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.
I know many people whose lives were radically changed by The Lord of the Rings, The Narnia Chronicles, Star Wars, or Ender’s Game.
The first three spawned a vast juvenile fantasy genre which convinces people that they’re in a war between pure good and pure evil, in which the moral thing to do is always blindingly obvious. (Star Wars at least had a redemption arc, and didn’t divide good and evil along racial lines. In LotR and Narnia, as in Marxism and Nazism, the only possible solution is to kill or expel every member of the evil races/classes.) I know people on both sides of today’s culture war who I believe were radicalized by Lord of the Rings.
Today’s readers don’t even know fantasy wasn’t that way before Tolkien and Lewis! It was adult literature, not wish-fulfilment. Read Gormenghast, A Voyage to Arcturus, The Worm Ouroboros, or The King of Elfland’s Daughter. It often had a nihilistic or tragic worldview, but never the pablum of Lewis or Tolkien.
Ender’s Game convinces people that they are super-geniuses who can turn the course of history single-handedly. Usually this turns out badly, though it seems to have worked for Eliezer.