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10 new things we’ve learned about cancer
Cancer's sweet tooth. Turning cancer cells into fat. Unveiling genetic secrets. Scientists are learning about cancer every day.
- Cancer is a leading cause of death among Americans, second only to heart disease.
- Researchers are unearthing cancer's genetic secrets and, with it, potential new treatments.
- Their efforts have seen the cancer death rate for men, women, and children fall year after year between 1999 and 2016.
The 21st century has been, and will continue to be, shaped by cancer. Although heart disease remains the United States' number one killer, cancer is quickly closing the gap and may soon surpass it. Some oncologists claim a cure is five, 10, certainly no more than 20 years away. Others aren't so sure because, in a way, cancer is the price we pay for evolutionary success.
"It is no coincidence that the very genes that allow our embryos to grow — our hands to grow, our feet to grow — if you mutate them in inappropriate contexts, [they] will ultimately release the disease that kills us," said oncologist Siddhartha Mukherjee, who dubbed cancer the Emperor of All Maladies, also the title of his Pulitzer Prize-winning book.
Whether for five years or forever, cancer won't be going anywhere any time soon. Yet, the more doctors and scientists discover about it, the better we can learn to live with it.
A love-hate relationship: Cancer and antioxidants
Contrary to what many believe, cancer enjoys a nutrient-rich diet as much as the next cell because it helps it grow, even those legendary antioxidants.
In two independent studies published in Cell, Swedish and American research teams found that lung cancer utilizes antioxidants to activate a protein called BACH1. This protein stimulates the cancer cells to metabolize glucose and accelerate metastasis. Even without a ready supply of dietary antioxidants available, the tumor would simply produce its own.
Professor Martin Bergo, who led the Swedish study, hopes this research will help develop new treatments. "We now have important new information on lung cancer metastasis, making it possible for us to develop new treatments, such as ones based on inhibiting BACH1," he said in a release.
Does this mean you should abstain from antioxidant-rich foods? Not at all. Antioxidants do neutralize the free radicals that cause oxidative stress on cells. Preventing such cell damage can help prevent cancer.
However, it's best to avoid antioxidant supplements unless prescribed by a doctor. As reported by the National Cancer Institute, of nine randomized-controlled clinical trials, none provided evidence that such supplements lower cancer risks. A few even found that beta-carotene supplements increased the risk of lung cancer so severely that the trials had to be ended prematurely.
Get your antioxidants from fruits, veggies, and beans instead. Research suggests that these antioxidants work in combination with additional molecules found in the whole foods. It's this tag-team effect that ultimately give antioxidants their salubrious power.
Cancer costs (in more ways than one)
It goes without saying that cancer is costly. The physical strain of treatment. The potential loss of life, whether one's own or the life of a loved one. And even if one survives, there's the emotional cost of the ordeal.
But the toll imposed by cancer is more than physical or psychological. A study released last year found "that 42 percent of patients deplete their life savings during the first two years of treatment." Of the 9.5 million newly diagnosed cancer patients surveyed, the study calculated average losses at $92,098.
Its authors dubbed the effect "financial toxicity" and concluded: "As large financial burdens have been found to adversely affect access to care and outcomes, the active development of approaches to mitigate these effects among already vulnerable groups remains of key importance."
Cancer's sweet tooth
A recent study found a positive association between a daily sugary drink and an increased risk of cancer.
Researchers asked more than 100,000 people to complete surveys looking at their usual consumption of 3,300 foods and beverages. The results? A positive association between daily consumption of a sugary beverage and an increased risk of cancer. The sugary drinks not only included soda but also 100 percent fruit juice and artificially sweetened drinks.
"These data support the relevance of existing nutritional recommendations to limit sugary drink consumption, including 100% fruit juice, as well as policy actions, such as taxation and marketing restrictions targeting sugary drinks, which might potentially contribute to the reduction of cancer incidence," the researchers stated in a release.
Don't go trashing the OJ just yet, though. As an observational study, the data could not establish a cause-effect relationship, and the researchers note the results are only preliminary. Additionally, the results hinge on the memories of the participants. (What exactly did you eat for breakfast the Monday before last?)
