Cancer

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Early diagnosis can help to defeat cancer

Early diagnosis of cancer is of utmost importance because the genetic heterogeneity of the early-detected small tumor is small thus the probability of successful therapy is high.

This article can be on the immortalist banner along with SENS points:
https://pubmed.ncbi.nlm.nih.gov/23805382/ (2013, 625 citations).
The authors tell how to beat cancer.
Authors argue that the problem with beating cancer is that current methods detect cancer when it has ~10^8 cells and 64mm3 volume.
Their mathematical model shows that in such a large number of cells there must be cells whose individual mutations make them resistant to multiple therapies at once. They survive after treatment, multiply, and the tumor becomes resistant to the therapies.

They have two conclusions on how to avoid this.
1) Figure 3 - the extreme importance of progress in early cancer detection. If you reduce the detection threshold from 5mm to 1mm, even modern methods can cure cancer. When there are fewer cells, there will most likely be no cells resistant to multiple therapies at once. (well, this is approximate reasoning for a specific mathematical model, but in general this is about right).
2) to increase the number (and quality) of therapies in combination, so that there are no cells resistant to all of them.

Importantly, both findings are mainstream in NIH/etc research, and receive a lot of funding.

Maybe one of the hottest topics of discussion among immortalists should be -- how to detect tumors 1mm in diameter? There is a post in russian that defeating cancer is immensely heplful to defeat aging[1]. P.S. It is clear that their model is simplistic, and there are all sorts of other theories, such as cancer stem cells, but still, in my opinion, more than worthy to be on the banner. Also, this is 2013y work. There can be even more interesting new works on this topic.

I like this article for my imagination shows me a confident smile of the authors, who look at a cornered cancer and say: "Cancer, cancer, we are going to eat you updefeat you, of course you can resist, but when the numerator in this formula becomes larger than the denominator, and it's a matter of time and thousands of grants are allocated for this, you're dead".

Better colonoscopy can defeat colorectal cancer?

There are statements in several places that colorectal cancer is ~90% preventable:
1) "cancer can be cured in more than 90% of cases if precancerous polyps are detected and removed" https://www.miwendo.com/#problem
2) "About 90 percent of colorectal cancers and deaths are thought to be preventable" https://www.ucsfhealth.org/education/colorectal-cancer-prevention-and-screening
Importantly, among cancer deaths, colorectal cancer is the one that causes the most deaths (although if we look at men only, prostate cancer deaths are slightly more common): https://seer.cancer.gov/statfacts/html/common.html ("New cases, deaths and survival").

Is it really true? After a cursory acquaintance with the topic, I get the impression that regular colonoscopy almost completely solves the problem of colorectal cancer. You just need to identify and remove large polyps (adenomas) while they are still small (up to 5-10 mm) and have not developed into early cancer. "Adenomas progress in size from small (1–5 mm), to medium (6–9 mm), to large (>=10 mm). Some adenomas eventually become malignant, transforming into Stage I cancer. The cancer then progresses from Stage I to Stage IV <...> More than 1 adenoma can occur in an individual, and each adenoma can develop independently into CRC [colorectal cancer]". https://pubmed.ncbi.nlm.nih.gov/16933324/

The problem is:
1) Colonoscopy so far does not notice all the growths/polips, especially the smaller ones. Old 2006y paper https://pubmed.ncbi.nlm.nih.gov/16933324/ tells that colonoscopy notices large (>=10mm) adenomas in 95% of cases, medium (6-9mm) in 85%, small (<=5mm) in 80%.
"Still 22% of polyps are missed" https://www.miwendo.com/#problem

Good to notice that colonoscopy is only done in the rectum and colon. The diameter of the colon is 3-8cm[2]. They don't stick the endoscope in the small intestine, and there's no need to, because 27 times less deaths from small intestine cancer: https://seer.cancer.gov/statfacts/html/common.html ("New cases, deaths and survival").
Also, colonoscopy is very inexpensive procedure which might be done even without anesthesia. Complications or mechanical tears are rare. Anyway the most of this procedure invasiveness comes from adenomas resection which saves lifes.

So the startup https://www.miwendo.com/#problem is very cool, they want to improve the quality of the endoscope for colonoscopy. So it can see in the microwave spectrum. Here's Nature talking about it: https://www.nature.com/articles/d41586-020-01802-x Nature also estimates that the market for colonoscopy devices will grow to $2.4 billion by 2025, and describes some other approaches to improving colonoscopy.

We should also mention deep learning, with many good articles on automatic detection of polyps on colonoscopy https://paperswithcode.com/search?q_meta=&q_type=&q=colonoscopy