This interview was done as part of the New Cancer Mentality initiative:
New Cancer Mentality is a grassroots organization focused on giving cancer patients a virual townhall to ask their questions to leading oncologists and researchers about their work. Furthermore, New Cancer Mentality focuses on bringing about collaboration between researchers as well as giving researchers an online forum to share their views and what needs to be done to cure this disease.
If you’d like to learn more or join the movement, check out blog and contact David.…
[This is part 3 of Epidemiology vs. Etiology]
You may have heard there is an epidemic of low vitamin D levels in the U.S. An estimated 60% of Americans are at a level that has been correlated with increased risk of nearly all chronic diseases, including cancer, heart disease, diabetes, autoimmune diseases, and depression. My personal belief is that the epidemiology is horribly flawed. But perhaps not in the way you might think….
As most people know by now, we humans photosynthesize vitamin D in our skin when it is exposed to direct sunlight. How fast depends on our ethnicity and amount of exposure. Since I’m light skinned and get a lot of sun in my normal life, it came as a huge surprise when some routine bloodwork I had done about 9 months ago indicated I was “dangerously low.”
My doctor immediately prescribed large doses of vitamin D supplement, but I was convinced that the result was spurious. Perhaps it was due to …
Use the arrows that appear if you hover over the bottom right of the Prezi. You may want to expand to full screen first.
All feedback welcome. If you like this, what subject would you like to see addressed next using Prezi?…
James Watson, co-discoverer of DNA’s double-helix structure recently called for a back to basics approach in dealing with cancer. In previous post threads I’ve discussed cancer’s complexity and in particular the confounding and scary implications of somatic evolution, which underscores some of the reasons we are not winning the “war on cancer.” Here I will discuss some cutting edge approaches to treating and preventing cancer and how they might pan out in light of the complexities of the disease. The categories below are not mutually exclusive, and the examples cited are nowhere near exhaustive, but this should give you some food for thought. If you have ideas, questions or know of approaches that should be highlighted, please comment.
Target & Kill Approaches
Biris and Zharov are making some exciting progress in using nanotubes to tag and then track cancer cells inside the body as they move around. They propose to kill the cancer cells by heating up the nanotubes using lasers, while others are …
Michael Pollan, as always, making perfect sense:
This is a very complex topic, as the following talk suggests:
The main takeaways from this that I got are:
- Cancers for which sunlight deficit is a risk factor are orders of magnitude more prevalent than the few for which overexposure is a risk factor.
- People who are using sunscreen regularly are precisely the ones who shouldn’t be.
- We should be very careful and sparing about recommending sunscreen usage or sun avoidance, and always temper such advice with the tradeoffs of not getting enough sunlight.
As someone who wonders on a regular basis whether the public has the right information to make informed decisions about health-related tradeoffs, I am curious… does the above strike you as surprising? What do you currently do regarding sun exposure, and are you likely to change anything based on the above? What do you think the overall message that reaches the masses is regarding sun exposure?…
Heng, et al recently published a review paper that brings together and touches on many different aspects of cancer complexity. I thought this an opportunity to selectively quote the paper and organize the quotes loosely around various complex systems concepts they relate to. I’m curious whether this makes sense to readers of this blog, or whether there’s too much unexplained jargon and too many large conceptual leaps. Please ask questions or make comments freely below.
One preface I think will help is to understand that genome, karyotype and chromosome refer roughly to the same thing. Here are several schematics that I will present without explanation that together illustrate how genes relate to genome/karyotype/chromosome structure, and how that in turn relates to the so-called genetic network (loosely equivalent to the “proteome”). Of course “gene” is an outdated and inaccurate concept, so don’t get too hung up looking for genes here, just understand that they are sub-structural elements of the genome.
From MSU website
Yesterday, from the Director of the National Cancer Institute, addressing one of the two largest cancer research conferences of the year:
NCI commenced a series of workshops that began to bring aspects of the physical sciences to the problem of cancer. We discussed how physical laws governing short-range and other forces, energy flows, gradients, mechanics, and thermodynamics affect cancer, and how the theories of Darwinian and somatic evolution can better help us understand and control cancer.
Read more on my Cancer Complexity Forum post.…
This is not news, health professionals of all sorts have been saying this for a long time. ABC News features a recent study supporting this.
A relevant footnote near the end of the article though:…
On the Cancer Complexity forum, I pose a question: if we could somehow replace all the damaged DNA in each of the cells of your body with an undamaged copy on a continuous basis, would that prevent you from getting cancer?
What do you think?…
Here is the scariest image in all of cancer:
Graph from Fortune Magazine article.…
Click here to read part 4 in this series.
