Archive for June, 2016

A Cancer Moonshot

Several months ago, President Obama announced what he termed a “moonshot” type of program to finally conquer cancer.  An admirable idea, and let me go on record as saying I’m all for it.  It’s being called a moonshot because we’re spending billions of dollars to achieve an easily visualized goal, like landing a man on the moon.  But cancer, being the type of disease it is, is not going to be easy to conquer.  Over the past fifty years or so, cancer has, in some of its forms, been conquered partially already.  A diagnosis of cancer used to be a death sentence; now it frequently isn’t.  Some forms are deadly in many instances, some forms have a death rate of only around 10 to 20%.  I’m certainly not an expert on cancer, but I understand much about the disease, and regardless of how much money we spend on trying to conquer cancer, I can say it won’t be easy, and it may not do what the cancer experts and politicians hope it will.

Cancer is a disease of individual cells.  Something goes wrong inside a cell and it changes.  Normally, most (but not all) cells don’t divide by mitosis much at all.  Only rarely do they divide, usually to repair an injury or to take the place of a dead cell.  Some exceptions are the blood-forming cells, which make the red and white cells of the blood.  But even those are closely regulated, and they don’t just go off on their own and divide rapidly like a cancer.  In other words, cells in a body, human or otherwise, don’t just divide unchecked.  The process of division is kept under very close control by processes known and unknown within each cell.  In cancer, a cell gets free of these normal processes, and it begins to grow wild, unchecked and unregulated.  Many things can stimulate a cell to go cancerous: sunlight, chemicals in the environment, chemicals in cigarette smoke—the list goes on and on.  Genetics can play a role.  Some genes make cells more susceptible to turning cancerous.  Some cancers are caused by viruses, which invade from outside.  So, there are a large number of different types of cancer, and the term “cancer” covers one helluva big area.  All in all, cancer is a very complex disease, and it isn’t any wonder it has taken so long to get a good handle on it.

But now we understand much better how cancer works, and a cancer “moonshot” at this stage may be a good idea.  But still, don’t get the idea that cancer will be conquered within the next few years, or even ten or twenty.  As I said above, I’m all for it.  But cancer has outsmarted us before.  It can, and probably will, do it again.

I’m not sure exactly how this “conquering” is supposed to work.  Are they going to eradicate cancer from the earth?  Unlikely.  Or just cure one form?  More likely.  Considering how cancer starts, in just one cell, curing is problematic.  A cure can only be done if all the cancer cells—and I mean all—are either killed or removed from the body of the person with the disease.  That’s hard to do, since one or a few cancer cells can stick around undetected.  Eradicating cancer totally from the earth, as though it were an infectious disease, may never work.  Cancer is spontaneous, arising from within a cell.  In any event, spending large sums of money can do a lot of good toward “conquering” cancer, or at least learning more about it, but don’t be surprised if it doesn’t.

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The Next Two Hundred Years

Several weeks ago I chanced to see a Facebook post about some predictions an artist had made in the early 20th Century of what life would be like a hundred years later, i.e., in the early 21st Century.  (I’m talking about the time around 1910, here.)  The predictions were interesting, but what came through for me was that the predictions seemed to be limited to devising objects and machines that would make life easier.  Household items that did the work for you, and so on.  Nowhere was there any prediction of major advances in health, communications, travel, and what have you.  No mention of television, organ transplantation, computers, even the telephone.   Those, of course, are much harder to predict.  It has always been difficult to predict new technology, and much easier to merely extrapolate from what we know into the future.  For example, computers, cell phones, electronic tablets and so forth have made communications much easier and more widespread than even twenty years ago.  But what is the future of the cell phone?  Will it just get faster and faster?  Or smaller and smaller?  So small it will fit on our fingernail?  Or will there be another revolution in the way we communicate, a revolution that will make a cell phone look like the telegraph looked in 1910?

Advances in most areas of technology and science are slow in coming and hard to predict.  When I started out in microbiology in the 1960’s, I couldn’t have foreseen the revolution in the handling of DNA that led to advances in cancer diagnosis and treatment, not to mention the treatment of many other diseases, or the ability to detect incomprehensibly tiny amounts of DNA on environmental surfaces that has transformed forensics and genealogy.  There was something on the horizon, to be sure, and we all knew that sometime, someone will break through and change the way we look at disease.  But it’s hard to look too far ahead.  All we can do is take research one small step at a time, and do the best we can.

So, what are your predictions for the next 100 or 200 years?  One thing that helps us in our attempt to look ahead is science fiction.  Back  in 1910, very little science fiction had been written, and it wasn’t anywhere nearly as popular as it is now.  To be sure, Jules Verne and H.G. Wells had published what we now term science fiction, but it had limited impact on the population.  Nowadays, we see sci-fi in so many places: television, movies, books, comics, etc.  We’re used to looking at spaceships that travel faster than light, or time machines that transport fictional characters to unknown and unlikely places.  Faster than light travel and time travel—if they ever come to exist—could be considered game changers in the same way jet aircraft changed the world for a 1910 person.  (The Wright Brothers had barely gotten off the ground in 1910.)  But now, let’s push the boundaries of life of an early twenty-first person.  What’s coming by 2110?  By 2210?  For a person born in 2010, what will they see in 2100?  They’ll be 90 years old, so that’s not unrealistic.  Can you get out of the rut of merely extending what is known now and make real substantial predictions?  I’m not sure I can.

Here’s a couple of my predictions, not necessarily game changers, though.  (I’m a life scientist, it should be noted.)  1. Surgery will be non-existent.  Cancer will be gone, and any necessary surgery (by 2000 standards) will be taken care of by non-invasive procedures.  Nanobots may be a part of this.  2.  Pollution will be gone.  That’s just a decision we have to make, not a technological advance.  Stopping climate change is a different matter.  Even if we made the decision world-wide right now, some climate change is inevitable, though it is possible someone, somewhere will find a way to halt climate change in its tracks.  3.  I don’t foresee Star Trek-style transporters, though I could be wrong.  Travel is travel.  You have to expend a certain amount of energy to move an object a given distance.  But what the hell, let’s go for it.  4.  Life span will be around 100 years, maybe even more.  I’m not expecting a fountain of youth, but advances in aging will be substantial.

That’s enough for now.  Got any other predictions?

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