But the study helps stress the American Institute for Cancer Research's (AICR) suggestion to limit sugary beverages. Try to remove soda from your diet. Drink 100 percent fruit juices with no added sugar sparingly. And of course, enjoy an active, healthy lifestyle.
Cancer on the grill
It's a summer tradition to throw some meat on the grill alongside a good beer. But grilled meats hide a few furtive carcinogens: polycyclic aromatic hydrocarbons and heterocyclic aromatic amines.
The hydrocarbons are carried in the smoke after fat burns on the flame, while the heterocyclic amines form when sugars, amino acids, and creatine react at high heats. Neither has been proven to cause cancer, but they are known mutagens that can damage DNA after being metabolized.
"Research shows that diets high in red and processed meat increase risk for colon cancer," said Alice Bender, AIRC Senior Director of Nutrition Programs. "And grilling meat, red or white, at high temperatures forms potent cancer-causing substances."
Like sugary drinks, however, you don't have to forever hang up your "Kiss the Cook" apron. The institute has several suggestions for safe summer grilling, such as limiting red meat, marinating foods beforehand, keeping a low flame, and throwing more vegetables into the mix.
A unified theory of leukemia
Acute lymphoblastic leukemia (ALL) afflicts about one in 2,000 children, and Mel Greaves, at the Institute of Cancer Research, London, believes he's found the cause. Researching 30 years of data and medical literature on childhood leukemia, he argues the "delayed infection" is the culprit.
According to this theory, children develop a pre-leukemia mutation in utero. The mutation remains inert until later in life when the child encounters a common infection. The microbes then trigger secondary genetic changes that led to overt leukemia.
Does this mean children are safe only in cleanrooms? Strike that, reverse it. Greaves believes exposure to germs in the first year of life is proactive. It trains the immune system to deal with pathogens, therefore preventing the secondary mutation from triggering.
"Childhood ALL can be viewed as a paradoxical consequence of progress in modern societies, where behavioral changes have restrained early microbial exposure," Greaves writes. "This engenders an evolutionary mismatch between historical adaptations of the immune system and contemporary lifestyles. Childhood ALL may be a preventable cancer."
The future of cancer treatment is genetic
A major stride toward our understanding of cancer came with the Human Genome Project. Why? At its core, cancer is a genetic disease.
Our ability to sequence and read cancerous genomes will be a major step toward cancer treatments. As Eric Green, director of the National Human Genome Research Institute, told Big Think:
"[The] standard of care for many types of cancer is going to be: Get that tumor, read out its DNA, sequence its genome and based on what you've seen what's wrong with that tumor -- not by looking at it under a microscope only or by looking at it in a sort of a gross fashion but actually looking inside its blueprint -- you will be able to have a much better way of deciding what types of treatments to pursue and have a much better idea about what's wrong in that kind of tumor."
A future treatment? The "cancer vaccine"
An airman receives a vaccine. Could the future of cancer treatment be as easy as a shot?
Rather than using chemotherapy to combat cancer with the subtlety of an atomic bomb, immunotherapies aim to uncloak cancer cells, so the body's immune system can go on the offensive
One example of an immunotherapeutic approach is the so-called "cancer vaccine." During its clinical trial, 11 patients had a tumor injected with a steroid to bolster the site's dendritic cells — immune system cells that specialize in processing antigens.
Following a light dose of radiation and a stimulant, the patients' dendritic cells directed T-cells to attack the cancer cells. Once the T-cells could recognize the tumor, they became able to locate cancer cells throughout the body.
Of the 11 patients, three saw their cancer go into regression or remission. Six others had their cancer stymied for at least three months.
"It's really promising, and the fact you get not only responses in treated areas, but areas outside the field [of treatment with radiation] is really significant," Dr. Silvia Formenti, chairwoman of radiation oncology at Weill Cornell Medicine and New York Presbyterian, told CNBC. (Dr. Formenti was not involved in the study.)
