Biology 466    Unsolved Problems Fall 2011

Special vulnerabilities of cancer cells (?)

Which of the following do you agree with?

a) To cure cancer, the main need is some (any!) way to kill cancer cells, that doesn't also kill normal cells.

b) Reversing the abnormalities of cancer cells isn't really what you should try to do. Effects too temporary.

c) Selective killing of faster growing cells has two big disadvantages:

    * Surrenders hope for curing slower growing cancers (maybe half of all cases).

    ** Very unpleasant side effects: Anemia, nausea, hair loss, even heart damage.

d) If cancer cells are morphologically distinguishable, this can only be because they have some physical, in the sense of mechanical, abnormality. (Can you change the shape of something without a physical force?)

e) When anyone claims that the reason a phenomenon isn't yet understood is "Because it's very complicated." the implicit claim is that the basic concepts are already fully understood, except for details?

f) In 1951, why wasn't the chemistry of genes yet understood? Because it was "very complicated"?
(Or was the answer already staring scientists in the face? Too simple for them to grasp?)

g) If current chemotherapy drugs and methods already cost hundreds of thousands of dollars per patient, then what economic motivation does anyone have to improve them?

h) Would an actual cure of cancer bankrupt, or enrich? Who stands to gain, other than the actual patients?

i) If a treatment can't be patented, why would anyone invest millions of dollars in testing, manufacturing, advertising and distributing it?

j) Why is there no current research of Coley's toxins, even though there is evidence they cured thousands?

    * Because you can't improve methods unless you understand the basic cause & mechanism?

    ** Because it's many years too late to patent them?

k) All B lymphocytes have their own special antibodies, whose binding sites differ from those of 99.9% of other B lymphocytes. Since all cancers are clonal, in the sense of being descendents of one original mutant cell, why not make monoclonal antibodies that specifically bind to the binding sites of each lymphoma patient's own cancerous lymphocytes? It was tried, and produced cures consistently! But it wasn't "economically feasible" because it cost thousands or even tens of thousands of dollars per patient to produce the mono-clonal antibodies against their particular cancer's binding sites.

It's one thing for cancer patients to be charged tens or hundreds of thousands of dollars for less-specific monoclonal antibodies. It's quite another thing for the antibodies to cost that much to manufacture!

l) If you discovered a chemical, or other treatment, that you had reason to think might cure cancer, who would test it for you?

m) Is cancer one disease? Or many different diseases, with a few things in common?

n) Are cancers of different organs therefore fundamentally different diseases?

o) Are cancers caused by mutations in the same oncogene (for example, ras) therefore fundamentally the same disease (even if in different organs).

p) Might it be practical to invent a way to cause individual cells to be killed as a direct result of having a mutant ras oncogene? Or would it be better to discover a drug that corrects the abnormality in the ras protein, so that the mutant cells would (temporarily) return to normal behavior?

q) Which company would you invest in? A company developing a treatment that caused cells to be killed by abnormal ras proteins? Or a company with a drug that makes mutant ras proteins behave normally?

r) Should government agencies develop and sell anti-cancer drugs, themselves. Or should the government confine itself to research on the basic biology, and leave drug testing and sales to the private sector.
(A long letter to the Editor published in Nature last May advocated the latter.)


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