Every day, something like 100 cells in your body become cancerous, but your immune system shoots them down before they can cause any harm. This is effectively a general prophylactic for cancer, so it's not unreasonable to think that we could discover a general cure for cancer (and that something immunotherapy is a promising candidate).

According to Thomas Seyfried, cancer is indeed one disease, fundamentally a metabolic disease [0]. Seyfried's theory suggests that cancer stems from mitochondrial dysfunction, which disrupts cellular metabolism and leads to abnormal cell growth. He argues that the root cause of cancer is not genetic mutations, as commonly believed, but rather metabolic disturbances that alter how cells process energy. Basically returning the damaged cells to "old pathways" of energy generation, without oxygen: fermentation. This process, known as the Warburg Effect (named after Otto Warburg who first described it in the 1920s), shows that cancer cells primarily rely on fermentation for energy production even in the presence of oxygen - a phenomenon called "aerobic glycolysis." However, glucose fermentation is only part of the story. Cancer cells also heavily depend on glutamine, an amino acid that serves as another crucial fuel source. Through a process called glutaminolysis, cancer cells convert glutamine into both energy and building blocks for rapid cell division. This dual dependency on glucose and glutamine makes cancer cells metabolically distinct from normal cells.

This metabolic theory challenges the traditional somatic mutation theory, which views cancer as a result of DNA mutations accumulating in cells. Seyfried proposes that targeting the metabolism of cancer cells—primarily through dietary interventions like ketogenic diets or therapies that restrict glucose—could effectively "starve" cancer cells while leaving healthy cells less affected. His approach implies that a general strategy for treating cancer could involve targeting this metabolic vulnerability shared across many cancer types. Furthermore, this theory suggests that combination approaches targeting both glucose and glutamine metabolism might be particularly effective, as they would address both major fuel sources that cancer cells rely on. This could include strategies such as ketogenic diets (to restrict glucose), glutamine inhibitors, and other metabolic therapies that work together to compromise cancer cell energy production while preserving normal cell function.

0: https://nutritionandmetabolism.biomedcentral.com/articles/10...

> Drowning, falling off a ladder, and a car crash are all a type of accident but it’s really hard to find a thread tying them all together to deal with it generally.

Indeed, but humanity has managed to reduce "accidental deaths" as a whole by honing in on individual accident categories before - say, alcohol influence, combating that one by a multitude of means reduced car crashes, workplace injuries and domestic accidents.

Something similar might be possible for cancer as well. I think the solution already exists in nature, hidden within large animals, we "only" need to find out how precisely a 200 metric ton whale or a 10 ton elephant manages to beat statistic odds.

(Additionally, ever since COVID shone a spotlight on it, there is more and more evidence that lots of cancers are caused by viruses, most prominently herpes / genital cancer)

No one talked about a general cure for cancer here. What I meant is a general cure for the specific disease. Specifically, it's easier to cure a patient with Biliary Duct Cancer than to find a cure for Biliary Duct Cancer.

"Cancer isn’t one disease, it’s a catch-all term for a bunch of vaguely related ones"

Also that's a pretty common misconception, cancer is pretty well defined, abnormal cell growth. I agree that there will be no single cure, but it's like a viral infection, or a system intrusion. There may be many causes and cures will be different, but there's no disagreement over what is an isn't a cancer or a viral infection.

People are attracted to "I climbed a ladder, and it was safe" stories, which are usually presented without the context on the societal harms of ladder use in aggregate.

Man ain't nothing one disease. Look at COVID. Why did the vaccine fail. Not one disease. Population variation of the virus. blah blah. Renal failure - shades of grey, shades of causes. Heart failure - shades of grey, shades of failure. High blood pressure - how high? Why? Who says it's high?

You see? Your point is unremarkable in the face of all diseases.

The handwavey reddit tier explanation you're shooting for is that cancer is genetically unique in each person. Which really is a gross oversimplification, there are non-unique genetic components of that are common themes across many cancers- TP53, PIK3CA, BRCA, KRAS, MSH, etc etc.

