[stouset]

A “general cure” for cancer is a pretty tall order. Cancer isn’t one disease, it’s a catch-all term for a bunch of vaguely related ones.

Maybe this is a bit of a stretch but it’s a bit like trying to find a way to end deaths from “accidents”. Drowning, falling off a ladder, and a car crash are all a type of accident but it’s really hard to find a thread tying them all together to deal with it generally.

[zkelvin]

Every day, something like 100 cells in your body become cancerous, but your immune system shoots them down before they can cause any harm. This is effectively a general prophylactic for cancer, so it's not unreasonable to think that we could discover a general cure for cancer (and that something immunotherapy is a promising candidate).

[Amarok]

Once the cancer starts to freely mutate it becomes much harder to contain. It's not just cleaning up defective cells, it's full on evultionary warfare between your immune system and the cancer.

[jorvi]

For the most part it is devolutionary warfare for the cancer.

[telgareith]

There is no such process.

[jorvi]

You should read up. This is basically cancer 101.

[mromanuk]

According to Thomas Seyfried, cancer is indeed one disease, fundamentally a metabolic disease [0]. Seyfried's theory suggests that cancer stems from mitochondrial dysfunction, which disrupts cellular metabolism and leads to abnormal cell growth. He argues that the root cause of cancer is not genetic mutations, as commonly believed, but rather metabolic disturbances that alter how cells process energy. Basically returning the damaged cells to "old pathways" of energy generation, without oxygen: fermentation. This process, known as the Warburg Effect (named after Otto Warburg who first described it in the 1920s), shows that cancer cells primarily rely on fermentation for energy production even in the presence of oxygen - a phenomenon called "aerobic glycolysis." However, glucose fermentation is only part of the story. Cancer cells also heavily depend on glutamine, an amino acid that serves as another crucial fuel source. Through a process called glutaminolysis, cancer cells convert glutamine into both energy and building blocks for rapid cell division. This dual dependency on glucose and glutamine makes cancer cells metabolically distinct from normal cells.

This metabolic theory challenges the traditional somatic mutation theory, which views cancer as a result of DNA mutations accumulating in cells. Seyfried proposes that targeting the metabolism of cancer cells—primarily through dietary interventions like ketogenic diets or therapies that restrict glucose—could effectively "starve" cancer cells while leaving healthy cells less affected. His approach implies that a general strategy for treating cancer could involve targeting this metabolic vulnerability shared across many cancer types. Furthermore, this theory suggests that combination approaches targeting both glucose and glutamine metabolism might be particularly effective, as they would address both major fuel sources that cancer cells rely on. This could include strategies such as ketogenic diets (to restrict glucose), glutamine inhibitors, and other metabolic therapies that work together to compromise cancer cell energy production while preserving normal cell function.

0: https://nutritionandmetabolism.biomedcentral.com/articles/10...

[atombender]

One heuristic I like is a kind of reverse Occam's Razor: When no clear solution doesn't emerge even after a huge amount of searching, it's probably because the problem actually is complex, not because it's simple.

For example, maybe cancer does have a single unifying cause that can be fixed very easily. But the millions of hours put into studying it suggests otherwise.

This seems to be generally true about most things. Only very rarely do we get something super simple like goiter being caused by the lack of iodine, or stomach ulcers being caused by H. pylori.

[mromanuk]

Interesting point, though I think we should also consider that our ability to understand diseases like cancer has historically been limited by the observational and analytical technology available. For example, it was recently suggested that Alzheimer’s might be linked to Candida albicans, a fungus that naturally inhabits our bodies but could play a role in the disease. Just as it took time to discover that iodine deficiency causes goiter or that H. pylori produces ulcers, the complexity of cancer might partly stem from the fact that we don’t yet have the necessary technology to closely observe the cells and underlying mechanisms. It’s not necessarily the inherent complexity of the problem but our technological limitations that delay understanding—and possibly a cure.

[atombender]

The Candida link is interesting but not proven — so in that sense it's equivalent to your cancer guy.

The other discoveries predate a lot of advanced medical technology, though. They were the low-hanging fruit in that sense. The only semi-recent discovery I can think of is that the Epstein-Barr virus causes cancer, though that does not necessarily qualify as "simple". EBV is also implicated in MS. EBV could ultimately be one of those "unifiers" that could explain multiple diseases.

[sausagefeet]

Thomas Seyfried is a bit of a quack. He believes a keto diet beats chemo for almost all cancers.

https://sciencebasedmedicine.org/ketogenic-diets-for-cancer-...

