How we will know the Great Cancer Breakthrough when it comes

(Below is an example of what retired old university professors and librarians like me are known for doing: composing an essay or random musings on a topic of what is to some only of academic interest. But I rather like the idea that I present below, and I hope that it does turn out to be a predictor of the future).

We seem to be in an era right now of "important," and "useful," and "helpful" discoveries and innovations in cancer research and treatment, which occur from time to time. Such things as a new drug coming out, or a "promising" new treatment being investigated.

But nothing has happened for a very long time that could be said to be a major, overwhelmingly significant, earth-shaking event of a breakthrough, one that totally changes the entire map as far as cancer research and treatment goes. It's the kind of thing that, when it does happen, it will be a stick of dynamite compared to the current research achievement firecrackers. Like Dr. Jonas Salk finding the vaccine for polio. Or smallpox being eradicated. Something like that could happen for cancer someday.

Personally, I don't accept that from now on progress in cancer research will only occur in small advances made only occasionally, and this will be the rule for some time to come. ("This new drug increases survival time by an average of four months!" Oh really? Well how about an average of four years? Then we're really talking something!). I really like to believe that the Louis Pasteur, or the Jonas Salk, of cancer research is out there somewhere, and will be announcing that huge breakthrough some day.

By all means let's do give credit to the cancer researchers who right now are toiling away out there, such smart and dedicated people, occasionally coming up with helpful new things. And I know we all respect and appreciate them for the things that they are doing. But what they have been giving us are "That's nice" moments. When is one of them going to give us a 'WOW!" moment?

So, I was wondering recently, how will we know or be able to recognize this tremendous breakthrough, this monumental achievement in cancer research and treatment, when it finally comes out? Well, of course after it has been around for a while there will be a marked and possibly total elimination of or control of certain cancers, or perhaps of all of them, and cancer mortality statistics will drop dramatically, to possibly near zero.

But those sorts of things usually come after the breakthrough has been made and put into practice. So how will we know at first, or reasonably suspect, that a certain newly published thing is indeed going to lead to the "magic bullet," the Holy Grail of cancer treatment, that we have all waited for so long to see?

Granted I am assuming that there will some day even be such a breakthrough, that the "That's nice" developments are not going to be all we get for a long time to come. But I am optimistic. I choose to believe that the "WOW!" moment is coming, that it's just a matter of time. I would even like to suggest in a paragraph below how it may happen.

I would also like to suggest a way that we may be able to recognize this great breakthrough when it comes. It's a way based on an experience I had years ago when I was working at my university. I had been there for five years and was coming up for tenure (the university's decision on whether or not to retain an employee as a permanent faculty member). As part of this process, I was required to attend a general advisory meeting (what to do to get tenure) along with the other university employees then coming up for tenure that year. The meeting was conducted by the university provost (a high-ranking university administrator). As he spoke to us, he emphasized that in order to receive favorable consideration, our tenure packets should contain research articles or projects that we had done that were of "significant" value. When asked what he meant by "significant," he replied, simply,

Something that completely changes the way you look at the field

Very simple, but also very elegant. After reading that article, or looking at that research project, you can never again look at the field, whatever it is, physics, chemistry, librarianship, cancer research, or anything, in exactly the same way as before. This is because this new thing has so dramatically changed the way you, or anyone, will now view that field. It's almost like it's not the same field anymore, this new thing has changed it so much.

Albert Einstein's article on relativity in 1905 is a good example of this. Before the article was published, physics was one thing. After the article came out, and exerted its influence, it was almost as if the field of physics had suddenly become an entirely new field.

But this concept applies not just to scientific fields, but to anything. Whether it's business, sports, auto mechanics, or whatever, you name it, anything that totally changes the way you look at it, so that it can never be viewed the same as it was before, is a truly significant change.

I believe it will be that way with the coming great, world-changing cancer breakthrough. That new thing, when it comes out, will be so significant that it will totally change the way we look at cancer research and treatment, and oncology in general, as if it has just become an entirely new field. Nothing in the old field of oncology or cancer treatment will continue to have any value or meaning unless it is now evaluated in terms of this new breakthrough.

And it's also possible that there could be as well a very interesting side feature to all this. Which is that, just as relativity seemed incredible and hopelessly fantastic to the traditionalist Newtonian physicists of Einstein's time, when it first appeared, so it may be with the coming great cancer breakthrough. What it says and how it works will be such a surprise to many that some will at first doubt it simply because of its amazing, radical and non-traditional nature. But it will eventually prove itself, simply because it is the truth.

So I think that's how we'll know and recognize this coming great cancer breakthrough when it arrives: first, it will totally change the fields of oncology and cancer treatment, so that the former fields and the way they used to operate will become almost unrecognizable because of this new thing, and secondly, it may also seem so totally radical and even impossible at first that it will be disbelieved, until repeated demonstration proves that it is true.

(BTW, I have personally always believed that not only is such a future amazing cure for cancer coming, but it's going to come out of pure, not applied research. That is, there is quite possibly some researcher working right now in a university or pharmaceutical research lab somewhere, who is going to find something extraordinary and completely new about the fundamental nature of cells, perhaps a previously unknown, very basic and very fundamental property or principle of all cell structure or function. The knowledge of this amazing new discovery will, as predicted above, then be developed into an entirely new treatment strategy that totally changes how cancer is seen and managed. By its nature it may also seem completely incredible at first, but it will eventually be established as reality and lead to a true cure for cancer).

