Cancer - Paul Davies Article

[Super Nova]

This is a crackingly good article. Worth a read.

By Paul Davies

When President Nixon declared war on cancer 40 years ago, he also sanctioned one of the biggest research programmes in history. The budget of America’s National Cancer Institute (NCI) is now $5 billion a year, more than Nasa spends on space exploration. Cancer accounts for a large slice of research funds in most other developed countries, too: Cancer Research UK, for example, has a budget of £500 million a year.


But despite this vast investment, the long-awaited “breakthrough” remains elusive. Although certain drugs (often very expensive) can prolong life, the brutal truth is that most patients diagnosed with metastatic cancer today fare little better than their counterparts did decades ago. And as life expectancy rises, more people will die of cancer. Given the escalating costs of treatment, the economic impact is unsustainable.


I became embroiled in this depressing story four years ago when I was called out of the blue by the deputy director of the NCI, Anna Barker. Dr Barker talked about the glacial pace of clinical progress and her frustration that, even with some of the world’s finest minds involved, no light could be discerned at the end of the tunnel. Her question to me was: “Can physicists help?”


I explained that my career was focused on quantum mechanics, cosmology, black holes. “I know nothing about cancer,” I said. “It doesn’t matter!” was her response. Physicists, she pointed out, think about the world in a distinctive way. They have elucidated the secrets of the atom and probed the farthest reaches of the cosmos, and have a good track record at cracking tough, complex problems. It was not so much new technology that she was after, but insights from our problem-solving approach.


Two years later, in a bold attempt to exploit this untapped expertise, the NCI created 12 centres of physical science and oncology, and I found myself directing the one at Arizona State University. So, how are we getting on?

Well, one of the virtues of being unencumbered by much knowledge of a subject is the ability to come at it afresh, to see it through different eyes. The basic story of cancer is very simple. Somewhere in the body, cells start to proliferate uncontrollably. If unchecked, they spread to other organs and colonise them. At that stage, the patient’s prospects are grim. Yet nobody has a convincing explanation for why this happens. The individual steps can be partially explained in terms of changes in the cells. But precisely why a cell from, say, a breast duct or the prostate gland starts roaming the body to make a home in the liver or the lung – a process called metastasis – remains a mystery.

Most research has focused on cancer as a human disease. But tumours are also widespread among animals and plants, suggesting that they have deep evolutionary roots. Cancer is such a formidable adversary because it is a fundamental part of the story of life itself, and I believe it can be properly understood only by seeing the grand evolutionary picture.

The earliest traces of life on Earth date back 3.5 billion years, but only about a billion years ago did complex, multi-celled organisms begin to evolve. This was a profound transition. Single cells have but one imperative – to replicate. They are, in effect, immortal. But when cells first formed co-operative assemblages, a new deal was struck. Most organisms outsourced their immortality to specialised germ cells (eg sperm and ova), and in return accepted death for themselves. Thus a typical tissue cell might reproduce a handful of times and then die.

Organisms police this contract with a variety of regulatory systems, including specialised genes that suppress runaway growth. I believe that cancer is a breakdown in this contract, initiated when a common-or-garden cell refuses to die on cue and embarks on its own agenda.

It would be a mistake, however, to suppose that cancer merely represents a cell that has “gone wrong”, and started running amok in the body. In fact, cancers possess a surprising degree of organisation. As they become more malignant, they deploy sophisticated tricks designed to evade the body’s defences and enhance their own prospects. This pre-programmed box of tricks is what makes combating them such a challenge.

Together with Charles Lineweaver at the Australian National University, I have been developing a theory of cancer based on the concept that it is an evolutionary throwback to our earliest ancestors. About 600 million years ago, there appeared a riot of modern-looking metazoa (the multi-celled creatures that make up the bulk of the animal kingdom), with many specialised cell types and organs. But this explosion didn’t happen in a vacuum. Hundreds of millions of years before, they – we – had precursors: clumps of semi-organised cells forming robust, tumour-like forms.

Our bodies are replete with ancestral genes that evolution has built on. These genes are retained because they are active in the early stages of embryo development, when the basic body plan is being laid down. Curiously, human embryos temporarily develop gills and tails, representing long-lost features of our evolutionary history.

Normally these ancient genes are silenced thereafter. But Lineweaver and I have proposed that cancer results from an accidental reawakening of the earliest metazoan genes, the ones programmed to build the sort of structures that inhabited Earth millions of years ago. Rather like a computer starting up in safe mode after an error of some sort, cancer may be a reversion to a tried-and-tested ancestral lifestyle in response to a physical stress such as a carcinogen.

