle of immunotherapy,
         | the five year survival rate is about 65%. At the same time, my
         | 78 year old aunt successfully fought lung cancer that was a
         | death sentence 20 years ago.
        
           | highwaylights wrote:
           | I've nothing to add to the discussion but just wanted to say
           | that, for what it's worth, I'm terribly sorry for your loss.
        
             | EQYV wrote:
             | Very much the same from me. I know +1 posts aren't
             | generally welcome here but I hope dang can forgive it.
        
             | Spooky23 wrote:
             | Thank you both!
             | 
             | I think it's important to share for a variety of reasons
             | but most importantly to add some humanity to a topic that
             | gets turned into technocrat babble.
        
         | dools wrote:
         | When my Aunt was diagnosed with MS in the 80s it was a
         | crippling and degenerative ailment.
         | 
         | When my brother was diagnosed with MS ~30 years later, it was a
         | nothing burger. He gets an infusion monthly and suffers no
         | significant impact on his quality of life.
        
           | NemoNobody wrote:
           | This is great to hear. I had an Aunt that was diagnosed with
           | MS around 40 and by 50 she was in long term care - it's the
           | only place I ever saw her and she had a terrible quality of
           | life, completely incapacitated. I've always had a fear of MS
           | bc of this bc apparently she was completely normal before.
           | 
           | Thank you for that comment.
        
         | adastra22 wrote:
         | Blame the FDA. It is near impossible to get these treatments
         | out to patients.
        
           | equasar wrote:
           | Can other countries conduct trials for these treatments at
           | the patient's own risk?
        
             | 2Gkashmiri wrote:
             | i find this funny. what do you mean "patient's own risk?"
             | 
             | that has always been the case. you go for a minor surgery,
             | you sign a waiver. you go to a doctor, they are supposed to
             | give reasonable care. No one can guarantee success. the
             | same with lawyers or drivers or mechanics or technicians.
             | basically anytime you go to someone for assistance, they
             | can't guarantee anything. the person is themselves always
             | responsible for everything.
        
               | adastra22 wrote:
               | With the FDA rules they are not legally allowed to offer
               | such services, however.
        
               | dahart wrote:
               | Of course there's always some risk with any drug or
               | medical procedure. But - _obviously_ - not all risk is
               | equal. Unapproved treatments are riskier because they
               | haven't been proven effective, and they haven't been well
               | tested for side effects. There is an uncountably large
               | list of cases throughout history of people willing to
               | sell ineffective and /or actively harmful treatments,
               | which is the whole reason the FDA exists. Look up people
               | who died taking ivermectin for Covid [1], or just pick
               | any ailment and do some research on fake treatments,
               | perhaps cancer for example [2]. The UN says half a
               | million people in Africa alone are being killed every
               | year by fake medicine today, currently [3].
               | 
               | [1] https://www.unmc.edu/healthsecurity/transmission/2023
               | /03/14/...
               | 
               | [2] https://en.wikipedia.org/wiki/List_of_unproven_and_di
               | sproven...
               | 
               | [3] https://www.un.org/africarenewal/magazine/february-20
               | 23/fake...
        
               | adastra22 wrote:
               | History is also full of examples of treatments that do
               | work under unknown (at the time) circumstances and were
               | standardized into common practice through trial and
               | error. This includes most over the counter medication and
               | procedures today.
               | 
               | Most of that advancement stopped with the introduction of
               | the FDA and its equivalents in other countries.
               | 
               | The story of efficacy trials falls apart when you
               | consider the complex reality of the human body and
               | pharmaceutical action. There are many medical procedures
               | and drugs which we know work on certain patients some of
               | the time, but we are prevented from giving to new
               | patients because the high standards of Phase III efficacy
               | haven't been met.
        
               | dahart wrote:
               | So what? The U.S. food and drug laws aren't protecting
               | against things that accidentally work, they are
               | protecting against things that don't work. These laws are
               | hard won and represent many people lost to both ignorance
               | and greed.
               | 
               | If something has efficacy, then trials will eventually
               | prove it, it's just a matter of time. You just made a
               | case that the process works. If efficacy can't be shown,
               | then it's very risky for people to try the treatment,
               | riskier than using something with known outcomes, and
               | potentially riskier than doing nothing at all.
               | 
               | Either way this is all irrelevant to your bogus claim at
               | the top that the FDA has anything to do with the
               | perception that treatments aren't improving. The top
               | comment's hypothesis is incorrect, which adds to the
               | multiple reasons your proposed explanation is wrong.
        
             | adastra22 wrote:
             | Trials? No. There are various other countries you can go to
             | in order to have these unapproved treatments performed, at
             | great personal cost because there are no economies of
             | scale. But there largely aren't countries performing trials
             | that would count as an FDA Phase II or Phase III trial.
        
               | reverius42 wrote:
               | > at great personal cost because there are no economies
               | of scale
               | 
               | I didn't realize the USA was the only Economy of Scale
        
               | adastra22 wrote:
               | I'm talking about treatments that aren't approved
               | anywhere.
        
               | NemoNobody wrote:
               | The US is the Primary economy of scale as it is the
               | primary economy in general.
        
         | cyberax wrote:
         | > people's treatment is not going any better
         | 
         | That's not true. It's improving steadily:
         | https://progressreport.cancer.gov/after/survival , and with the
         | newer advances it's going to become even better.
         | 
         | Yes, it's not like an exponential Moore's law graph, but there
         | is a steady drumbeat of incremental steps. And they keep
         | reinforcing each other.
        
