Calling cancer a disease is like calling aging a disease. We definitely want to call it a disease, because otherwise it couldn’t get federal funding. But a doctor is unlikely to see two cancer cases in her lifetime which have exactly the same causes. Cancerous cells appear to typically have about 100 mutations, about 10 of which are likely to have collectively caused the cancer, based on analysis of the gene networks they affect. Some of the genes mutated are mutated in many cancers (eg BRCA1, p53); some are not.
The gene networks disrupted in cancer are generally related to the regulation of the cell cycle, DNA repair, or apoptosis. Any set of mutations that damages these networks sufficiently may cause cancer, but the specific way cancer develops will depend on the precise mutations. So when we ask “what causes cancer”, we’re not asking a question that has a specific answer, like “what causes AIDS”; we’re asking a question which is more like asking “what causes my car to stop running”. DNA damage may cause cancer, just like shooting enough bullets at your car may cause it to stop running.
Today we can distinguish cancers with about the level of resolution that we might say, “This car stopped running because its tires deflated”, “This car stopped because its oil leaked out”, “This car stopped because its radiator fluid leaked out.” To fix the car, you’d really like to know exactly which of many hoses, fuses, or linkages were destroyed, which is analogous to knowing exactly which genes were mutated. (My analogy loses accuracy here because car-part networks can be more-easily disrupted, while gene networks can be more-easily pushed back into a healthy attractor by a generic up-regulation or down-regulation caused by some drug. Also, you can’t fix a car by removing all the damaged parts.)
It’s been obvious for many years that curing cancer requires personalized medicine of the kind mentioned in this post, in which what the FDA approves is an algorithm to find a custom cure for any individual, not a specific chemical or treatment. I’m very glad to hear the FDA has taken this step.
I expect a generic algorithm to cure cancer will require cell simulation, and probably tissue and biofilm simulation to get the drugs, siRNAs, plasmids, or whatever into the right cells.
Calling cancer a disease is like calling aging a disease. We definitely want to call it a disease, because otherwise it couldn’t get federal funding. But a doctor is unlikely to see two cancer cases in her lifetime which have exactly the same causes. Cancerous cells appear to typically have about 100 mutations, about 10 of which are likely to have collectively caused the cancer, based on analysis of the gene networks they affect. Some of the genes mutated are mutated in many cancers (eg BRCA1, p53); some are not.
The gene networks disrupted in cancer are generally related to the regulation of the cell cycle, DNA repair, or apoptosis. Any set of mutations that damages these networks sufficiently may cause cancer, but the specific way cancer develops will depend on the precise mutations. So when we ask “what causes cancer”, we’re not asking a question that has a specific answer, like “what causes AIDS”; we’re asking a question which is more like asking “what causes my car to stop running”. DNA damage may cause cancer, just like shooting enough bullets at your car may cause it to stop running.
Today we can distinguish cancers with about the level of resolution that we might say, “This car stopped running because its tires deflated”, “This car stopped because its oil leaked out”, “This car stopped because its radiator fluid leaked out.” To fix the car, you’d really like to know exactly which of many hoses, fuses, or linkages were destroyed, which is analogous to knowing exactly which genes were mutated. (My analogy loses accuracy here because car-part networks can be more-easily disrupted, while gene networks can be more-easily pushed back into a healthy attractor by a generic up-regulation or down-regulation caused by some drug. Also, you can’t fix a car by removing all the damaged parts.)
It’s been obvious for many years that curing cancer requires personalized medicine of the kind mentioned in this post, in which what the FDA approves is an algorithm to find a custom cure for any individual, not a specific chemical or treatment. I’m very glad to hear the FDA has taken this step.
I expect a generic algorithm to cure cancer will require cell simulation, and probably tissue and biofilm simulation to get the drugs, siRNAs, plasmids, or whatever into the right cells.