Turning tumors into fat
Cancer cells spreading to other parts of the body through the circulatory system.
A deadly tool in cancer's arsenal is cell plasticity, a cell's ability to alter its physiological characteristics. It is one of the reasons cancers can metastasize throughout the body, and it helps the disease resist treatments.
Researchers at the University of Basel, Switzerland, have hijacked this ability and turned it against cancer. Using a drug therapy that combined an anti-diabetic drug and MEK inhibitors, they attacked cancer cells and turned them into adipocytes (a.k.a. fat cells).
While this did not remove the tumor, it did make the cells post-miotic, meaning they could no longer divide. This inhibited the cancer's ability to spread.
"In future, this innovative therapeutic approach could be used in combination with conventional chemotherapy to suppress both primary tumor growth and the formation of deadly metastases," senior study author Gerhard Christofori told Medical News Today.
An image of the E. coli bacteria. Will these become the next breakthrough in cancer therapies?
Another advancement in cancer treatment is synthetic biology, a field in which scientists use the principals of engineering to redesign biological systems. In one example, researchers genetically programmed a non-pathogenic E. coli strain to attack tumors in lab mice.
Once injected, the rewired bacteria took refuge in the tumor, where they self-destructed. These dead bacteria leaked from the tumor, and thanks to encoded nanobodies, drew the attention of T-cells which devoured the bacteria and tumor alike.
Of course, lab tests in mice do not guarantee a successful transition to human patients, but it remains a promising avenue for treatment.
"At some point in the future, we will use programmable bacteria for treatment," Michael Dougan, an immunologist at Massachusetts General Hospital, told the New York Times. "I think there's just too much potential."
A new attitude toward cancer
Medical professionals originally viewed cancer as a disease to be destroyed with extreme prejudice; the treatment was only better than the disease because the disease ended in death.
But as David Agus, professor of medicine and engineering at USC, told us, there are better ways to approach cancer:
"Well, to me cancer is a verb and not a noun. You're cancering, it's something the body does and not that the body gets. And so that philosophy needs a very different way of approaching disease, and it means changing the system in addition to trying to target the cancer."
One way is to approach treatment holistically. Agus points to a trial that gave premenopausal women with breast cancer a bone-building drug. The drug didn't target the cancer, yet it reduced recurrence by 40 percent because breast cancer metastasizes in bone.
Another method is psychosocial oncology. In this relatively new field, the practitioners' goal is to enhance the quality of life for cancer patients through mental health care as a part of physical care.
Living with cancer
Cancer death rates in the United States by cancer type, male and female, age standardized.
Scientists have learned a lot about cancer, but there remains much we don't know. Does that mean we should despair for the future? Quite the contrary. Thanks to the knowledge accumulated by scientists, we have much to be hopeful for.
Headlines are correct that the total number of new cancer cases and deaths continue to increase. However, the rates of cancer diagnoses and death have declined year after year. This is because absolute numbers don't account for metrics like population growth and increased life expectancy. In fact, the Annual Report to the Nation on the Status of Cancer found that the cancer death rate for men, women, and children fell year after year between 1999 and 2016, as did cancer incident rates.
"Death in old age is inevitable. The job of science is to prevent unanticipated deaths in unanticipated times. I find that is a perfectly reasonable goal," said Mukerjee. "If you're saying to me that we will have a more profound, more proximal reconciliation with cancer in the next few decades, I think the answer is absolutely yes."
We may not be able to eradicate cancer as we did with diseases like smallpox and polio. But we're learning how to live with it more and more every day.
- Organic food reduces cancer risk by 25% - Big Think ›
- Great white shark genome reveals clues about cancer - Big Think ›
- New therapy turns cancer into fat to stop its spread - Big Think ›
Scientists discover what our human ancestors were making inside the Wonderwerk Cave in South Africa 1.8 million years ago.
- Researchers find evidence of early tool-making and fire use inside the Wonderwerk Cave in Africa.
- The scientists date the human activity in the cave to 1.8 million years ago.
- The evidence is the earliest found yet and advances our understanding of human evolution.