           | ekianjo wrote:
           | Only for specific sites of cancer. Many others are just as
           | deadly as they have ever been.
        
             | D-Coder wrote:
             | Well, yes, but that's typically how progress works in _any_
             | field.
        
         | narrator wrote:
         | Remember Calico and Altos Labs which were moonshot cure
         | longevity companies? After years they emerge out of stealth and
         | all they got is some cancer drugs. The gravitational pull of
         | the billions of dollars to treat cancer patients and extend
         | their lives a few more months eats up all the attention of the
         | biotech world because there is such an astronomical amount of
         | money in it and you'll just have to come up with a new way to
         | kill cells which is relatively easy.
         | 
         | So usually when people talk about new cancer drugs it meant
         | that great scientists will make billions wasting their lives
         | barely improving the quality of life for some terminally ill
         | cancer patients and it's just kind of sad, honestly.
        
           | Nevermark wrote:
           | Or maybe heroic efforts are being made to solve a very hard
           | but worthwhile problem?
           | 
           | You don't get to decide how long the road is to a complete
           | solution. Just whether it will be worth it incrementally and
           | in the end.
           | 
           | You don't propose any constructive alternative.
           | 
           | Life, even just extending life of millions of people a bit,
           | survival rates just a bit, is worth a lot.
        
             | narrator wrote:
             | Here's your alternative that precisely nobody is going to
             | make any money off of : https://isom.ca/article/targeting-
             | the-mitochondrial-stem-cel...
        
         | wbl wrote:
         | HIV has gone from death sentence to completely preventable with
         | a single daily pill or every 6 months injection, and readily
         | treatable to the point where we have geriatric HIV patients.
         | Obesity is now effectively treatable even taking into account
         | compliance. Hep C can be cured entirely with just six months of
         | oral medication rather than a barely tolerable intravenous
         | course that didn't work all that well. These are massive
         | improvements that have changed how hundreds of millions of
         | people are treated and their prognosis.
         | 
         | The road to the clinic is long, but there have been very big
         | improvements.
        
           | agumonkey wrote:
           | It seems like stock markets, a lot of bubbles pop, and it's
           | easy to miss the trend .. every 5 years some progress is
           | made.
        
           | DennisP wrote:
           | And stage 4 melanoma used to mean you'd be dead in a year. I
           | know someone who got diagnosed with it almost a decade ago,
           | got three doses of immunotherapy, and is now cancer-free.
           | Doesn't even have to get scans anymore.
        
             | adamredwoods wrote:
             | Melanoma is the main cancer that responds well to
             | immunotherapy, PD-1 inhibitors. Other solid cancers, not so
             | much, although in combination with other therapies, is
             | seeing some okay results.
             | 
             | They recently found some types of rectal cancer to be PD-1
             | sensitive.
             | 
             | https://www.nejm.org/doi/full/10.1056/NEJMoa2201445
        
         | ekianjo wrote:
         | > great advancements in many incurable and chronic diseases
         | (like Alzheimer'
         | 
         | There is virtually no new treatment for Alzheimer for 20 years
         | and no progress in understanding its mechanism either.
        
         | randcraw wrote:
         | Each medical innovation overcomes but one hurdle on a path to a
         | treatment/cure, often revealing new hurdles that weren't
         | visible (or important) until the first hurdle fell.
         | 
         | A good example is lipid nanoparticles, which for the first 15
         | years or more of their existence were horrifically lethal in
         | every hominid, making their potential for delivering
         | transformative genetic or immune cargo into cells impossible.
         | Finally, PEGylation was introduced into their formulation,
         | bypassing the toxic effect they had in precipitating out nearly
         | all of each animal's platelets upon treatment. Within just a
         | few years, LNPs became a very effective way to deliver MRNA
         | vaccines to BILLIONS of human patients, effectively ending the
         | worst of the Covid pandemic.
         | 
         | Medical revolutions are like evolutionary punctuated
         | equilibrium -- barriers to advancement are overcome
         | nonuniformly and often incompletely, requiring a lot of
         | continued effort even after a revolution begins. So it
         | shouldn't be surprising that more battles are won than wars. We
         | should celebrate whatever victories we can. Cancer promises to
         | be a war to end all wars.
        
         | drawfloat wrote:
         | 10ish years ago Myleoma was a semi death sentence, it's now
         | coming close to being treated like a chronic condition. There
         | are definitely improvements happening, but we'll often miss
         | them because it's incremental rather than "we developed this
         | cure for lung cancer and it's no longer a problem"
         | 
         | Edit: some of the replies below are pretty bleak "it's just a
         | few months that's nothing". The difference between a 5 year and
         | 15 year life expectancy for a parent being diagnosed with blood
         | cancer around 60 is huge.
        
           | master-lincoln wrote:
           | I am curious: why would it make a difference for a 60 year
           | old if they are a parent and have 5 or 15 years vs not? I
           | would have thought by that age children are long
           | independent...
        
             | popcorncowboy wrote:
             | The difference between your grandkids meeting you or not.
        
               | steveBK123 wrote:
               | Exactly - in my father's case would be difference between
               | dying before all your kids marry vs meeting all your
               | grandkids, helping to watch them.. and seeing them grow
               | up and start going to school.
        
             | eCa wrote:
             | Plenty of people have kids in their 40s and 50s.
        