So such an explanation is lame because if there's all these common genes than it seems curable - which it would be if that were the long and short of it. Reason it's hard to cure is half those genes I name jack up replication machinery so it makes errors all the time. So now our cancer is not a genetically unique cancer, it's billions of genetically unique cells in one body, always mutating. Now it's not drug developer versus cancer, it's drug developer vs Charles Darwin, evolution. And of course there is a solution for that. Immunotherapy, or as the link shows, immunostimulation. Because the immune system also uses evolution / artificial selection!

If you could increase the general health of the person. Like, a lot. That might work as a general cure.

It's called Cancer, not X, Y and Z.

It's one disease -- just a very complex one.

Jake Seliger's problems weren't really "Right-to-try".

The first problem was finding the damn trial in the first place since nobody wants to share information as it might tell their competitors something.

And then he had to pass the prerequisites for the trial. The problem there was navigating the US health system that moves like a glacier and either couldn't get a test run fast enough or wouldn't take a test from somewhere else.

Finally, after all that, then you reached the "Right-to-try" level where there were different questions of whether to subject him to the treatment based upon whether the doctor thought it might or might not be effective.

And through it all, he and his wife understood that the odds were very, very bad.

To me, the counterargument to "Right-to-try" are the Alzheimer's drugs. The underlying Amyloid hypothesis appears to be broken and fraudulent and all the drugs based on it have failed miserably. And, yet, one got through FDA approval because the consumer push is so huge and everybody wants something--even if it doesn't work.

There is big money behind pushing the boundaries--be very careful about eroding them.

https://en.wikipedia.org/wiki/Right_to_repair

I remember this being posted. It's a bit surreal to read now.

I'd probably go further and say it must be free of charge.

The problem with a nominal fee is fraudsters can be really clever at finding ways to bump up production costs.

You might give the company doing the research relaxed liability, but even then you'd want to be careful. After all, you wouldn't want a coal mining operation conducting "research on lung cancer treatment" by sending in miners without PPE.

If this is a legitimate research into curing cancer then eating the cost to treat test subjects is the least a company could do. The results are what's can be worth a lot of money.

Conversely, if you ban actually charging for last-attempt experimental research services, then those desperate people will only be left to seek:

1- Honest researchers who can't charge too much. 2- Unscrupulous quacks who will take all your money regardless of law.

With the second option being much more common due to incentives. If however you allow research facilities to take donations/payments to fund research related to a specific disease, then you will increase the incentive for legitimate companies, even if the odds are still low or close to 0.

This is an hilariously straightforward and brilliant idea. It's no holds barred, but the goal has got to be a real, approved drug in the future. Not profits right now.

I think you also need a caveat that failures must be recorded, and a specific treatment can only be used so many times without success. That will avoid providrrs who are self-deluded about the efficacy of their favourite drug/therapy.

How can we collect useful data on experimental medicine outside of a controlled study?

Why not leave that question to the person getting treated?

Why not ask the scientist treating themself?

It sounds like this might be a bit like off-label medicine though. It would need to start with a doctor. Maybe any plan needs an independent sign off from another doctor who is qualified enough.

It exists because, in the very recent past, a lot of shady stuff has happened just because people were curious. The “Tuskegee Study of Untreated Syphilis in the Negro Male”; Dr. Chester Southam injecting cancer cells into unconsenting patients; Josef Mengele's experiments in Nazi concentration camps… Maybe they overcorrected, but there's good reason!

The only people who could do that investigation would be China, and they seem disinclined. Or possibly they already have done the investigation and aren't telling the rest of the world their results.

> With any cancer treatment the exact same procedure will struggle to generalize well across cancer types

As someone with family members living with cancer, modern genetic sequencing has been the biggest surprise.

Not that we could sequence tumors, but that we could do so at scale and classify therapies by effectiveness against specific mutations (in general, even ignoring targeted therapies).

Widespread cancer sequencing seems like the missing link to promote better outcomes, particularly in metastatic cases.

There's a long history of OVT clinical trials, if someone's bored and interested they could try tracking down why they (mostly*) failed.

See table 1 for a list (as of 2021, probably incomplete) https://pmc.ncbi.nlm.nih.gov/articles/PMC7913179/

* As the article points out, there is one approved OVT therapy.

In the US? No you can do pretty much whatever you want here.

Isn't year 1 or 2 of medicine just about knowing general facts about the body? Like the names of muscle and bones. Actually treating diseases coming much later, and practical knowledge is mostly learned as an intern.