One of the oldest activities carried out by humans has been identified in a cave in South Africa. A team of geologists and archaeologists found evidence that our ancestors were making fire and tools in the Wonderwerk Cave in the country's Kalahari Desert some 1.8 million years ago.
A new study published in the journal Quaternary Science Reviews from researchers at the Hebrew University of Jerusalem and the University of Toronto proposes that Wonderwerk — which means "miracle" in Afrikaans — contains the oldest evidence of human activity discovered.
"We can now say with confidence that our human ancestors were making simple Oldowan stone tools inside the Wonderwerk Cave 1.8 million years ago," shared the study's lead author Professor Ron Shaar from Hebrew University.
Oldowan stone tools are the earliest type of tools that date as far back as 2.6 million years ago. An Oldowan tool, which was useful for chopping, was made by chipping flakes off of one stone by hitting it with another stone.
An Oldowan stone toolCredit: Wikimedia / Public domain
Professor Shaar explained that Wonderwerk is different from other ancient sites where tool shards have been found because it is a cave and not in the open air, where sample origins are harder to pinpoint and contamination is possible.
Studying the cave, the researchers were able to pinpoint the time over one million years ago when a shift from Oldowan tools to the earliest handaxes could be observed. Investigating deeper in the cave, the scientists also established that a purposeful use of fire could be dated to one million years back.
This is significant because examples of early fire use usually come from sites in the open air, where there is the possibility that they resulted from wildfires. The remnants of ancient fires in a cave — including burned bones, ash, and tools — contain clear clues as to their purpose.
To precisely date their discovery, the researchers relied on paleomagnetism and burial dating to measure magnetic signals from the remains hidden within a sedimentary rock layer that was 2.5 meters thick. Prehistoric clay particles that settled on the cave floor exhibit magnetization and can show the direction of the ancient earth's magnetic field. Knowing the dates of magnetic field reversals allowed the scientists to narrow down the date range of the cave layers.
The Kalahari desert Wonderwerk CaveCredit: Michael Chazan / Hebrew University of Jerusalem
Professor Ari Matmon of Hebrew University used another dating method to solidify their conclusions, focusing on isotopes within quartz particles in the sand that "have a built-in geological clock that starts ticking when they enter a cave." He elaborated that in their lab, the scientists were "able to measure the concentrations of specific isotopes in those particles and deduce how much time had passed since those grains of sand entered the cave."
Finding the exact dates of human activity in the Wonderwerk Cave could lead to a better understanding of human evolution in Africa as well as the way of life of our early ancestors.
If you ask your maps app to find "restaurants that aren't McDonald's," you won't like the result.
- The Chinese Room thought experiment is designed to show how understanding something cannot be reduced to an "input-process-output" model.
- Artificial intelligence today is becoming increasingly sophisticated thanks to learning algorithms but still fails to demonstrate true understanding.
- All humans demonstrate computational habits when we first learn a new skill, until this somehow becomes understanding.
It's your first day at work, and a new colleague, Kendall, catches you over coffee.
"You watch the game last night?" she says. You're desperate to make friends, but you hate football.
"Sure, I can't believe that result," you say, vaguely, and it works. She nods happily and talks at you for a while. Every day after that, you live a lie. You listen to a football podcast on the weekend and then regurgitate whatever it is you hear. You have no idea what you're saying, but it seems to impress Kendall. You somehow manage to come across as an expert, and soon she won't stop talking football with you.
The question is: do you actually know about football, or are you imitating knowledge? And what's the difference? Welcome to philosopher John Searle's "Chinese Room."
The Chinese Room
Searle's argument was designed as a critique of what's called a "functionalist" view of mind. This is the philosophy that argues that our mind can be explained fully by what role it plays, or in other words, what it does or what "function" it has.
One form of functionalism sees the human mind as following an "input-process-output" model. We have the input of our senses, the process of our brains, and a behavioral output. Searle thought this was at best an oversimplification, and his Chinese Room thought experiment goes to show how human minds are not simply biological computers. It goes like this:
Imagine a room, and inside is John, who can't speak a word of Chinese. Outside the room, a Chinese person sends a message into the room in Chinese. Luckily, John has an "if-then" book for Chinese characters. For instance, if he gets <你好吗>, the proper reply is <我还好>. All John has to do is follow his instruction book.