> Seyfried, in my readings, appears all too often to speak of “cancer” as if it were a monolithic single disease. As I’ve pointed out many times before, it’s not. Indeed, only approximately 60-90% of cancers demonstrate the Warburg effect.

> Dr. Seyfried presents mouse studies that are interesting and suggestive that there might be something to this whole ketogenic diet thing, at least in brain tumors, such as this one. However, this is what we in the oncology biz would call pretty preliminary data, worthy of further investigation but not supporting the grandiose claims that Dr. Seyfried makes.

> Irritatingly, during the same talk, Dr. Seyfried refers to having done a “biopsy” on the GBM when the case report clearly says that the patient underwent a partial excision of the temporal pole with incomplete debulking of the tumor, which is a different thing. > ... > He also heaps scorn on the hospital for insisting that the patient undergo standard of care therapy, clearly demonstrating that he has no understanding of clinical trial ethics.

> This brings me back to the question of whether cancer is a metabolic disease or a genetic disease, the answer to which I promised early on. The likely answer? It’s both! Indeed, a “chicken or the egg” argument continues about whether it is the metabolic abnormalities that cause the mutations observed in cancer cells or whether it is the mutations that produce the metabolic abnormalities. Most likely, it’s a little of both, the exact proportion of which depending upon the tumor cell, that combine in an unholy synergistic circle to drive cancer cells to be more and more abnormal and aggressive. Moreover, cancer is about far more than just the genomics or the metabolism of cancer cells. It’s also the immune system and the tumor microenvironment (the cells and connective tissue in which tumors arise and grow). As I’ve said time and time and time again, cancer is complicated, real complicated. The relative contributions of genetic mutations, metabolic derangements, immune cell dysfunction, and influences of the microenvironment are likely to vary depending upon the type of tumor and, as a consequence, require different treatments. In the end, as with many hyped cancer cures, the ketogenic diet might be helpful for some tumors and almost certainly won’t be helpful for others. Dr. Seyfried might be on to something, but he’s gone a bit off the deep end in apparently thinking that he’s found out something about cancer that no one else takes seriously—or has even thought of before.

[mromanuk]

BTW, saying that someone "is a bit of a quack" is an ad hominem fallacy. The article linked talks about the "keto" part of the protocol, it does not discuss the glutamine portion of the treatment. I'm not sure who is right, but I would love to see, someone debunking it with data. Protocol: https://www.nature.com/articles/s42003-019-0455-x

[sausagefeet]

No it is not. If you want to consider informal logical fallacies, it is closest to "poisoning the well", as I am tarnishing his name in an effort to make you not believe is claims. I am not saying he is wrong because he is a quack, I am saying he is a quack, and here is an article going into why he is wrong.

> but I would love to see, someone debunking it with data

The problem is Seyfried doesn't have data. His science is bad and extrapolating from marginal results. Some parts of these ideas might pan out, but all I've seen indicates he's made this his hobby horse is riding it.

[Calavar]

Speaking of fallacies, dismissing an argument because you found a single fallacy within it without addressing the main substance of the argument is known as the fallacy fallacy.

There is a lot chew on in that comment and that article beyond "a bit of a quack"

[derangedHorse]

The fallacy fallacy is when you dismiss a conclusion based on a faulty argument. Him not addressing the argument isn't that. Him dismissing the conclusion of the argument is that.

[nwienert]

Speaking of the fallacy fallacy, calling out someone for calling out someone for a fallacy using the fallacy fallacy is the fallacy fallacy fallacy — as an initial fallacious fumble may indeed foretell further fallacious findings in a given figure.

[TZubiri]

I know it's a joke. But he just named the phenomenon, not discredited the whole argument.

Edit: so you commited a faux meta fallacy

[TZubiri]

Oh nice to learn that. I knew a less formal version in my country which we call "the fat virgin fallacy" which is when you denounce a fallacy in a somewhat informal less strict conversation. Made popular because libertarian argie president liked to tweet and denounce fallacies like so.

[hatenberg]

If it quacks like a quack it’s fine to call it one.

[ifyoubuildit]

Where else are the major discoveries going to come from when we've hit local maxima?

[sausagefeet]

What is your complete, coherent, argument here?

[ifyoubuildit]

Innovation comes in two flavors: incremental, which is what you'll mostly get from your establishment, and paradigm shifts, which you're more likely to get from your cranks.

That's not to say all (or even many) cranks are secretly geniuses. But they're able to explore parts of the search space that the establishment can't for all sorts of reasons.