             | steveBK123 wrote:
             | 60+15 => 75, a pretty normal "lived a full life" age.
             | 
             | 60+5 => 65, maybe dying before you even retire from your
             | job.
             | 
             | Seems significant.
        
         | verisimi wrote:
         | This all makes sense once you consider health as a business.
         | There is no great interest by business in a cure to this or
         | that. However, an expensive perpetual treatment (lifetime
         | service contract) is far more appealing - the revenue stream is
         | superior.
         | 
         | What we call a 'health' industry is a misnomer - it is a
         | sickness industry, like the ministry of defence is really the
         | ministry of attack.
         | 
         | If you want to really get cynical, you can consider the
         | possibility that a lot of treatments are not only unnecessary,
         | but actively detrimental to the person receiving the
         | "treatment". The person in future may develop diseases that
         | will then open further revenue streams from what would
         | otherwise be a healthy individual. This would assure a healthy
         | pipeline of future revenue for the pharmaceutical companies.
         | 
         | Luckily we have government agencies to manage the
         | pharmaceutical products we are given. Unfortunately, it is
         | something of an open door policy as senior government staff are
         | then given senior positions in pharmaceutical companies.
         | 
         | I'm sure it all works out in the end!
        
           | JumpCrisscross wrote:
           | > _There is no great interest by business in a cure to this
           | or that_
           | 
           | Of course there is. Cures make billions.
           | 
           | This might be a conspiracy theory stupider than flat
           | Eartherism. It requires not only every Western pharmaceutical
           | company's collaboration, but also every one in every _other_
           | country, and also all the public labs, and every world leader
           | and their families to suck it up for the conspiracy's sake.
        
             | verisimi wrote:
             | Goldman Sachs analysts agree with me!
             | 
             | https://m.youtube.com/watch?v=2m-u4cr3fJ0
             | 
             | Most people act against their conscience pretty much every
             | day for money, more so in senior positions. That money is a
             | great motivator is not really a conspiracy.
        
               | JumpCrisscross wrote:
               | Go beyond the YouTube video reporting on the report's
               | title and you'll find a thoughtful paper on drug pricing.
               | TL; DR Sick people and governments will pay a lot for
               | cures.
               | 
               | > _Most people act against their conscience pretty much
               | every day for money, more so in senior positions_
               | 
               | This isn't about conscience, it's about greed. Cures are
               | great business. Also, again, rich people get cancer. If
               | you want to come up with healthcare conspiracies, don't
               | pick a disease the rich and powerful get.
        
             | NemoNobody wrote:
             | Treating diseases makes billions forever curing those
             | disease makes billions once.
             | 
             | Which option is selected in a capitalist society?
        
         | rsynnott wrote:
         | > I really find strange how I've been reading news lines over
         | the past years about great advancements in many incurable and
         | chronic diseases (like Alzheimer's, diabetes, and cancers) yet
         | after all that time people's treatment is not going any better.
         | 
         | ... I mean I think you are possibly not just paying attention.
         | All sorts of things that were absolute death sentences within
         | recent memory are now very treatable. News articles tend to
         | overhype, of course, but cancer treatment now is a different
         | world to a few decades ago.
        
         | gus_massa wrote:
         | > _I 've been reading news lines over the past years about
         | great advancements in many incurable and chronic diseases_
         | 
         | There is a lot of overhype in the news. When they claim that a
         | new 80% improvement in batteries we all know it's a joke a
         | laugh. When there is a similar exaggeration in cancer cures we
         | get sad.
         | 
         | The saddest part is that the overhype shadows all the
         | small/local improvements. They are better explained in sibling
         | comments. Medicine is not my area so they give better examples
         | than what I can choose.
         | 
         | When I read a new about my area or something close enough, it's
         | fun to try to guess what was the original new before it was
         | badly rewrote by the press and how interesting it is. But when
         | there are lives related to the new, it's not fun to read post
         | with unrealistic promises.
        
           | DennisP wrote:
           | The thing about batteries is that those big discoveries in
           | the lab take a long time to reach the market. By the time
           | they do reach the market, they're just an incremental
           | improvement over all the other big discoveries that are
           | already in production.
           | 
           | So we never seem to get a dramatic breakthrough, but what we
           | do get is steady improvement over the course of decades. And
           | that's why we have electric cars now with ranges over 400
           | miles, while back in 1996 the EV1 had 70 to 100 miles.
           | 
           | I think cancer treatments are pretty much the same.
        
           | NemoNobody wrote:
           | Ok are you fr? The phone I'm typing this on is superior to
           | the computer in highschool to play video games on and it's my
           | old phone that can't hold a candle to my new phone. The
           | batteries in both devices are both MORE THAN 80% superior to
           | the battery in my first phone.
           | 
           | F*ck. Progress does exist - life has got enormously better
           | but people reuse to see it and focus their entire lives on
           | living the same day over and over and wonder why they are
           | unhappy.
        
             | gus_massa wrote:
             | Mmm... I think we?
             | 
             | The problem is that most of the 80% advance in your
             | batteries are small 2-3% advances that never got a huge
             | press cover. The 80% improvement press announcement are the
             | unrealistic ones.
             | 
             | PS: My favorite weird quantum anecdote that nobody know and
             | everyone uses was Giant Magnetoresistance. Have you ever
             | read about it? Do you have a device that uses it at your
             | home? Is it weird to have two currents instead of one?
             | https://en.wikipedia.org/wiki/Giant_magnetoresistance But
             | now the SSD ruined the anecdote :( .
        
