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by bad_username 7 days ago
> Cancer is not one thing,

I know this is a popular "well actually" to do, but it is not always useful in a conversation. Yes, all cancers are different, but yes, cancer is also one thing: unchecked, harmful division of cells.

Bacteria are also all different, but still they are "one thing", and despite their diversity, antibiotics exist that can deal with many species of them at once. It is reasonable to talk about bacteria and antibacterial medications, it is also reasonable to talk about cancer and cancer treatment. I truly hope cancer will meet its "penicillin" one day (yes I know this is unlikely).

7 comments

It seems relevant here because the question was “How will this potentially help me if I get cancer?” and the answer is “Not at all unless you get a particular form of cancer that this applies to”.

> Bacteria are also all different, but still they are "one thing", and despite their diversity, antibiotics exist that can deal with many species of them at once.

Except people don’t ask “what if I get bacteria” the way they ask about cancer. If the story was about a new antibiotic that only affected 20% of common infectious bacteria strains and someone asked “in laypersons terms, how will this help me if I get a bacterial infection”, it would be appropriate to clarify that it only applies to some bacteria.

> Except people don’t ask “what if I get bacteria” the way they ask about cancer.

Yeah, but doctors also don't tell people "you have bacteria" or claim "we found a cure for bacteria". The lack of nuance on average is largely due to a lack of nuance from experts. The media treats cancer as one big thing and bacteria and viruses as separate things. Thus the average joe inherits 'treating cancer as one big thing' from the media.

I agree with you about the media. Cancer is often presented as a monolithic thing by the media. I don’t agree at all about experts. Doctors and scientists who research cancers do not lack nuance.
Is it? I'm pretty sure oncologists will say "you have stage 2 breast cancer," but I wasn't in the room at the time.
Oncologists are actually way more specific than even that. Because there are many forms of breast cancer and different treatments depending on the type.

But yeah, oncologists aren’t telling people “you have cancer” the way they might say “you have MRSA”.

Yeah, it's WAY more specific. We got a genetic breakdown, multiple pamphlets on the drugs being used, what they are targeting, and why they work (along with the risks).

Honestly, I think people probably get false impressions because cancer usually hits old people and old people are, frankly, often not reliable narrators.

I understand where you are coming from here, but I think it is helpful for people to overtly grasp that there are very different cancers, very different treatments, and indeed very different outcomes.

Without this understanding it becomes a quick jump from "we're spending all this money on cancer" to "we've made no progress"

An example of the nuance plays out in the common cancers (like breast and prostrate). These have between 90 and 100% 5 year survival rates. Others (like the one in this article, pancreatic) have very poor survivability.

As you note, it's very unlikely that we'll "cure cancer". But we already "cure" (for some definition of cure) some cancers. Progress is slow, methodical, and incremental. It can feel like a lost cause when viewed from afar, but up close very real progress is being made. And that's an important message to pass along.

The other part that is simply missing is that cancer, very unfortunately, evolves and mutates. That's how you go from a cancer that responds to treatment to one that is treatment resistant.

Like you said, for a lot of common cancers we have multiple treatments. It's usually not just one magic drug, but rather the doctors working with the most effective treatments down to the least effective treatments.

Depressing: evolution has discovered a universal cure for cancer, and it's reproduction. You make a whole new human without the bad bits. Other humans have to evaluate which bits are bad.
The problem is the similarities of cancer to normal cells. We have penicilin that works against all human cells. We call that poison.

Now, "no, i mean poisons that attack the special chemistry of cancer," oh yes, those we call chemo.

For chemo it's often "these chemicals kills cancer cells faster than they kill regular cells".
Which is why we got ecchemo.. where the cancer affected pathways get seperated from the regular ciculatory system via shunt and then get fed the chemo seperately and get a little wash before reconnection to the full circulation. It would be even more ideal if you had the whole navel setup in two entirely seperated systems.. sorry, a man can dream..
if you can separate a tumour's circulation why not just leave it permanently disconnected?
Most likely you can’t isolate the tumor but can do organ-level shunts like e.g. the whole kidney. You don’t want to throw away the healthy bits.
> We have penicilin that works against all human cells.