As 2008 closes, it appears that momentum is picking up for the somatic evolution view of cancer. Here are three recently published papers of note:
- The Evolution of Cancer (Goymer, et al, Aug 2008, Nature)
- Cancer Research Meets Evolutionary Biology (Pepper, et al, in press, 2008 Evolutionary Applications; Santa Fe Institute working paper)
- Genome Based Cell Population Heterogeneity Promotes Tumorigenicity: The Evolutionary Mechanism of Cancer (Ye, et al, Dec 2008, Journal of Cellular Physiology)
For those who missed the first three parts:
Any underlying theme of this thread is how reliance on reductionism causes us to miss the key invisible etiologies that are necessary to make progress on understanding, treating, detecting and preventing cancer.
In the first three parts of this series, I pointed out how the invisible etiology of somatic evolution has great explanatory and predictive power for oncology. A new paper by some researchers on the vanguard of complex systems thinking shows how adding a complementary ecological model leads us to the promising approach of ecological therapy.
A Nature Review article published a couple of years ago summarizes the case for cancer as an evolutionary and ecological process
hat tip: David Basanta…
An incidentaloma according to wikipedia is “a tumor (-oma) found by coincidence (incidental) without clinical symptoms or suspicion.” The provocative NY Times article below suggests that indolent tumors (i.e. ones that do not need treatment) may come and go as a normal part of life. With better detection tools, we are finding more and more of these. However our protocol for dealing with tumors is based on a time when tumors found were almost always non-incidental, non-indolent and requiring of positive action (like surgery). According to Dr. Donald A. Berry, chairman of the department of biostatistics at M. D. Anderson Cancer Center:
It’s possible that we all have cells that are cancerous and that grow a bit before being dumped by the body. ‘Hell bent for leather’ early detection research will lead to finding some of them. What will be the consequence? Prophylactic removal of organs in the masses? It’s really scary.
The following is a recent paper by Henry Heng published in JAMA. I’ve linked concepts mentioned in the paper to corresponding explications from this blog.
The Conflict Between Complex Systems and Reductionism
Henry H. Q. Heng, PhD
Author Affiliations: Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan.
Descartes’ reductionist principle has had a profound influence on medicine. Similar to repairing a clock in which each broken part is fixed in order, investigators have attempted to discover causal relationships among key components of an individual and to treat those components accordingly. …
[ I’m asking for your help in answering this question, read past the fold to see how ]
In my post on invisible etiology, I challenged us all to be as open-minded as possible when dealing with our most complex problems, for this is the only way to make the invisible become visible. Here’s where I attempt to practice what I preach.…
Kevin points out that perhaps I am giving chemotherapy short shrift and not looking at the bigger picture. I would counter that you can’t really make the latency analogy with human life because we are all born terminal. “Mean survival time” is a squirrely measure at best because how do you know if someone died (a) because of the cancer, (b) because of the chemo, or (c) because of some other factor (in which the cancer or chemo or both) could be confounding?
If you buy the somatic evolution (SE) argument then there are all sorts of consequences which contraindicate chemo in most cases. …
When I posted part 1, I didn’t realize that Scientific American would be coming out with an entire special issue devoted to cancer in the same month, including an article by Carl Zimmer entitled “Evolved for Cancer?“.
I had hoped that the article would be about the somatic evolution of cancer, and while it touches on this aspect briefly and tangentially, it mostly talks about the evolution of defenses against cancer within the human population as a whole. There is a critical distinction here: somatic evolution occurs on the cells within a single body in the course of a single human lifetime,* while human evolution happens in a population of many humans over millions of years.**…
For anyone interested in learning about the complexity of cancer, I’d like to invite you to check out a forum I started a while ago (but only recently made public) called Cancer Complexity.
One of the main themes (but not the only one) in Cancer Complexity is the notion that cancer is an evolutionary process (as in Darwinian evolution), except that instead of populations of individual animals, the population of interest is the set of cells in the body of a single animal.…
Pop Quiz: Which is a bigger determinant of cancer mortality in America, being poor or being black?
According to Dr. Harold Freeman of the National Cancer Institute, poverty is the bigger factor today, but it hasn’t always been so:…
Many people would admit to not understanding cancer well, but fewer people would admit to not understanding evolution well. Here are some challenges to our understanding of both.
Starvation may help cancer treatment. “As little as 48 hours of starvation afforded mice injected with brain cancer cells the ability to endure and benefit from extremely high doses of chemotherapy that non-starved mice could not survive.”
In the March 9, 2008 Sunday Magazine section of the NY Times, Freakonomics authors, Stephen Dubner and Steven Levitt wrote about an idea I shared with them (with my permission of course). Given all of the interest and critique that’s resulted, I am posting the original conception below and encourage you to express your thoughts about the project either in the comments here or on the Freakonomics blog. If you are interested in becoming involved beyond just providing public input, just say so in your comment and I will contact you directly.