By connecting the dots of evolutionary, developmental and cancer biology, we have come to view cancer not so much as a disease to be cured as a condition to be controlled. Like ageing, cancer must be accepted as part of life. But by careful management, its effects can be mitigated. For example, 90 per cent of cancer deaths result from metastasis. Slowing or arresting this spread would make a big difference.

Even when cancer cells make a home in a remote organ, the micro-tumours often fail to progress, or may lie dormant. Many people who appear to have survived unscathed eventually succumb when the cancer returns years or even decades later, with enhanced malignancy. If we can understand how these micro-tumours remain in equilibrium with their environment, we could work to extend that quiescent phase. After all, a cancer that reappears after 50 years instead of five is not too serious a health risk.

The great advantage here is that such improvements could come without requiring us to unravel fully the stupendously complex innards of cancer cells, with their myriad genetic and chemical pathways and survival mechanisms. If Lineweaver and I are right, and a special cassette of ancient genes drives the basic behaviour of cancer, then we will have a well-defined target for therapy. The challenge is to find a way to seize control of the cassette’s operating system and tweak it to do our bidding, by reducing the cancer cells’ wanderlust or keeping the micro-tumours stable.

Cancer touches all of us. Public health programmes, such as the campaign against smoking, have had a big impact. And a handful of cancers are, in effect, curable. But headway against this scourge has stalled, and requires some radical new thinking, including concepts that cross subject boundaries and emphasise control over cure. The NCI’s bold initiative of inviting perspectives from physical science needs to become an integral part of the next phase of cancer research.

Paul Davies is director of the Beyond Center for Fundamental Concepts in Science at Arizona State University. For more details,

[IQS.RLOW]

That is a very good article

It explores that cancer is not actually a disease but a part of life..which it actually is. Cancer is natural. Not nice,but natural

Combating global warming is akin to spending trilllions of money to combat global cancer

...let's make society suffer instead

Fucktards

[annielaurie]

Excellent article, Nova. As a cancer patient myself, I have done a lot of reading and have a layman's understanding of the disease. I have come to the basic conclusions stated in the essay.

The potential for cancer seems to be built into some cells, and would appear to be hereditary on a microscopic level, perhaps even a sub-atomic level.

I no longer believe there is a "cure" for cancer of any kind. Medical science can treat most cancers to prolong lifespan or merely to improve quality of life if unable to prolong it. But that seems to be a far as they can take it. That is what they are doing for me, palliative treatment to prolong and improve quality of life, but unable to cure.

Cancer seems to be a genetic predisposition built into many living, replicating organisims. Many, perhaps not all.

[AiA in Atlanta]

Cancer is natural. Not nice,but natural

Yes, cancer is natural like diabetes and heart disease all which used to be uncommon.

[AiA in Atlanta]

The idea that cancer has an evolutionary aspect is fascinating. When one considers that our body doesn't recognize much of the food we eat in a evolutionary context (we have been eating grain products for only 10,000 years which is like yesterday for our 2 million year old DNA) and that for our Paleolithic ancestors involuntary fasting was a way of life this finding makes sense:

Short fasting cycles work as well as chemotherapy in mice
February 8, 2012
Man may not live by bread alone, but cancer in animals appears less resilient, judging by a study that found chemotherapy drugs work better when combined with cycles of short, severe fasting.


The study in Science Translational Medicine, part of the Science family of journals, found that five out of eight cancer types in mice responded to fasting alone: Just as with chemotherapy, fasting slowed the growth and spread of tumors.

And without exception, "the combination of fasting cycles plus chemotherapy was either more or much more effective than chemo alone," said senior author Valter Longo, professor of gerontology and biological sciences at the University of Southern California.

For example, multiple cycles of fasting combined with chemotherapy cured 20 percent of mice with a highly aggressive type of children's cancer that had spread throughout the organism and 40 percent of mice with a more limited spread of the same cancer.
No mice survived in either case if treated only with chemotherapy.
Only a clinical trial lasting several years can demonstrate whether humans would benefit from the same treatment, Longo cautioned.

Results from the first phase of a clinical trial with breast, urinary tract and ovarian cancer patients, conducted at the USC Norris Comprehensive Cancer Center and led by oncologists Tanya Dorff and David Quinn, in collaboration with Longo, have been submitted for presentation at the annual meeting of the American Society of Cancer Oncologists.
The first phase tests only the safety of a therapy, in this case whether patients can tolerate short-term fasts of two days before and one day after chemotherapy.