         | jimbokun wrote:
         | > yet after all that time people's treatment is not going any
         | better.
         | 
         | What is your basis for this claim?
        
         | interludead wrote:
         | Yep, breakthroughs get announced, but the real-world impact can
         | feel slow
        
         | z3ncyberpunk wrote:
         | A lot of it is the case of bad science being popularized and
         | then blindly built upon. This is exampled by the recent
         | redaction of a huge amount of Alzheimer's papers which formed
         | the nucleus of Alzheimer's research. Academia and science are
         | often the largest purveyors of misinformation despite.
        
       | biotechbio wrote:
       | There's a decent amount of cynicism in the comments, which I
       | understand. I think this is a really cool and novel study,
       | though.
       | 
       | Historically, cancer was treated with therapies that are toxic to
       | all cells, relying on the fact that cancer cells divide quickly
       | and are unable to handle stress as well as normal cells
       | (chemotherapy, radiation).
       | 
       | The last couple of decades we've seen many targeted cancer
       | therapies. These drugs generally inhibit the activity of a
       | specific protein that lets the cancer cells grow (e.g. EGFR
       | inhibitors) or prevents the immune system from killing the cancer
       | cells (e.g. PDL1 inhibitors).
       | 
       | This mechanism is way more interesting. The gene BCL6 is usually
       | turned on in immune cells when they are mutating to recognize
       | foreign invaders. This process involves lots of DNA damage and
       | stress, but BCL6 stops the cells from dying and is therefore
       | important for normal immune function. Unfortunately, this makes
       | BCL6 a gene that is often co-opted in cancer cells to help them
       | survive.
       | 
       | The method cleverly exploits the oncogenic function of BCL6 not
       | by inhibiting it, but by turning it into a guide, enabling the
       | delivery of activating machinery to the targets of BCL6 and
       | reversing the inhibitory effects on cell death.
       | 
       | The whole field of targeted degraders, molecular glues, and
       | heterobifunctional molecules is a growing area of interest in
       | cancer research.
        
         | vlovich123 wrote:
         | What would be the kinds of expected side effects of such
         | approaches?
        
           | melagonster wrote:
           | oop talked about mechanism, so we can't know side effects
           | here. someone will publish a new drug that relies on this
           | mechanism, and then they will check the side effects of the
           | specific drug on cells, rats, or other experimental species.
        
           | joconne wrote:
           | My understanding is that even though immunotherapy's
           | mechanism may seem more natural than chemotherapy and
           | radiation, and in some instances may be a magic bullet, up-
           | regulating the immune system can have serious consequences. I
           | remember reading about a clinical trial showing similar
           | progression free survival but increased grade 4-5 toxicities
           | (requiring hospitalization or being fatal). My assumption was
           | that these are autoimmune conditions that are aggravated in
           | some of the patient population.
        
         | celltalk wrote:
         | I haven't read the paper yet but the news article seemed a bit,
         | meeh.
         | 
         | BCL-2 inhibitors, mainly Venetoclax, is used in cancer
         | therapies quite often which also triggers cell apoptosis and
         | it's very effective. It was also designed to target B-cell
         | related cancers, but it found to be so effective that FDA
         | approved it to be used in primary cases of Acute Myeloid
         | Leukemia. So, killing cancer with triggerring apoptosis is very
         | well known. I think the novel part might be the two protein, so
         | it is probably more targeted for metabolic activities... but
         | yeah didn't read the paper yet.
         | 
         | Anyways, for the side effects a major one could be Tumor Lysis
         | Syndrome (TLS). Basically, if you apoptose the cancer cells
         | super fast, the molecules from those cells spread everywhere
         | and it becomes toxic for the patient. This is at least the case
         | for Venetoclax.
        
           | sylware wrote:
           | How much cancerous cells are similar to let us know how to
           | target them and deliver a payload?
           | 
           | I guess some payload delivering mechanisms expect very
           | 'standard' features from cancer cells?
        
             | inglor_cz wrote:
             | Cancerous cells are fairly diverse across individuals, or
             | even within a single individual, and many biological
             | treatments require precise sequencing of the tumor DNA of
             | that individual patient to adjust and work. In some
             | cancers, there is a nasty "Russian roulette" effect in
             | play, where a certain treatment may be extremely efficient
             | (in practice a cure, even though oncologists avoid that
             | word) in people with a certain mutation and totally useless
             | in others, even though from the macroscopic point of view,
             | their tumors look the same.
        
               | sylware wrote:
               | Then, basically, each cancer, cancer cells should be
               | sequenced, then based on the type of cell and DNA
               | sequencing, we have a list of "tools" to deliver payload
               | to those very cells (without delivering such payload to
               | sane cells, ofc)?
        
               | inglor_cz wrote:
               | That would be the ideal scenario, yes.
               | 
               | In practice, we can only make use of some known
               | mutations. Not just for delivering chemicals, but also
               | for "teaching" the immune system to attack such cells,
               | which, once it is able to recognize them, it will do
               | vigorously.
               | 
               | Let's hope that this catalogue will grow until it covers
               | at least all the typical cases.
        