The Chinese speaker outside of the room thinks they're talking to someone inside who knows Chinese. But in reality, it's just John with his fancy book.
What is understanding?
Does John understand Chinese? The Chinese Room is, by all accounts, a computational view of the mind, yet it seems that something is missing. Truly understanding something is not an "if-then" automated response. John is missing that sinking in feeling, the absorption, the bit of understanding that's so hard to express. Understanding a language doesn't work like this. Humans are not Google Translate.
And yet, this is how AIs are programmed. A computer system is programmed to provide a certain output based on a finite list of certain inputs. If I double click the mouse, I open a file. If you type a letter, your monitor displays tiny black squiggles. If we press the right buttons in order, we win at Mario Kart. Input — Process — Output.
Can imitation become so fluid or competent that it is understanding.
But AIs don't know what they're doing, and Google Translate doesn't really understand what it's saying, does it? They're just following a programmer's orders. If I say, "Will it rain tomorrow?" Siri can look up the weather. But if I ask, "Will water fall from the clouds tomorrow?" it'll be stumped. A human would not (although they might look at you oddly).
A fun way to test just how little an AI understands us is to ask your maps app to find "restaurants that aren't McDonald's." Unsurprisingly, you won't get what you want.
The Future of AI
To be fair, the field of artificial intelligence is just getting started. Yes, it's easy right now to trick our voice assistant apps, and search engines can be frustratingly unhelpful at times. But that doesn't mean AI will always be like that. It might be that the problem is only one of complexity and sophistication, rather than anything else. It might be that the "if-then" rule book just needs work. Things like "the McDonald's test" or AI's inability to respond to original questions reveal only a limitation in programming. Given that language and the list of possible questions is finite, it's quite possible that AI will be able to (at the very least) perfectly mimic a human response in the not too distant future.
What's more, AIs today have increasingly advanced learning capabilities. Algorithms are no longer simply input-process-output but rather allow systems to search for information and adapt anew to what they receive.
A notorious example of this occurred when a Microsoft chat bot started spouting bigotry and racism after "learning" from what it read on Twitter. (Although, this might just say more about Twitter than AI.) Or, more sinister perhaps, two Facebook chat bots were shut down after it was discovered that they were not only talking to each other but were doing so in an invented language. Did they understand what they were doing? Who's to say that, with enough learning and enough practice, an AI "Chinese Room" might not reach understanding?
Can imitation become understanding?
We've all been a "Chinese Room" at times — be it talking about sports at work, cramming for an exam, using a word we didn't entirely know the meaning of, or calculating math problems. We can all mimic understanding, but it also begs the question: can imitation become so fluid or competent that it is understanding.
The old adage "fake it, 'till you make it" has been proven true over and over. If you repeat an action enough times, it becomes easy and habitual. For instance, when you practice a language, musical instrument, or a math calculation, then after a while, it becomes second nature. Our brain changes with repetition.
So, it might just be that we all start off as Chinese Rooms when we learn something new, but this still leaves us with a pertinent question: when, how, and at what point does John actually understand Chinese? More importantly, will Siri or Alexa ever understand you?
With the rise of Big Data, methods used to study the movement of stars or atoms can now reveal the movement of people. This could have important implications for cities.
- A treasure trove of mobility data from devices like smartphones has allowed the field of "city science" to blossom.
- I recently was part of team that compared mobility patterns in Brazilian and American cities.
- We found that, in many cities, low-income and high-income residents rarely travel to the same geographic locations. Such segregation has major implications for urban design.
Almost 55 percent of the world's seven billion people live in cities. And unless the COVID-19 pandemic puts a serious — and I do mean serious — dent in long-term trends, the urban fraction will climb almost to 70 percent by midcentury. Given that our project of civilization is staring down a climate crisis, the massive population shift to urban areas is something that could really use some "sciencing."