"We don't know whether in humans it's effective," Longo said of fasting as a cancer therapy. "It should be off limits to patients, but a patient should be able to go to their oncologist and say, 'What about fasting with chemotherapy or without if chemotherapy was not recommended or considered?"

In a case report study with self-reported data published in the journal Aging in 2010, 10 cancer patients who tried fasting cycles perceived fewer side effects from chemotherapy.
Longo stressed that fasting may not be safe for everyone. The clinical trial did not enroll patients who already had lost more than 10 percent of their normal weight or who had other risk factors, such as diabetes. Fasting also can cause a drop in blood pressure and headaches, which could make driving and other activities dangerous for some patients.
In mice, the study found that fasting cycles without chemotherapy could slow the growth of breast cancer, melanoma, glioma and human neuroblastoma. In several cases, the fasting cycles were as effective as chemotherapy.

Fasting also extended survival in mice bearing a human ovarian cancer. In the case of melanoma, the cancer cells became resistant to fasting alone after a single round, but the single cycle of fasting was as effective as chemotherapy in reducing the spread of cancer to other organs.
For all cancers tested, fasting combined with chemotherapy improved survival, slowed tumor growth and/or limited the spread of tumors.

As with any potential cancer treatment, fasting has its limits. The growth of large tumor masses was reduced by multiple fasting and chemotherapy cycles, but cancer-free survival could not be achieved. Longo speculated that cells inside a large tumor may be protected in some way or that the variety of mutations in a large mass may make it more adaptable.

But he noted that in most patients, oncologists have at least one chance to attack the cancer before it grows too large.
Longo and collaborators at the National Institute on Aging studied one type of breast cancer in detail to try to understand the effects of fasting.
While normal cells deprived of nutrients enter a dormant state similar to hibernation, the researchers saw that the cancer cells tried to make new proteins and took other steps to keep growing and dividing.

The result, Longo said, was a "cascade of events" that led to the creation of damaging free radical molecules, which broke down the cancer cells' own DNA and caused their destruction.
"The cell is, in fact, committing cellular suicide. What we're seeing is that the cancer cell tries to compensate for the lack of all these things missing in the blood after fasting. It may be trying to replace them, but it can't," Longo said.

The new study bookends research published in Proceedings of the National Academy of Sciences in 2008.
In that study, Longo's team showed that fasting protected normal cells against chemotherapy, but did not address the effect on cancer cells. The study also focused only on a single cancer and chemotherapy drug.
The new study on a range of cancers and common chemotherapy drugs extends the 2008 results by showing that fasting not only fails to protect cancer cells, but makes them more vulnerable.
Longo called the effect "Differential Stress Sensitization" to reflect the change in vulnerability between normal and cancerous cells.
Longo's interest in fasting and cancer grew from years of studies on the beneficial effects of fasting in yeast and other organisms. He showed 15 years ago that starved yeast cells enter a stress-resistant mode as they wait for better times.
By contrast, he said, the mutations in cancer cells come at a cost, such as a loss in adaptability to diverse environments. For example, Longo found that yeast genetically modified to resemble cancer cells become much more sensitive to several toxins.

"A way to beat cancer cells may not be to try to find drugs that kill them specifically but to confuse them by generating extreme environments, such as fasting that only normal cells can quickly respond to," Longo said.

[mantra]

Regardless of our complex and often unsuitable diet which might explain some cancers, we still live longer than our ancestors, although this may not continue. Those born in the first part of the 20th century seem to have a longevity of life that other generations might not have - particularly Generations Y and Z.

We have to be born with a predispostion to cancer - otherwise we couldn't explain why so many who are clean living with perfect diets seem as susceptible as those who do all the wrong things in regard to their health.

I've seen this a lot in animals. Sometimes the more careful I've been with an animal's diet - the earlier they've contracted cancer. In the early days when I didn't have a clue about a good diet for pets - those animals died of old age.

[AiA in Atlanta]

We live longer because the of the Industrial Age. It added 25-30 years to all of our lives.

[mantra]

We live longer because the of the Industrial Age. It added 25-30 years to all of our lives.

This might have been the case in the 20th century - but look at the massive health problems arising now. Technology is exacerbating brain cancer and obesity is doing the same for another range of cancers - or so the experts say.

[AiA in Atlanta]

People are living longer and longer while sicker and sicker. The ultimate sweet spot for Big Pharma.

[mantra]

People are living longer and longer while sicker and sicker. The ultimate sweet spot for Big Pharma.

Yes - good point. I forgot about the pharmaceutical companies. If we were animals and leading such a poor quality life with bad health - we'd be put down, but us humans want to hang on at any cost.

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