Vincent DeVita, popular head of the National Cancer Institute, described the massive progress we've made on cancer treatment in his book "The Death of Cancer." Before being the warhead of the NCI in the War on Cancer, he was a research physician. DeVita described a time where certain cancers in his hospital had a 100% death rate. In response, he closed himself into a room with other top research doctors, most smoking cigarettes, and scribbled on a chalkboard all day. He argued with top minds on how to cure cancer. Combination chemotherapy emerged from these sessions -- the idea that the 'kitchen sink' approach is a more effective regimen for chemotherapy than using one drug at a time. It worked spectacularly. In his clinics, 100% death rate cancers were now cured.
"Cure" is a taboo word in biology, unless you are fixing the "gene" that is responsible for the disease. "Gene" is etymologically linked to "Genesis," meaning "Origin." Biologists often unwittingly subscribe to a genetic determinist viewpoint, in which genes are the origin of traits, behaviors, and susceptability to disease. Students are taught the "central dogma" of biology, where information flows from DNA to RNA to proteins, and never backward. I think calling it a dogma is appropriate, as it's one of the first reductionist assumptions a fresh biologist questions when they learn about reverse transcription in HIV, where information flows 'backwards' to protect a virus. Unfortunately, they often fail to question more absurd assumptions.
If genes are the origin of all biological processes, you cannot cure cancer without fixing the gene that caused it. The only two valid approaches to cure cancer, therefore, are to kill every cell with the "bad genes" or to fix every mutation in the cancer-causing genes.
Large tumors sometimes spontaneously regress, maybe even >20% of the time. [1] In fact, patients with spontaneously regressing tumors have had biopsies taken and their cancer cells analyzed. Compared to progressing cancer cells, the regressing cells had a vastly different (epigenetic) program: "shrink and go away." [2]
The oncogene hypothesis considers cancer to be downstream of specific genetic mutations that cause cancer. If this is true, then how can a large population of cancer cells suddenly decide to shrink and go away? They should still have the oncogene.
Stress can cause genetic instability, and cancer cells are very stressed. Certain mutations surely can make cancer worse, but you cannot mutate a single locus and cause cancer. On the other hand, the Levin lab has simply changed the electrical potential of melanocytes and induced a metastatic melanoma, with no genetic mutations. [3] Cells can have the 'cancer mutations' and not be cancer. Our first line of treatment against cancer is radiation, which in any other context would be thought to cause cancer, because it creates more mutations.
When confronted with the idea that cancer can be reversed rather than killed, the biologist asks "but what about the mutations? You can't cure the cancer tissue, the mutations will still be there!"
In the eye of the biologist, the only way to win is to kill.
And this has worked before. Chemotherapy and radiation have had huge success in treating many cancers. We believed that we could kill cancer, and we did it. This should serve as a testament to the effiacy science when belief is aligned with reality. We're hitting the walls of this approach, though. Chemotherapy and radiation are awful pro-aging treatments. Surgery is disfiguring and unsustainable if we live longer as a species. These approaches work well for certain cancers, but they are not a general cure. With genetic determinism, there is no cure.
This is the fundamental problem that is preventing a cure for cancer from emerging. No one is even trying.
Genetic determinism is clearly the wrong model for biology and is preventing progress. Replacing it with an equally bad model will also do no good.
There are many better models of the cell than genetic determinism or its complementary poison, membrane theory, such as Gilbert Ling's Association-Induction Hypothesis, or Herbert Frohlich's Biological Coherence. Biologists are not physicists, though. The story of the gene, akin to a blueprint, is easier to understand than phenomena that purely occur on the nano-scale or emergent phenomena of theoretical physics.
If you train a language model on its own output, it does not improve. Modern biology is trained on its own output. We've lost something. We lost it around the time the internet was invented.
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footnotes:
Check out James A Shapiro, "Evolution: A View from the 21st Century" for a more detailed explanation of how the central dogma is wrong.