You certainly can take pictures. And not to be too reductive: cells are visible in a light microscope. The point is that the scale that cells are at is not really at the quantum level. People have been interacting with individual cells for decades: https://www.youtube.com/watch?v=GTiKFCkPaUE
I also have a degree in physics but in addition I have a degree in computer science. 36 Trillion is not a very large number for modern computers anymore. I am sure even today we could build machines that would filter the cells in your blood by images and do it at 10s of millions per second.
On the other hand, maybe it would be enough to filter out every cell that is not identified as a blood cell. This should be an easier task.
Probably we could direct only a small part of blood into this filtering machine at a time. Sounds like it would be still more like a machine detecting if there are cancer cells present in the bloodsteam rather than a machine eliminating metastasization.
I think the "cure cancer without biology" approach makes somewhat sense (I assume you would still need some biology :) ). Don't many surgeries already fall into this category? Let's say we made an automated colonoscopic machine that scanned the whole intestine and destroyed all abnormal colonic crypts. Now if this machine worked well, you would essentially cure at least those colon cancers that go through some aberrant crypt stage.
Appealing to the authority of a pathologist is safe in my book given the subject matter and the education of the counterparty. There is a lower bound of requisite knowledge beneath which it's not worth even trying to entertain your claims about just "find and destroy rogue cells". You can't even begin to respond with logic and refutation if you haven't achieved anything close to the level of expertise required to be certified as a pathologist. Coming in here trying to play the angle of "well just model with supercomputers" isn't the winning ticket. Contrary to stereotypes of computer-illiterate doctors, there are some wicked smart people working in medicine (I've met and befriended many) and I guarantee your genius approach was considered and abandoned decades ago.
I am literally saying that avoiding the hard problem is going to work in the general case. I would argue that radiation therapy is in this vein.
Why?
Which feels like it should be true for a sufficiently targetable "laser" right?
Metastatic cancer is defined by essentially there being too many things to hit though, but therein lies the entire detail: you can't treat someone faster than they die of either the cancer or the treatment.
*Laser is being used metaphorically
Google paraneoplastic syndromes. Cancer is rarely a problem of just tumors.
> just "laser" all the tumours out and problem solved right?
No. The tumors don't just evaporate. The treatment causes tissue necrosis. Your laser causes inflammation. Even the high tech IMRT you're picturing has those problems.
>Metastatic cancer is defined by essentially there being too many things to hit though,
Metastasis as a concept is fairly meaningless in how you're using it. There are so many more factors in treatment of various cancers that have nothing to do with the distribution. There's a lot that clinpath looks at and frankly I care much more about what's on those reports than playing where's Waldo with nodules. Frequently we assume micrometastasis just based on the cell line or other characteristics.
> therein lies the entire detail
So no.
> you can't treat someone faster than they die of either the cancer or the treatment.
Again far more consideration goes into it but I'm losing my desire to debate these contrived simplistic takes.
I am aware of necrosis. You need to either completely break down the cell or remove the material. Radiation of course does not do this but surgery of course does.
My appeal to you would be to allow more disruption in this space. Software and Hardware are (mostly) unregulated which allowed for the explosion of progress.
> My appeal to you would be to allow more disruption in this space
No. There is far too much disruption that we don't want/need. If you want to help, go put yourself through medical school first, and then bring your CS knowledge to supplement it.
Jumping in when you haven't learned the basics wastes everyone's time like you have here.
The fact of the matter is that I think any kind of refutation is actually pretty difficult for you (perhaps due to the medical training). It likely would have been easier had you just agreed and said "Yes if you can destroy the cancer cells you can treat >90% of all cancer."
My ignorance has a model like: If you keep putting sugar in the gas tank, how do you fix the car? How do I stay healthy if I eat only crap? How do I stay fit if I never get out of my chair?
Shit, would it be one of those cause and effect things?
Today I learned cancer is basically Cotton Eyed Joe.
Seriously, though, excellent write up!
Cancer is not a simple anomaly detection problem. I mean, there's that, but so much more. These cells, each one of them, by their very nature, looks exactly like your normal healthy cells, on the outside. It's what inside the cell that's going to kill you. The uncontrolled replication. There are 36 trillion cells in the human body. How are you going to monitor them all? Well, turns out we have several methods built in, collectively called the immune system. But again, they're mainly looking for "not self". Because if they were looking for "self" you'd have another problem, called auto-immunity.
The uncertainty is real. It's not a hypothetical uncertainty. Combinatorics is a bitch.
There are 3 billion base pairs per normal human cell. The difference between a normal cell and a cancer cell can be on a similar order (a cancer cell may have many billions or less than a billion base pairs). There are similar problems for the number of proteins, lipids, polysaccharides, metal ions etc, per cell.
Three billion times 36 trillion, oh, and many generations of many of those 36 trillion over time. So, let's casually say a billion billion cells in a human life time. Times 3 billion base pairs. If one of those cells gets out of control, you've got a problem. Shockingly, only one in six people die of cancer.
Only under the most austere circumstances can we partially characterize a single cancer cell, and even then we waste many, many other cancer cells to surface that one cell (e.g. single cell transcriptomics).
Other methods allow us to examine many cells, but we can't examine them as closely (histology, histochemistry, immunochemistry, targeted genomics, shotgun sequencing, karyotyping, etc), and we still never see most of the cells.
To get a basic understanding, it's advisable to take the ground up approach used in statistical mechanics: in cancer, from the ground up, a single cell is the source of the initial problem. That cell and its progeny divide many times, let's say 30-40 times. Now you have a billion cells, maybe 10-100 billion cells. Every one of which is starting from an unmanaged state, highly vulnerable to additional mutations. And probably the cell of origin died 20 generations before you find the tumor. Even in a basic science research setting, it would be exceedingly challenging to demonstrate you had found "the cell of origin".
This is very similar to physics: there are things we can know at one energy level that we can't know at another energy level. You can't explore Bose-Einstein condensates with the LHC. You're off by 20 orders of magnitude. You can't do single cell transcriptomics on a 1 kg en bloc cancer resection specimen, you're off by 20 orders of magnitude.
Complicating matters, fission is actually pretty straight forward compared to biology. In fission, you've got a very small number elements involved, at very high, specified purity. In biology, you can barely guess most of what the organism consumed in the last 24 hours, let alone what they've been exposed to over a lifetime.
Cancer, nuclear physics, internet-scale computation, most of the really interesting problems: you can't just "take pictures" of the whole thing. It would be like assuming you can "just understand" what's happening in an actual nuclear explosion using some cameras and a sound understanding of math. Or the proposal that we could just understand the global economy by examining the ledger of all transactions. It's ridiculously beyond the realm of possible.
Even in the Trinity explosion, a highly controlled, intensively studied nuclear explosion, we can't even be sure how many neutrons the beryllium-polonium initiator produced. 8? 10? Not really sure which atoms produced them, for sure. And how many got produced in each succeeding fission generation? Meh? I mean, we can do some statistics, but that's it. That's roughly the scale of the problem we're dealing with in cancer research: where'd the thing come from? And where's it going? Statistically, we can make some guesses, but no one understands the whole thing.