So if a future announcement about a newly made cancer breakthrough possesses these two features, that's the way we'll know that it just may be something really significant.

Won't that be exciting!

Having a bad day, TA? 81GyGuy obviously put a lot of time and thought into his post, and we all know the basic question that he was attempting to pose.

And, you attack his phraseology? Come on, he deserves better than that, and you can do better, also.

ASAdvocate - There was nothing personally disparaging in what I said - I'm sorry you took it that way, and I hope 81GyGuy didn't. It was not about phraseology - it goes to the heart of the theme in his essay. I hope it's OK with you that I disagree with his (and the President's) POV about this. I think it shows respect (and I hasten to add that I greatly respect our President) that I am being analytical about it and responding to it. Afterall, he presumably posted it to provoke discussion.

81GyGuy - I'm not a scientist -- I'm a writer -- and a very philosophic one at that. I also volunteer my time to lead discussion groups among the elderly on current events. That's why I key in on the ways that language can be used and misused to frame discussions and debates. It's not that I'm not hopeful about finding cures for all diseases - I very much am, and do also write about them - guardedly sometimes, enthusiastically at others.

I'm only pointing out that there was what I believe to be a couple of what I consider to be erroneous assumptions inherent in the way you framed your question. I think that politicians try to make hay out of pressing for "The Cure," as if there were one. Also, I've found that cures and treatments come from many years of painstaking plodding, one small step at a time, rather than sudden "breakthroughs." In your essay, you dismiss this POV out of hand, without justification. Isn't "a Great Cancer Breakthrough" a form of magical thinking? I think it's important to respect the process and to have realistic expectations. It's also important to have sustained long-term funding, rather than a one-time billion dollar bequest that this "breakthrough" mentality engendered.

- Allen

Going back to the title of the thread and in a more lighthearted vein...

"How will we know...?"

I was gonna reply: "Tall Allen will tell us dummy"!

Hum, very interesting, and I, too, have wrestled with Wittgenstein in my youth, and came out a poor loser. True, 'cancer' is many diseases, and there will likely be many paths to "cure" (whatever that really means). That being said, my look at the Gordian Knot of "cancer" suggests that there may well be a single explanation--and a single breakthrough that will start the unraveling.

Why? Because at it's most basic definition, "Cancer" is defined by and as, the unregulated growth of the body's own cells. In this sense, it is one disorder, genetic in nature, that can appear in any of the body's organs, and can affect any of the body's systems. The answer, in this view, is within the genetic material housed in our cells. We are, all of us, born with the potential for "Cancer" in our bodies, and a likely key is in understanding how that genetic material functions. Some of the discoveries are so simple, it's hard to believe.

And, so mr GyGy, I'm with you. Some researcher will have a true 'eureka' moment where an obvious truth will erupt into vision, and in the end it will be so simple that every other researcher will scratch their head and say, "who woulda thunk it?" After all, the structure of DNA suddenly came into focus when Watson and Crick had the vision to see that it would work perfectly IF the deoxyribose formed the rails of a twisting ladder--and the base groups (the famous A-T and C-G pairs) were the steps of the ladder, rather than the ribose sugars forming the center post of a spiral staircase with the bases sticking out.

We'll know it's the right answer because it will be simple, elegant, and beautiful. Because that is true of all good science. Occam's razor, after all, is still very sharp.

Why don't I see TAll Allen's posts???
Bob

Jerry L. -

You're welcome.

81

I agree that approaching PC from the point of view of managing it as a system, seems like the most comprehensive way of making sense of it.

My dad's oncologist put it in a way that I found rather philosophically beautiful: he said, cancer (in general) is an evolutionary guarantee that each human being carries within a "fail-safe" mechanism ensuring its end.

Of course, looking it at this way makes things more optimistic: our focus should be to convert PC to a chronic, manageable condition long enough to reach ripe old age.

On the other hand, such chronic conditions can indeed be called a cure, no?

Sometimes it really feels that we are on the cusp of making PC a chronic condition for the advanced cases (like my dad's): I'm hoping if Prostvac, Galeterone, and Yervoy show effectiveness in the next 2-3 years, it'll really make PC a chronic condition for many metastatic cases??

Arthur

And it may be here or coming. The prostate vaccine is in clinical trials. Yippe Yi Yay. This may not be the one but it's coming.

Good discussion/debate. Initially I was going to write that cancer is many diseases. But then I saw that Tall Allen beat me to it. Halbert's post though made me think some more.
Many (most?) cancers are caused by genetic changes (in the cellular DNA). If we could 'edit' these changes soon after they occur, could we prevent various cancers? The 'technology' to do just that has recently become available (CRISPR/Cas9). How to apply this methodology to prevent carcinogenesis is the problem (in my simple mind).

On the other hand, changes in the DNA can be a good thing as well. Otherwise we would still walk on all fours. So how can we edit the 'bad' changes while leaving the 'good' ones intact?
My head is bursting by now; I will stop.