         | ray__ wrote:
         | This comment hits the nail on the head. Another big
         | consideration with the technology in this paper that hasn't
         | been mentioned in this thread is that it opens up a huge range
         | of possibilities for targeting "undruggable" protein targets.
         | Most drugs are small molecules that bind to sites an
         | (relatively much larger) proteins, thereby getting in the way
         | of their function. Unfortunately the vast majority of proteins
         | do not have a site that can be bound by a molecule in a way
         | that 1) has high affinity, 2) has high specificity (doesn't
         | bind to other proteins) and 3) actually abolishes the protein's
         | activity.
         | 
         | With "induced proximity" approaches like the one in this study,
         | all you need is a molecule that binds the target protein
         | somewhere. This idea has been validated extensively in the
         | field of "targeted protein degradation", where a target protein
         | and an E3 ubiquitin ligase, a protein that recruits the cell's
         | native proteolysis machinery, are recruited to each other. The
         | target protein doesn't have to be inactivated by the
         | therapeutic molecule because the proteolysis machinery destroys
         | it, so requirement #3 from above is effectively removed.
         | 
         | The molecule in this study does something similar to targeted
         | protein degradation, but this time using a protein that effects
         | gene expression instead of one that recruits proteolysis
         | machinery. The article focuses on the fact that cancers are
         | addicted to BCL6. This is an important innovation in the study
         | and an active area of research (another example at [1]), but
         | leaves out the fact that these induced proximity platforms are
         | much more generalizable than traditional small molecules
         | because it's the proteins that they recruit that do all the
         | work rather than the molecules themselves. This study goes a
         | long way to validate this principle, pioneered by targeted
         | protein degradation and PROTACs, and shows that it can be
         | applied broadly.
         | 
         | [1] https://www.biorxiv.org/content/10.1101/2024.07.27.605429v1
        
       | midtake wrote:
       | I am tired of news like this that never gets anywhere. We have a
       | billion way to destroy cells, great. Let's get a reliable
       | delivery system working now. While that is in the works, I will
       | stick to fasting and other simple methods of decreasing oxidative
       | load.
        
         | v3ss0n wrote:
         | Bought out and shutdown by profiting businesses as usual.
        
           | purplethinking wrote:
           | No, this whole spiel of big pharma wanting to keep people
           | sick is insane. That could work if there was a single pharma
           | company in the world, but all it takes is one company making
           | an effective cure for a disease and they will make big bucks.
           | Even if you think the people in charge are evil profiteers,
           | we all win in the end
        
         | adamredwoods wrote:
         | As someone who tried to keep a cancer patient alive for as long
         | as possible, this type of news offers hope, and encourages
         | young people to become oncologists and researchers, which we so
         | desperately need.
        
         | elcritch wrote:
         | The entire point of this research is to develop a targeted
         | delivery mechanism based on malfunctioning gene activations.
         | It's a simple but clever approach IMHO.
        
       | aetherspawn wrote:
       | This seems too straightforward to be credible? If I was
       | researching in this field surely this is the first thing I'd try?
       | 
       | If it is indeed credible ... this sounds like the "CRISPR moment"
       | of cancer treatment, sure. And I'm really happy for that.
       | 
       | But I will be honest and write what I'm thinking: if this is real
       | then frankly I'm disappointed it took this long. Do we really
       | have our best people working on cancer? I have known so many who
       | died waiting.
       | 
       | It seems like there has been roughly the same investment this
       | decade (around $200B) in climate tech compared with cancer
       | research, and yet electric cars and batteries are now a "solved
       | problem" that's just waiting to scale. The progress with Cancer
       | is noticeably less. Is the money being well spent? Or are we
       | donating $100B-s for researchers and labs to sit on a gravy train
       | making sub tier progress.
       | 
       | Here's a wild theory. Perhaps as a society we built the wrong
       | prerequisites to get into cancer research and we filtered out all
       | the Mozart's and Leonardo's...
        
         | pama wrote:
         | I work in this area.
         | 
         | It took time to know what each protein does in a cell (we still
         | dont really understand most of them), it took time to find all
         | the ways that various cancers use the protein machinery in the
         | cell to their benefit (new ways are still being discovered
         | these days), it took time to think about molecular glues and
         | turn them practical, and it took time to build the right
         | chemistry and then test it (it takes time even after you know
         | all of the previous steps.) It will still take years, possibly
         | over a decade before this particular development can lead to a
         | drug that passes human clinical trials and is eventually
         | approved. It is not the lack of geniuses that slows things
         | down, rather it is the very careful consideration of risks to
         | minimize the loss of human life during experimentation, and the
         | attempt to optimally allocate the resources across too many
         | different challenging problems in order to maximize the long
         | term benefit to society. The true amount of money spent in
         | cancer research is much higher than the $200B over a decade
         | that you mentioned, however the vast majority of it is just
         | capital losses of various companies spent on the tools and
         | research in early stage discovery across tens of thousands of
         | projects, and a separate huge and more obvious chunk goes to
         | attempts and failures at human clinical trials. The cost of
         | drug discovery has stopped increasing exponentially during the
         | last decade but is still pegged at several billion dollars per
         | approved drug without counting costs from competitors who never
         | get anything approved.
        
         | krisoft wrote:
         | > If I was researching in this field surely this is the first
         | thing I'd try?
         | 
         | Let me ask a clarifying question: Are you saying that the first
         | thing you would have tried is to synthesize bivalent molecules
         | that link ligands of the transcription factor B cell lymphoma 6
         | (BCL6) to inhibitors of cyclin-dependent kinases (CDKs)?
         | 
         | Or are you just saying that you would have tried to drive
         | cancer cells to self-destruct (but have no clue how)?
        