All that to say that doing 1 year of med-school may not be that useful unless you intend to do 10 more and become an actual doctor. Maybe nursing would be a better bet: shorter studies, and more practical.

The relevant Wikipedia page says all that too, but then confuses matters by listing about 50 notable examples.

https://en.wikipedia.org/wiki/Self-experimentation_in_medici...

That's not actually true though is it, suicide is illegal in many jurisdictions. Not just self- euthanisation towards the end of life anyway (which is more controversial/media-discussed) but any form.

> You can do whatever you want to yourself.

No you can't. Maybe in your country.

For ex, it's suicide is illegal where I live. Yeah.

> you can do whatever you want to yourself.

Uh, women would like a word.

I don't think it's a good ground to rejected observational data. If you want the published data to be less biased you should introduce as little arbitrary (not connected to the quality of data itself) barriers as possible.

This is bullshit, especally since she also got "traditional" therapy after. This is just a statement by someone that is desperately looking for a negative point. You have to have access to equipment and skills that not many people have. And then if they have it, that's one more thing to try, the effects are quick if it works and you can revert to radio/chemo therapy if needed.

Decades? In your comment and in your thinking lies everything that is wrong with this world.

It does scale because it eliminates dozens of redundant oncologist visits.

The former is a reason why there actually is a lot of research into this already/couple drugs approved (cancer is usually very profitable), the latter is why all drugs, not just these, need extensive clinical trials and strong regulation. Because it's measles virus and herpes virus etc etc, and often genetically engineered, so the safety risks are ... obvious

Real ethics isn't what you think it is. Real ethics is in getting the treatment asap to everyone that it can save.

Uber offers higher rates when moving into an area, sometimes the point of making a loss per ride. Once an area is established, they cut rates to drivers. Obviously, the drivers make the rational decision you’ve outlined above; but the taxi companies don’t come back.

Uber burned investor money in major markets for years operating at a loss to drive smaller operations out of business, only to become at least as expensive as their former competitors but as the only game in town.

> how can they be underpaying people (i.e. paying them less than competing employers) and yet people still choose to do it?

"paying them less than competing employers" being synonymous with "underpaying" is probably not a great assumption, although I'm sure it's the definition an MBA would use.

Most regular people are choosing the least-worst option in terms of employer. That doesn't mean that the least worst option is necessarily good, or paying fairly on an absolute scale. It could just be the job that means workers can handle one unexpected large bill before going bankrupt instead of not being able to handle any at all working for the next-worst option.

In other words, there's an imbalance of power between employers and the "regular person" workforce. The workers technically have a choice of where to work, but in many cases, none of the choices are good.

I'm a bit unclear what you're trying to say re BHH or if that actually is a different reason. Totally fair point on Uber though, I didn't read that one closely enough, but I'll still argue that's unethical for a more relevant reason: surge pricing reinforces inequality by blocking less wealthy people from access to services while those who can afford it are unaffected. The distribution of who is able to use the service under heavy demand is massively skewed towards the class of people that most likely would be just fine without it while the ones most heavily impacted by a missed appointment or being late to work or whatever are the ones left out to dry.

I'm not sure where you got the idea my post was claiming taxis were superior in any way, I explicitly said Uber was better. Taxis weren't practical but they at least they existed. I have lived in cities that used to have taxis which were annoying and unreliable, but after Uber came and left there was literally no way at all to get from point A to point B without getting a ride from a friend.

Regardless I will admit I misread the issue stated in the article a bit and addressed that more here: https://news.ycombinator.com/item?id=42097052

In Texas most times I called a cab I expected them to never come. Only exception was scheduled airport rides a day or more in advance.

How about "flying a commercial airliner without a license" ?

I would encourage reading about Jim Allison (the nobel prize winner in medicine for immunotherapy) and his difficulty having his research acknowledged / getting funding as an immunologist working in cancer research.

Wired magazine did a piece on him detailing how funding for this type of research was largely stonewalled because it ignored status quo ideas on cancer treatment.

My understanding is that traditionally ovt research was nearly impossible to get funding for but has begun to become easier as the status quo research and researchers from the 2000s have been replaced.

“A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents die, and a new generation grows up that is familiar with it.”

With opinions like yours, the US would never have developed mRNA vaccines.