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Rory
Post  Post subject: Cancer 'due to bad luck'  |  Posted: Fri Jan 02, 2015 7:21 am
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So says the BBC, that most cancer types are due to 'bad luck' (i.e. unavoidable random genetic mutations) - but just a few days ago they were pushing the story that cancer is mostly due to lifestyle factors. Frankly I think it would be a good idea for the BBC to leave the reporting of Science to the scientifically literate, or else to at least signpost some of the important differences between studies in terms of methodology and remit. If news is to become just a vehicle for paraphrasing the concluding remarks of published studies within the brackets "one study shows" then I better get my news corporation opened now and make a quick buck :lol:

http://m.bbc.co.uk/news/health-30641833

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iNow
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Fri Jan 02, 2015 4:17 pm
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Isn't it both genetic and behavioral? Can't I be predisposed to certain things due to my parents biology AND have increased risk due to smoking or exposure to nuclear radiation, for example?

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Rory
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Fri Jan 02, 2015 4:36 pm
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Quote:
iNow wrote:
Isn't it both genetic and behavioral? Can't I be predisposed to certain things due to my parents biology AND have increased risk due to smoking or exposure to nuclear radiation, for example?


Yes, of course, but it can't be both mostly due to random genetic mutation/genetic predisposition AND mostly due to lifestyle factors.

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marnixR
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Fri Jan 02, 2015 7:31 pm
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the way it was explained was that lung cancer, skin cancer and colon cancer are down to lifestyle, but brain, pancreatic and some other cancers were not

however, i read somewhere (can't remember where though) that some people have better repair mechanisms and as such mutated DNA is less likely to lead to full-blown cancer, and that difference surely is genetic

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iNow
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Sat Jan 03, 2015 12:32 am
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I think Marnix just nailed it. Depending on which specific cancer type being discussed, different causes ARE "mostly" responsible. The problem is when we see or use the term "cancer" in monolithic and generalized ways. Perhaps THAT'S where the BBC editors could have done better? Specify where the cancer is instead of just blindly saying "cancer?"

On another note, I read recently that the way we currently discuss and treat cancer based on its location (breast or pancreas or prostate, for example) is fundamentally misguided and it's potentially part of the reason it's taken us so long to make significant progress in treating and resolving it.

http://www.cbsnews.com/news/billionaire ... ional-way/
Quote:
Patrick Soon-Shiong: A cancer is not what people think, cells growing. Cancer is actually the inability of the cells to die.

The key is figuring out the genetic mutation or glitch that prevents cells from dying a natural death. Soon-Shiong's hope is to provide patients with the precise genetic mutations that fuel their cancer regardless of where tumors are found in the body.

Patrick Soon-Shiong: The mutation that happens in lung cancer could be the exact same mutation that happens in the breast cancer. So you need to treat that patient based on its mutation not on its physical, anatomical location.

Sanjay Gupta: That's a big idea. I mean, you know, the idea that the breast cancer specialist, they're looking for breast cancer mutations and they may be missing the ball.

Patrick Soon-Shiong: Absolutely.

A lung cancer drug could work on breast cancer, for instance, if the mutation is the same.

The concept of doing away with labeling the disease by where it's found is not unique to Soon-Shiong, but it is a tectonic shift in the fight against cancer, the notion of classifying a cancer by its mutation.

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Rory
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Sat Jan 03, 2015 11:03 pm
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I have no bones to pick with the fact that both lifestyle and genetic factors determine cancer risk - and that differences in genes encoding repair enzymes will have a large impact. I just take issue with the way that Science is reported to a lay audience. If you use the headline 'most cancers caused by lifestyle factors' or 'most cancers caused by unavoidable random genetic mutations', I don't think it's fair to expect the audience to infer that you are only referring to certain cancer types, or to a certain demographic under specific conditions. The problem is that media corporations are more interested in jumping on a story than they are in being rigourous about their reporting. As for labelling cancers by anatomical location - deleterious mutations in tumour suppressors or gain of function mutations in proto-oncogenes will tend to increase cancer risk regardless of the anatomical location but certain cancer types have a very clear and predictable sequence of mutations e.g. colorectal cancer and Ras/APC/p53. It is also helpful to refer to cancers in terms of anatomical location because that is one thing that people usually enquire about, although it might help to start referring to them as 'cancer of the [organ]' rather than as '[organ] cancer'.

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iNow
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Sun Jan 04, 2015 1:16 am
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Rory wrote:
I just take issue with the way that Science is reported to a lay audience. <snip> The problem is that media corporations are more interested in jumping on a story than they are in being rigourous about their reporting.