           | aetherspawn wrote:
           | With a little domain knowledge and research you find out
           | pretty quickly that:
           | 
           | BCL6 is lymphoma.
           | 
           | CDK regulate cell death, amongst other things.
           | 
           | So yes, I am saying that it seems very straightforward as an
           | approach to attempt to trigger a CDK cell death when BCL6 is
           | present.
           | 
           | It seems hard to believe that it is presented as novel with
           | the amount of funding that has been spent on cancer.
        
             | krisoft wrote:
             | > With a little domain knowledge and research you find out
             | pretty quickly
             | 
             | That's cool. Where do you think that domain knowledge comes
             | from? Did we just found it in a fortune cookie? Or does the
             | cancer research conducted has something to do with that we
             | have this knowledge?
             | 
             | > BCL6 is lymphoma.
             | 
             | That's not correct. BCL6 is a protein, or a gene which
             | codes that protein. Mutations in BCL6 can lead to B cell
             | lymphomas. BCL6 is not lymphoma.
             | 
             | > I am saying that it seems very straightforward as an
             | approach to attempt to trigger a CDK cell death when BCL6
             | is present.
             | 
             | Excellent. Sounds like you are an oracle of oncological
             | research roadmap. What should be the next target to develop
             | drugs for?
        
               | aetherspawn wrote:
               | I am glad that you know these things, but cancer research
               | has still failed society as a whole.
               | 
               | 3 of my immediate family have had cancer, 2 took chemo
               | and it ruined their lives (it caused weak bones, their
               | spines to virtually dissolve, which led to surgeries to
               | insert plates and things, which have failed multiple
               | times, it has been a mess).
               | 
               | The third was not eligible for chemo because they were
               | too sick and they had an existing case of lupus. So we
               | started trying things -- probably 100 different things at
               | first. What worked for them is taking Sanguinaria
               | canadensis daily orally. It is now 15 years later and
               | they still have cancer but are living a normal and
               | healthy life.
               | 
               | You know, despite being the most effective treatment you
               | could possibly hope for in this situation (besides an
               | actual cure), there are only a few papers on Sanguinaria
               | canadensis, and most research discredits it. Other
               | friends of mine have tried chemo and died in a horrible
               | way. Now you understand my criticism of cancer research.
               | For all the money that has been spent, the most viable
               | treatment available through a hospital is still a living
               | nightmare.
        
       | equasar wrote:
       | Wonder if the study is freely available without paywall.
        
         | Faaak wrote:
         | Sci-hub.pub
        
           | jobigoud wrote:
           | Is this still working? Am I being blocked at the ISP level?
           | 
           | For me sci-hub.pub opens a simple page listing other sci-hub
           | URLs, but each and every one of them fails, ending in "Unable
           | to connect" as if the server did not exist. (Tested: sci-
           | hub.ee, sci-hub.ren, sci-hub.ru, sci-hub.se, sci-hub.st, sci-
           | hub.wf).
           | 
           | Is sci-hub still working for people, I haven't been able to
           | use it for a while.
           | 
           | edit: Wow, it works if I go there via VPN... incredible. So
           | sci-hub is illegal in France?
        
             | Retr0id wrote:
             | https://en.wikipedia.org/wiki/Internet_censorship_in_France
             | #...
        
       | skibidisigma wrote:
       | We got a cure for cancer before gta 6
        
       | szundi wrote:
       | I love these headlines
        
         | moffkalast wrote:
         | Using prions to destroy cancer, pitting one cosmic horror
         | against the other. Nice.
        
       | dottjt wrote:
       | Hopefully it can help people with Sarcomas.
       | 
       | My partner was diagnosed with stage 4 sarcoma about a month ago
       | and life as I know it has been flipped upside down.
        
         | adamredwoods wrote:
         | I'm so sorry. We all hope for a magic formula, but even with
         | clinical trials, bench-to-bedside takes years.
         | 
         | >> the chimeric compound killed only diffuse large cell B-cell
         | lymphoma cells
        
           | dottjt wrote:
           | It's been a very weird 6 weeks. It's like, everything was
           | fine. We had our normal suburban life. Things were going
           | great. We had just celebrated our daughter's first birthday.
           | 
           | Then it's like, you realise that everything you had imagined
           | over the next 40 - 50 years is suddenly not going to happen
           | anymore, and it just feels so surreal.
           | 
           | Thankfully, a lot of the initial hysteria is gone. But
           | there's definitely a sense of "why me?"
        
             | elcritch wrote:
             | Sorry about your partners disease. Learning such news about
             | loved ones is difficult.
             | 
             | I have a chronic condition and spent years wondering "why
             | me?". Now my thoughts are more like "why not me?" and to
             | try and embrace what life we're lucky to get and live day
             | by day. Godspeed
        
               | dottjt wrote:
               | Thank you. Did any readings or practices help you?
        
             | mattigames wrote:
             | The "why me" for others is the first time they realize they
             | have a chronic illness, that sudden realization that the
             | universe is an uncaring dance of atoms, the realization
             | that every attempt at ordering it's just a house of cards,
             | including our DNA and everything else we rely on. I was
             | expecting myself to land that line of reasoning into some
             | comforting words but I have failed miserably ha, hold on
             | tight.
        
