"Cancer cells are not simply a disorder or breakdown in a mechanism, but an organism going on a full-tilt offensive, using multiple, often shifting strategies to produce and use molecular fuel, win resources, and evade the immune system. If so, then the rules of the game may change—these insights suggest that the war on cancer may be endless."
I don't have any expertise here, so I'm not saying he's right or wrong. But it doesn't seem to be a lack of imagination.
E.g. we think of stars as big balls of fusing matter. But that's an idealisation. Is a star really less complex than a human body? It all depends on which questions we want to answer. So there's an asymmetry in this argument.
Take a thing that we're trying to understand down to the finest detail, and compare it to a caricature of some other thing that we're not trying to understand at such a fine resolution.
If you simply gather a very large number of hydrogen atoms into a region of space at a certain density, you will create star. From this angle, it isn't terribly complex.
The instructions for creating a cell from scratch are... immensely more complicated.
The star's behavior, .e.g. the movement and changes of the convection zones, fusion dynamics, how the magnetic fields change over time, coronal mass ejections, sunspots, etc. may be extremely complex. I think few people who know much about stars would disagree on that.
But I would wager there are many more orders of magnitude of complexity going on in a human cell, from an information theory perspective. Even just describing individual proteins themselves and how they fold is phenomenally difficult.
Of course, I may be wrong about the cell's behavior having higher complexity. The important take away is that it is possible to make such comparisons in a meaningful way.
So, we're back to comparing thing A that we need to understand at the finest scale, to thing B where we ignore its individual complexity in favour of the stereotypical version. It's easy to estimate the gravitational attraction or mass of a cell. It's this fine-scale manipulation that causes these severe requirements for deep understanding.
EDIT> :) The instructions for creating life are even simpler. 1) Have a Big Bang. 2) Wait.
Even if the information theory metric of complexity is somewhat flawed, given our limitations, I think it is a useful tool. I'm not sure what would be a better way of comparing complexity.
At the very least, I think I can make statements such as: "a closed container of hydrogen gas at room temperature and pressure is a much simpler system than a Swiss watch", which we could roughly quantify in a somewhat robust way. The hydrogen part is easy, as the atoms are indistinguishable, and their movements can be closely approximated with simple formulas.
P.S. I just remembered a good (and short) minutephysics video on entropy & complexity, perhaps it is worth linking: https://youtu.be/MTFY0H4EZx4
Also: this is a really great, really stellar thread.
any person's cancer is millions/billions of semi-independent, extremely complicated, poorly understood state machines, with a variety of mutations, constantly interacting and evolving against any treatments applied and immune reactions.
imho, cancer is a fundamental disease/property of multicellular life, and trivial reductionist perspectives completely out of touch.
I like analogizing between multicellular organisms and nation-states, in that both are complex systems built upon the coordination of many individual systems (cells/people). In the case of cancer, what we have is essentially rebellion, a failure of control: individual cells decide to stop cooperating and instead begin competing with the body that houses them. So I agree with you... rebellion is always a threat to any system of control.
Unlike actual rebellion, though, there's no way the cancer can "win" in the sense of taking over control of the body. If only cancer could realize the futility of its crusade...
This is of course ridiculously ambitious compared to the current state of the art, but I think it's a reasonable start to countering the claim that a general cure for cancer is impossible in principle.
That said, I don't want to say that cancer is fundamentally beyond us. I think cheap sequencing and emerging highly targeted DNA editing systems, along with better understanding of the immune response to cancer, will get us most of the way there in a practical sense.
What you suggest is more or less what I mention; you could, say, try to add back some genetic machinery for the cancer cells to recognize that they're defective, and then they kill themselves. Or help the higher level repair mechanism (the immune system) target cancer cells.
To my understanding, trying to fix anything at the level between whole cell and DNA mutation is much harder.
It's like arguing that entropy always increases and therefore fighting disease is fundamentally hopeless, or requires non-logical approaches. Yes, of course "ill health" can't be cured in general, but we can drive disease rates ever lower.
Sure, but no one disputes this. Silicon valley investing in cancer research does not imply anyone takes such a silly position.
Agreed that we don't yet know how to regulate the apoptosis, or understand how metastasis works. DNA Methylation, small RNA regulation, and purpose of non-coding RNA isn't very well understood yet, too.
> I believe it's much easier to simply figure out the right cocktail that would change cancerous cells into normal cells again, and then find the delivery mechanism for that.
I reckon much of this has to do with small RNA and miRNA based regulation of transcription. Essentially the specific portions of the RNA/DNA are "silenced" by several regulatory factors. If a growth regulator gene, say CDKNA is accidentally silenced then the cell would undergo an uncontrolled growth, _with_ mutations. This in turn will grow "diseased" cells, eventually causing cancer. Trouble is, we just do not understand this properly, yet.
I have little doubt cancer will be someday as well. It might not -- probably won't -- happen in my lifetime. But if humanity hasn't collapsed, I find it very unlikely that we're still dealing with cancer in a thousand years.
I think for people with cancer right now, waiting for magic would be a lot more misguided than chemotherapy.
Even if determinism holds (and, spoiler alert from about 1927, it doesn't), you can't avoid chaos. Lorenz found that out and defined Chaos: where the present determines the future, but the approximate present does not approximately determine the future.
I assure you, biological systems exhibit all the hallmarks of (possibly) deterministic mathematical chaos.
More concretely, the combinatorial complexity of the state-machine approach makes it infeasible.
So the universe is just math, basically? Or maybe a computer program?
The universe is logical. Each cell in the human body is at its core just a very complex state machine.
What we call cancer is just a particular state for a cell, and its descendents.
Find a way to change the cell state, we end cancer. And we know we can change a cell state-we can transform skin cells into stem cells, so what would make it impossible to turn cancerous cells into non-cancerous cells?
We just haven't found out the proper way to do so. It takes data, and simulation, and lots of time. At some point we'll figure it out.
I think the only misguided attempts are chemotherapy-based - damaging cells indiscriminately, just because cancer cells multiply faster and thus accumulate dna damage faster and thus die faster than normal cells. This means that unless you kill all the cancerous cells your cancer will come back. The problem is chemotherapy drugs will also be damaging your body in other ways, depressing your immune system, and thus making it easier for any remaining cancerous cell to start it all over again.
I believe it's much easier to simply figure out the right cocktail that would change cancerous cells into normal cells again, and then find the delivery mechanism for that.
I can see a future where we can transform cancerous cells into cancer-killing cells (let's say T/B Cells) that would just cascade into the complete eradication of cancerous cells within an organism.
This guy's argument boils down to lack of imagination.