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Thoughts on Cancer

In Medical Musings on November 3, 2010 by David Tagged: , ,

I don’t know enough about cancer to understand its treatment, but I had an curious thought. Would appreciate any thoughts on why it wouldn’t work, how its currently done in current medicine, or just opinions/suggestions.

In my mind, it seems like cancer treatment is equivalent to the endgame in chess. There’s only a limited move set (only so many drugs that are available and efficacious), and there are only so many ways that the cancer can respond. Sometimes, the treatment forces the cancer’s hand, selecting for more resistant and virulent genotypes and quickly leading to either success or failure. My analogy to chess is that with only a limited number of moves (cancer is often determined at late stages), can we anticipate and plan the best course of action. In some ways, this is already done with frontline therapeutics used before secondary treatments. Clinical trials have been run testing the efficacy of using one drug first vs. using another drug first, but I have the following questions:

Are late stage cancers uniformly harder to treat and more lethal? I am reminded of my undergrad biology class, where we learned about dynamic equilibriums. In a population of different organisms, or cells in this exam, although we can imagine one group would theoretically “more fit” and overrun the entire ecosystem, there can be dynamic equilibriums where unique environmental pressures would allow each organism to create its own niche and allow for coexistence of multiple organisms.

Can there be a similar example in cancerous cells, where more invasive, metastatic cells are held in check by less invasive, but perhaps faster growing cells? If the less invasive cells are more susceptible to exogenous cancer treatments, the therapeutic can ultimately select for the more deleterious cell type and speed up cancer progression?

Is there any situation where delaying treatment can improve patient outcome?

Are there any ways to homogenize cancer cell populations prior to treatment?

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