               | rkuzsma wrote:
               | "There is no justice in the laws of nature, no term for
               | fairness in the equations of motion. The Universe is
               | neither evil, nor good, it simply does not care. The
               | stars don't care, or the Sun, or the sky.
               | 
               | But they don't have to! WE care! There IS light in the
               | world, and it is US!"
               | 
               | -- Eliezer Yudkowsky, Harry Potter and the Methods of
               | Rationality
        
               | kibwen wrote:
               | I don't like this quote because it suggests a sort of
               | separation between ourselves and the universe, or it
               | suggests that the universe is some all-powerful
               | omnipotence that might deign to heal us if only we could
               | supplicate ourselves to it, but that's mistaken.
               | 
               | We're made of all the same stuff as those stars. We _are_
               | the universe, and if we care, that means the universe
               | cares as well. When we have the power to do something,
               | that means the universe has the power to do something.
        
               | TylerLives wrote:
               | Mattigames, there is a logic flaw in your little aphorism
               | that seems quite telling. Since you and I are part of the
               | Universe, then we would also be indifferent and uncaring.
               | Perhaps you forgot, mattigames, that we are not superior
               | to the Universe but merely a fraction of it.
        
             | adamredwoods wrote:
             | Time slows down. We spent our lives week by week. I was her
             | care taker and hope-keeper, and I would share oncology news
             | like this with her to help keep our family sane. I think it
             | helped.
        
         | danieldbird wrote:
         | Firstly im so sorry to hear this. I can completely empathise as
         | i lost my father who was my best friend to Pancreatic Cancer.
         | Like you, one day we were fine and joking, the next day my
         | world collapsed with the news. Uncontrollable sadness, then
         | anger, then desperation and the why me / why my dad. I just
         | wanted to write to you to say that you are not alone. You dont
         | know me, i dont know you, but i wish you and your partner well
         | and send thoughts and love. It is a surreal thing to happen. I
         | remember looking at other people living their regular lives
         | smiling and laughing and thinking, how can they be happy. An
         | unbelievable amount of varied emotions. Seeing really unhealthy
         | people, or bad people on the news, and i know this sounds bad,
         | but wondering, why us, why not them. Just mind spinning type
         | stuff, a plethora of every conceivable emotion. I hope you have
         | loved ones you can vent and talk to. Again, you're not alone.
        
           | dottjt wrote:
           | Thank you. I can relate to everything you're saying.
           | 
           | I think what's been helping has been reading about death and
           | what that means and potentially feels like. I think part of
           | the issue is that the topic of death is so misunderstood and
           | feared, that it creates no reasonable way forward mentally.
           | So hopefully I can learn more about that over the coming
           | weeks.
        
       | unit149 wrote:
       | Inducing ketogenesis whose byproduct is the retention of water
       | and generation of ATP has historically acted as an epiphenomenal
       | method of apoptosis. Survival rates vary but fasting has proven
       | to be an effective method.
        
         | Funes- wrote:
         | A ketogenic diet or a strict fasting regimen are two health
         | strategies that are too frowned upon, still, and unfortunately
         | so. Food (or whatever passes for "food" in modern times) has
         | become such a crutch, and people have such potent emotional
         | ties to it, that the sole idea of restricting one's diet will
         | come across as negative from the get go. Nonetheless, there
         | have been advancements in that regard, culturally, I believe.
        
           | NemoNobody wrote:
           | Apparently I'm an incredibly healthy individual - just had a
           | physical that stated that. I do have a good genetic base but
           | in general I don't live a particularly healthy lifestyle, my
           | activity is pretty much the same as everyone else - except my
           | diet.
           | 
           | I'm a vegetarian and a celiac (no gluten) so I don't eat a
           | lot of processed food. Rice, oatmeal, corn tortillas, black
           | beans, cheese, hemp hearts, flax seeds, chia seeds, Sriracha,
           | coffee w/honey and hazelnut creamer - all that is easily 90%+
           | of my diet. I also drink a protein drink called OWYN daily.
           | 
           | About once a week I'll have a little to eat in the morning
           | and then I just won't really get hungry again til really late
           | and I'll often just not eat then and go to bed. Intermittent
           | fasting is great. A few times a year I'll go a few days
           | without really eating - there are so many benefits to the
           | process. The primary being autophagy - that I sus is the
           | reason I look so much younger than people my age.
           | 
           | The science of sleep radically disagrees with the next thing
           | I'm about to say.
           | 
           | The process with food and the body is very similar to the
           | process of sleep and the brain.
           | 
           | Occasionally pulling an all nighter playing video games
           | (can't be a stressful all nighter) is actually good for you -
           | it resets some stuff in your head. This can be particularly
           | effective for dealing with certain states of depression or
           | melancholia.
        
       | bulbosaur123 wrote:
       | When can this be used to cure prostate cancer?
        
       | steveBK123 wrote:
       | All of this stuff is promising, and I hope the diagnostic side
       | catches up as well.
       | 
       | Just went to a funeral this weekend for a 40 year old who died of
       | breast cancer 4 weeks after diagnosis at her first annual
       | mammogram.
       | 
       | A lot of skeptical people under 30 here haven't lived through
       | regularly various cancer diagnoses in their friends & family
       | group that your late 30s/early 40s starts to bring.
       | 
       | I don't have the data on it, but anecdotally I notice that
       | women's cancers seem to strike 5-10 years earlier than mens even
       | if they can be caught early & treated well.. Though apparently
       | men have overall worse cancer survival rates.
        
         | fwip wrote:
         | I believe I read, but can't find the source now, that the sex-
         | specific survival rate is mostly explained by men not catching
         | it and starting treatment as early as women.
         | 
         | Even for cancers that shouldn't be sex-specific, like lung
         | cancer, men are less likely to survive it.
        