Penicillin works against bacteria, in particular gram-positive bacteria; to a lesser extent gram-negative bacteria too (this depends on the cell membrane structure of bacteria; there are other penicillin derivatives that are also more effective on gram-negative bacteria than penicillin is, but by and large the main target will be gram-positive bacteria). It does not work against human cells. If your comparison is about drugs in general, then of course cytotoxic drugs will have an effect; simplest example I can remember off-hand is colchicin. Of course it should work against cancer cells and non-cancer cells, unless there are some mutations where colchicin could no longer bind to, but that seems very very rare, due to the natural target of colchicin involved in cellular division.

It was an analogy. Just like penicillin kills a broad variety of bacteria we also know substances that kill a broad variety of cancer cells. Arsenic, for instance, and shotgun bullets. The problem is they usually select for all cells or all human cells, not cancer cells more specifically.
> I truly hope cancer will meet its "penicillin" one day (yes I know this is unlikely).

Penicillin blocks a specific enzyme (transpeptidase).

https://en.wikipedia.org/wiki/Penicillin-binding_proteins

Cancer cells, by definition, are not a uniform mass. It will depend on the cancer type, which in turn is defined by the properties those cells have. And mutations happen all the time, often more in cancer cells when their repair systems also have mutations, e. g. are less efficient. By that definition alone, there can never be a wonder-cure for all cancer types. At best you can find some proteins more important (p53 for instance) and while more than 50% of cancer cells have some form of mutation in p53, others simply don't. By that definition there will never be a penicillin-equivalent to all cancer types.

The correct way to read the sentence is “all cancers do not have the same causal mechanism” but people don’t talk like that because it’s off putting. Language is fluid and it’s generally on the reader to infer meaning from context. If we can do so reasonably, we do it, and we don’t need to then write additional posts chiding people over an interpretation that’s highly unlikely to be the intended one. I don’t mean to be pushy about this, btw. It’s just that pedantry can be valuable, but only if it isn’t abused.
Benign cancers are a thing. They might not kill like they show in the Hollywood movies, but your quality of life will be significantly diminished.
Squamous cell carcinoma does not metastatize, but my god it can disfigure people really badly if not treated in time.
> Squamous cell carcinoma does not metastatize (sic)

This is false; it does so, but slowly.

https://www.moffitt.org/cancers/squamous-cell-carcinoma/diag...

> Benign cancers are a thing.

No, they aren't. Cancer is malignant by definition.

There are benign non-malignant tumors.

"Malignant" and "benign" isn't a dichotomy, it is a loose sliding scale.

"Benign" is any cancer where wait-and-watch is a valid medical approach.

You're simply wrong. Again, cancer is malignant by definition. And again, you seem to be confusing "cancer" with "tumor" -- your description applies to the latter, not the former.

https://jamanetwork.com/journals/jamaoncology/fullarticle/27...

"Malignant tumors are cancerous (ie, they invade other sites)."

https://www.cancer.org/cancer/understanding-cancer/what-is-c...

"Tumors are lumps or masses of abnormal cells (neoplasms) that can be malignant (cancer) or benign (not cancer)."

https://www.merriam-webster.com/dictionary/benign

"of a mild type or character that does not threaten health or life especially : not becoming cancerous"

That cancer is malignant by definition is extremely well known. I won't respond further.

P.S. I looked through your other comments and can highly recommend you to https://www.reddit.com/r/confidentlyincorrect/

> cancer is malignant by definition

A distinction without a difference.

You can label a slow-growing tumor as "not-cancer" if you want, for psychological reasons, I guess; "cancer" just sounds scarier. Some slow-growing "not-cancer" tumors are faster than others. It's a sliding scale, not a dichotomy.

"cancer is malignant by definition"

> A distinction without a difference.

What distinction? This is a phrase that this confidently wrong ignoramus apparently doesn't know the meaning of.

You've been downvoted but I would say you are right. It would be more accurate to say "cancer does not have one cause".