In other words, your establishment has all the resources and can incrementally make its way to local maxima better than any crank could. But any members that start making bold claims that might threaten that establishment will be punished, out of a simple survival instinct.

[sausagefeet]

Do you have any evidence to support this claim?

[7bit]

Establishment? Bro, you should listen to yourself...

[robertlagrant]

It's true that that theory would combine things, but it's just a theory, and I don't know how evidence based it is.

[mschuster91]

> Drowning, falling off a ladder, and a car crash are all a type of accident but it’s really hard to find a thread tying them all together to deal with it generally.

Indeed, but humanity has managed to reduce "accidental deaths" as a whole by honing in on individual accident categories before - say, alcohol influence, combating that one by a multitude of means reduced car crashes, workplace injuries and domestic accidents.

Something similar might be possible for cancer as well. I think the solution already exists in nature, hidden within large animals, we "only" need to find out how precisely a 200 metric ton whale or a 10 ton elephant manages to beat statistic odds.

(Additionally, ever since COVID shone a spotlight on it, there is more and more evidence that lots of cancers are caused by viruses, most prominently herpes / genital cancer)

[TZubiri]

No one talked about a general cure for cancer here. What I meant is a general cure for the specific disease. Specifically, it's easier to cure a patient with Biliary Duct Cancer than to find a cure for Biliary Duct Cancer.

"Cancer isn’t one disease, it’s a catch-all term for a bunch of vaguely related ones"

Also that's a pretty common misconception, cancer is pretty well defined, abnormal cell growth. I agree that there will be no single cure, but it's like a viral infection, or a system intrusion. There may be many causes and cures will be different, but there's no disagreement over what is an isn't a cancer or a viral infection.

[ejstronge]

> Also that's a pretty common misconception, cancer is pretty well defined, abnormal cell growth

I don't think cancer biologists would subscribe to this simple definition (and it's not hard to find cases of 'abnormal cell growth' that do not ultimately constitute cancer). There have been, and continue to be, publications that pose the question of what it means for a patient to have cancer (cf https://www.cell.com/fulltext/S0092-8674(11)00127-9 )

Cancers quite clearly cause different diseases - it's even the case that cancerous cells can yield distinct clinical presentations simply based on whether they are primarily found in the blood or in solid organs.

I don't think anyone would disagree that 'viral infection' is also an unhelpful description. Viruses may transiently infect host cells and die out (the common cold, for example) or permanently become part of the host genome (consider the various herpesviridae).

[tsimionescu]

The term "vaguely-related" is perhaps wrong, but the "it's not one disease" is clearly correct. Just like "viral infection" is not a single disease, going by your own example, but a series of completely different diseases that have one particular mechanism in common.

[HlessClaudesman]

People are attracted to "I climbed a ladder, and it was safe" stories, which are usually presented without the context on the societal harms of ladder use in aggregate.

[fasa99]

Man ain't nothing one disease. Look at COVID. Why did the vaccine fail. Not one disease. Population variation of the virus. blah blah. Renal failure - shades of grey, shades of causes. Heart failure - shades of grey, shades of failure. High blood pressure - how high? Why? Who says it's high?

You see? Your point is unremarkable in the face of all diseases.

The handwavey reddit tier explanation you're shooting for is that cancer is genetically unique in each person. Which really is a gross oversimplification, there are non-unique genetic components of that are common themes across many cancers- TP53, PIK3CA, BRCA, KRAS, MSH, etc etc.

So such an explanation is lame because if there's all these common genes than it seems curable - which it would be if that were the long and short of it. Reason it's hard to cure is half those genes I name jack up replication machinery so it makes errors all the time. So now our cancer is not a genetically unique cancer, it's billions of genetically unique cells in one body, always mutating. Now it's not drug developer versus cancer, it's drug developer vs Charles Darwin, evolution. And of course there is a solution for that. Immunotherapy, or as the link shows, immunostimulation. Because the immune system also uses evolution / artificial selection!

[swayvil]

If you could increase the general health of the person. Like, a lot. That might work as a general cure.

[eptcyka]

Preventative measures are not cures. You can’t eat your veggies out of stage 2 cancer.

[lostemptations5]

It's called Cancer, not X, Y and Z.

It's one disease -- just a very complex one.

[TZubiri]

https://en.wikipedia.org/wiki/List_of_cancer_types

It's actually not,

here are the names of cancers that start with P

Paraganglioma Pineal astrocytoma Pineocytoma Pineoblastoma Pituitary adenoma Pilocytic astrocytoma Primary central nervous system lymphoma Primitive neuroectodermal tumor