           | steveBK123 wrote:
           | This is very believable given gender differences in being on
           | top of healthcare..
        
         | frowin wrote:
         | I'm finishing my PhD in hyperpolarization (hopefully) soon. In
         | my opinion, hyperpolarization will significantly contribute to
         | early-stage diagnosis. We're designing machines, processes, and
         | chemicals that create novel contrast agents for MRI, enabling
         | the localization of cancer cells and even tracking their
         | metabolism. For example, it's possible to inject hyperpolarized
         | pyruvate and track its conversion to lactate. Essentially, this
         | technique boosts the MRI/NMR signal of the contrast agent by up
         | to 100,000-fold. When the contrast agent undergoes metabolism,
         | it creates a unique signal footprint through chemical shift
         | changes, which can aid in characterizing cancer.
        
           | steveBK123 wrote:
           | Sounds exciting. Routine periodic medical imaging seems like
           | one of those Star Trek technologies thats in reach but not
           | quite been implemented outside of rich countries in Asia.
        
           | whatshisface wrote:
           | I have a question, if you don't mind. What are the nuclei
           | polarized relative to? The molecules in a liquite rotate a
           | lot and I am curious whether the nuclear spins stay aligned
           | with the electron systems or if they remain fixed in an
           | inertial frame.
        
             | ray__ wrote:
             | There are two semi-connected concepts at play here.
             | Polarization in this context refers to the ratio of
             | neutralizing (i.e. "up" vs "down") spins in a given system.
             | For most nuclei in organic systems like protons, carbons,
             | and nitrogens, this ratio is naturally very small, which is
             | the reason that magnetic resonance approaches like MRI
             | usually have poor signal-to-noise. Hyperpolarization
             | techniques usually involve the transfer of polarization
             | from a source of high ratio, like a free electron, to a
             | relevant target (in the original poster's example, 13C in
             | pyruvate). The polarization in this case is hyperpolarized
             | 13C, which has an "up"-to-"down" spin ratio that is much
             | higher than regular 13C, which makes the signal-to-noise
             | that you get from the pyruvate much higher than it would be
             | otherwise. Tumors love pyruvate so this approach means that
             | tumors will light up like a beacon in your MRI.
             | 
             | The physical rotation/tumbling of molecules in an MRI is
             | also very important, because the strong magnetic field is
             | the thing inducing the "up"-vs-"down" split in the first
             | place, and if the molecular motion is happening at a
             | certain frequency with respect to the external magnetic
             | field there are other interactions that can come into play
             | which can affect the coherence of the nuclear spins (i.e.
             | they can fall out of sync). Thankfully, the rotation of a
             | small molecule like pyruvate is very fast (might higher
             | then the "spin" frequency-a.k.a the Larmor frequenct of 13C
             | at the magnetic field strengths involved in MRI) so the
             | physical tumbling of pyruvate doesn't really come into play
             | when trying to measure its signal. It can be another story
             | for molecules that don't tumble quickly, like the ones that
             | make up tissues, fat, etc.
        
         | interludead wrote:
         | The urgent need for advancements not only in treatment but also
         | in diagnostics
        
         | shaky-carrousel wrote:
         | Four weeks... I didn't know that it could be so fast. That's
         | awful.
        
           | steveBK123 wrote:
           | We were surprised, but it happens. Breast cancer can be very
           | fast moving. Unless they have family history, women aren't
           | told to do annual exams until you hit 40. The symptoms may
           | not be too specific or startling even when it is into stages
           | 3 & 4.
           | 
           | Worth reminding the women in your lives to check their family
           | history and consider getting early exams either way. A lot of
           | times it turns out women do have family history that went
           | undiscussed until they ask mom, aunts, grandmothers, etc.
           | 
           | The other cancers that worry me are the slow moving
           | imperceptible symptomless ones like pancreatic, liver,
           | kidney, etc. Know a few people who around 50 discovered they
           | had stage 2-3 cases due to unrelated scans they got from an
           | accident injury. Some of these you have 5-10+ years window to
           | treat it and live without impact to lifespan.. but most
           | people don't catch it until stage 4 when they actually feel
           | sick and it is too late.
        
           | soperj wrote:
           | Pancreatic cancer is the worst. Many people don't get a
           | month.
        
           | pvaldes wrote:
           | Some people die by cancer, other overcome the cancer, and a
           | small amount don't stand the treatment and die by the
           | chemotherapy. Sometimes by genetics, and can't always be
           | known before. It also depends on how much advanced and
           | aggressive is the tumor.
        
       | zackkatz wrote:
       | Strange: the New York Times wrote about this on July 26, 2023.
       | 
       | https://www.nytimes.com/2023/07/26/health/cancer-self-destru...
        
         | Duller-Finite wrote:
         | That describes a related but previous Nature paper from the
         | same group, whereas this is referring to a more recent Science
         | paper.
        
       | mannyv wrote:
       | The next challenge is getting the protein in there.
        
       | lawrenceyan wrote:
       | Current SOTA (state of the art) treatment for cancer is:
       | 
       | Sequence patient's tumor mutanome distribution, create
       | personalized therapy encoding the top N neoantigens
       | 
       | +
       | 
       | Anti-PDL1 checkpoint inhibitor
       | 
       | +
       | 
       | mRNA encoded albumin-IL2
        
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