I completely agree. It's about traffic and click bait more than accuracy and educating. I frequently encounter people lamenting about poor scientific news reporting and have for several years now, and I suspect that is unlikely to change anytime soon. It's so pervasive that there are even comics about it.

http://www.smbc-comics.com/index.php?db=comics&id=1623
Image

http://www.phdcomics.com/comics/archive ... micid=1174
Image

http://www.explainxkcd.com/wiki/index.p ... ignificant
Image

Rory wrote:
It is also helpful to refer to cancers in terms of anatomical location because that is one thing that people usually enquire about

Perhaps this is merely due to past experience. It's something that began decades ago when cancer was less well understood, but has since become outdated.

Maybe as we continue learning new things, educating the public, and using proper terminology these trends will shift and referring to cancer based on anatomical location will be the equivalent of Referring to a refrigerator as an ice box.

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iNow
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Sun Jan 04, 2015 2:02 am
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As to the actual research noted herein, PZ Myers (biology prof at Uni of Minnesota known primarily as being an atheist with no patience for religion and related ignorance) has a really nice well-rounded overview of the work here: http://freethoughtblogs.com/pharyngula/ ... -bad-luck/

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Rory
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Sun Jan 04, 2015 9:22 am
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I laugh but I'm sad that I laugh because that means the comics resonate with an aspect of reporting in the real world. :lol: :shock:

Oh, I only mean that people enquire about the anatomical location in the same sense that the friend of a cancer patient would probably request this information out of curiosity or as a way of predicting the probable symptoms. For example, if your friend had a brain tumour, you would want to know so that you could anticipate and excuse the various cognitive or motor errors resulting from the disease i.e. to be a more sensitive and compassionate friend.

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iNow
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Sun Jan 04, 2015 4:23 pm
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I'm glad you liked those. They gave me a slightly depressed chuckle, too.

On the phrasing, though, I find myself wanting to replace anatomical descriptors for cancer, even though they can sometimes be useful in the ways you suggest.

I'd love to see our understanding of the subject advance in such a way that when a friend tells us they have cancer our first question becomes, "do you know what mutation type it is?" Then, only as a secondary or follow-up question would we potentially ask, "do you happen to know if it's located in any specific regions of the body, or is it instead being found in many places?"

I think this would be a more productive dialog as we could focus more then on treatment paths and strategies than on stuff like anticipating cognitive decline or some forthcoming mastectomy.

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Rory
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Sun Jan 04, 2015 6:36 pm
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Even knowing one of the main mutations in the tumour or cancer probably would not suffice to be able to treat it effectively. Tumours, while macroscopically homogenous, are molecularly heterogenous. Within any given tumour there might be one clone of cells all harbouring just one mutation in a gene encoding a DNA repair enzyme, a second clone containing that mutation plus a mutation in a gene encoding a critical cell cycle regulatory protein, and then a third clone of cells containing the first two mutations plus a mutation in a gene encoding a protein involved in cell death regulation. If you treat the patient with just an inhibitor designed against the second mutant protein (e.g. constitutively active kinase that positively regulates cell cycle progression) alone, then you are not going to halt the evolution of the other two clones (especially not the third one, which has more time to hang around and acquire further mutations in tumour suppressor genes or proto-oncogenes. At the very least the treatment regimen would need to involve three specific therapeutic agents used in combination. But I don't think medicine is there yet.

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iNow
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Sun Jan 04, 2015 7:22 pm
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Rory wrote:
Even knowing one of the main mutations in the tumour or cancer probably would not suffice to be able to treat it effectively.

Implied here seems to be the suggestion that knowing anatomical location would suffice to effectively treat, and I'm pretty sure that's not the case (nor likely what you intended to convey with your response).

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Rory
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Sun Jan 04, 2015 7:44 pm
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You're right that that is not what I was meaning to imply. The most accurate way of communicating the disease would be to hold up a red/green gene expression profile.

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Prometheus
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Sun Jan 04, 2015 11:06 pm
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So what i don't understand is that if, like the article claims, 1/3 of cancers are preventable why there isn't a greater fanfare. Imagine a treatment with a 1/3 cure rate - it would be heralded as the cure to cancer.


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Rory
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Mon Jan 05, 2015 8:54 am
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Don't worry Prometheus, next week the media corps will be hailing vegetables and exercise as a miracle cure for cancer. It will get its moment in the spotlight :lol:

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marnixR
Post  Post subject: Re: Cancer 'due to bad luck'  |  Posted: Mon Jan 05, 2015 12:42 pm
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i think the main thing about this article is that for 2/3 of the cancers, it's not so much life style that needs to be targeted, but early detection and treatment

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