Is urbanization going to make things worse? Will it make things better? Will it lead to more human thriving or more grinding poverty and inequality? These questions need answers, and a science of cities, if there was such a thing, could provide answers.
Good news. There already is one!
The science of cities
With the rise of Big Data (for better or worse), scientists from a range of disciplines are getting an unprecedented view into the beating heart of cities and their dynamics. Of course, really smart people have been studying cities scientifically for a long time. But Big Data methods have accelerated what's possible to warp speed. As "exhibit A" for the rise of a new era of city science, let me introduce you to the field of "human mobility" and a new study just published by a team I was on.
Credit: nonnie192 / 405009778 via Adobe Stock
Human mobility is a field that's been amped up by all those location-enabled devices we carry around and the large-scale datasets of our activities, such as credit card purchases, taxi rides, and mobile phone usage. These days, all of us are leaving digital breadcrumbs of our everyday activities, particularly our movements around towns and cities. Using anonymized versions of these datasets (no names please), scientists can look for patterns in how large collections of people engage in daily travel and how these movements correlate with key social factors like income, health, and education.
There have been many studies like this in the recent past. For example, researchers looking at mobility patterns in Louisville, Kentucky found that low-income residents tended to travel further on average than affluent ones. Another study found that mobility patterns across different socioeconomic classes exhibit very similar characteristics in Boston and Singapore. And an analysis of mobility in Bogota, Colombia found that the most mobile population was neither the poorest nor the wealthiest citizens but the upper-middle class.
These were all excellent studies, but it was hard to make general conclusions from them. They seemed to point in different directions. The team I was part of wanted to get a broader, comparative view of human mobility and income. Through a partnership with Google, we were able to compare data from two countries — Brazil and the United States — of relatively equal populations but at different points on the "development spectrum." By comparing mobility patterns both within and between the two countries, we hoped to gain a better understanding of how people at different income levels moved around each day.
Mobility in Brazil vs. United States
Socioeconomic mobility "heatmaps" for selected cities in the U.S. and Brazil. The colors represent destination based on income level. Red depicts destinations traveled by low-income residents, while blue depicts destinations traveled by high-income residents. Overlapping areas are colored purple.Credit: Hugo Barbosa et al., Scientific Reports, 2021.
The results were remarkable. In a figure from our paper (shown above), it's clear that we found two distinct kinds of relationship between income and mobility in cities.
The first was a relatively sharp distinction between where people in lower and higher income brackets traveled each day. For example, in my hometown of Rochester, New York or Detroit, the places visited by the two income groups (e.g., job sites, shopping centers, doctors' offices) were relatively partitioned. In other words, people from low-income and high-income neighborhoods were not mixing very much, meaning they weren't spending time in the same geographical locations. In addition, lower income groups traveled to the city center more often, while upper income groups traveled around the outer suburbs.
The second kind of relationship was exemplified by cities like Boston and Atlanta, which didn't show this kind of partitioning. There was a much higher degree of mixing in terms of travel each day, indicating that income was less of a factor for determining where people lived or traveled.
In Brazil, however, all the cities showed the kind of income-based segregation seen in U.S. cities like Rochester and Detroit. There was a clear separation of regions visited with practically no overlap. And unlike the U.S., visits by the wealthy were strongly concentrated in the city centers, while the poor largely traversed the periphery.
Data-driven urban design
Our results have straightforward implications for city design. As we wrote in the paper, "To the extent that it is undesirable to have cities with residents whose ability to navigate and access resources is dependent on their socioeconomic status, public policy measures to mitigate this phenomenon are the need of the hour." That means we need better housing and public transportation policies.
But while our study shows there are clear links between income disparity and mobility patterns, it also shows something else important. As an astrophysicist who spent decades applying quantitative methods to stars and planets, I am amazed at how deep we can now dive into understanding cities using similar methods. We have truly entered a new era in the study of cities and all human systems. Hopefully, we'll use this new power for good.
A small percentage of people who consume psychedelics experience strange lingering effects, sometimes years after they took the drug.