Aiming too low.

I just read about that “Stand Up to Cancer” initiative in Time magazine and realized that, while it introduces some things that people should have been doing from the beginning, other aspects are essentially more of the same in another guise.

The “dream team” concept is ok, although this again brings up the issue of selection accuracy and the goals as well as the abilities of the people you’re selecting. Putting these people together is phenomenal and could produce some exciting collaborations.

Going for cancers such as GBM and pancreatic is also a great idea, as these have been neglected and currently have very poor survival rates. These forms of cancer are essentially death sentences today, and treatments that can raise survival rates are long overdue.

The problem is one of metrics. Everyone wants only the best scientists to work on their projects. But how are these scientists going to be selected? Publication counts? Approval of their peers? “h-index”?

Whatever it is, it won’t be directly on the strength of their ideas. This is a pity, because the existing methods don’t work on the cancers you’re targeting (and they don’t work too well in general). Even the notion of a survival rate is absurd. Do people speak about survival rates for influenza? For the cold? Even for the black plague these days? No – because these diseases are either innately harmless or have been rendered harmless. It is highly unusual for people to die of them. Cancer isn’t like that – it’s innately harmful, and only very few cancers have actually been rendered harmless by medicine.

That brings me to a bigger mistake – one that Stand Up to Cancer makes in the same way that existing research programs do. Research scientists don’t get funding unless they have results. SUtC scientists won’t get funding unless they have a treatment. You’re calling it something else, but the bottom line is: you want to see an immediate return on your investment.

Cancer is a big problem, like energy independence. There is no immediate return on the investment, and if you try to make one, you’ll end up with “publish or perish” in a new form – tons of simple incremental advances which do nothing to revolutionize the field.

And that is tied in with the third, and largest, problem with this endeavor: no one is speaking of a “cure”. You all want to “increase” survival rates, not to render the concept obsolete. If you can get the 5 year survival rate of pancreatic cancer up from 3% to 6%, you’ll call it a victory and tout how much progress you’re making.

True, the other 3% will appreciate it. It’s worth it. But it’s short of the goal you need to look for.

If anyone over the age of 8, even a world renowned oncologist, were to speak of “curing cancer”, you would laugh at him. The entire scientific community would laugh at him. He wouldn’t find funding. His research endeavors would be doomed from the start.

And the bottom line is this: you have set the bar too low because you are collectively afraid of failure. You ridicule anyone who attempts to make an audacious advance, because it’s far easier to tout a string of minor successes.

But in the end, it’s that major advance that’s required to do away with this disease. And you’ll never find it if you’re averse to the very idea that a cure could exist.

One might be right under your nose, and you’d miss it. Imagine if Fleming had discovered Penicillin and, instead of remarking on its properties, shouted “preposterous!” and dumped it in the trash. (And that brings up another point: Fleming was another of what I call “near misses”, because, were it not for Chain, his work may have never attained publicity).

So if you want earnest results, start making earnest attempts. Be committed. Be bold. Give it 100% and don’t accept anything short of 100% as an end goal.

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