"We are on the verge of a revolution in medicine: understanding, treating, and ultimately preventing the causes of degenerative aging. But medical revolutions only happen if we all stand up in support of funding and research. We did it for cancer. We're doing it for Alzheimer's. We can do it for aging - and create an era of longer, healthier lives!"

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  • Sunday, January 21, 2007

    To What Degree Is a Robust Cancer Cure Sufficient?

    I've been discussing advances in cancer research a fair bit over the past couple of months. Cancer is a big, bad part of the aging process; a haywire form of uncontrolled biochemical rot in the gears of your body. It's waiting for all of us if we manage to engineer the medical technology to evade heart disease, neurodegeneration and all the other failure modes of age-damaged biochemistry that kill before cancer can.

    Here is a question for the floor: to what degree is a robust cancer cure sufficient for a future of ongoing, step by step healthy life extension leading to the defeat of death by aging?

    What do I mean here? By a robust cancer cure, I mean a foreseeable level of medical technology whereby cancer is neither fatal nor greatly expensive to deal with in the degree to which it occurs in the old today. It can be detected early, eliminated in any but the latest of stages, and doing so will not dramatically increase the patient's expenditures on healthcare. I envisage technology based on microarray scans of blood for the earliest signs of cancer, and targeted, highly efficient therapies capable of eliminating cancer cells without damaging healthy systems in the body - the widespread technology base of 2015 to 2025, give or take a few years, in other words.

    By "sufficient" I mean this: if ever more sophisticated refinements on the above themes are all we have to work with, would that be enough to stave off cancer for almost all people if other first generation rejuvenation technologies - in combination with general improvements across the board in medical technology - increased life span by two or three decades?

    We envisage healthy life spans to increase in steps; a old person taking advantage of each new step might beat the curve, a little rejuvenation at a time, to live into an age in which aging was truly defeated. The first step, consisting of first generation attempts at most of the repair technologies outlined in biomedical gerontologist Aubrey de Grey's Strategies for Engineered Negligible Senescence (SENS), might plausibly provide a couple of decades of additional healthy life. That would mean a couple of decades in which medical science can further advance and improve - and so on, a step at a time.

    The risk of cancer in any tissue increases with age - and as for most failing machines, quite dramatically so in later life. This stems from underlying changes in biochemistry and the simple rules that determine failure rates in machinery based on gradual wear in component parts - possibly the shortening of your telomeres, possibly damage to stem cells, possibly something else, possibly all of the above. Is it good enough to have a good after-the-fact cure on hand when the risk of occurance is increasing enormously with each passing year? Is there a point past which a good therapy is just overloaded by sheer weight of new cancer bursting from your cells, and where does that point occur?

    Ultimately, we would want to change our biochemistry so as to prevent cancer from occuring at all. Like all projects aiming to safely re-engineer a very complex system, this will be challenging indeed - but it will get easier with time. At what point will we need to have absolute cancer prevention in hand to beat the curve of aging, and thus remain alive and in good health to take advantage of the next anti-aging technology in line? At what point does a cure for cancer fail us?

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    Posted by: Mike Linksvayer at January 21, 2007 7:18 PM

    Does what you're asking amount to "how many years would eliminating cancer add to life expectancy?"

    I've seen fairly small numbers thrown around, but don't recall any sources. A quick search turned up http://www.sciencedaily.com/releases/2000/01/000104065154.htm which claims "If all major forms of heart and blood vessel disease were eliminated, U.S. life expectancy would rise by almost seven years"

    As cancer is the #2 cause of death after heart disease, my wild guess is that it would net aboout the same increase and both together, presumably significantly less than double that.

    Nothing to sniff at, but no guarantee of reaching AEV either.

    [Posted by: Mike Linksvayer at January 21, 2007 7:18 PM]

    Posted by: Brian Wang at January 22, 2007 10:58 AM

    It would be more significant if as the original article indicates we are combining cancer control with other forms of life extension. Some of those forms like triggering regeneration in humans the way they have in mice and chickens, increase the risk of cancer. This increased risk would not matter if we were confident in the control of cancer. We could use aggressive cell rejuvenation techniques and not worry about cancer.

    So the question of how good would the cancer control have to be ?
    I would think if it could be statistically calculated to cause at least less than 1% of the deaths that still occurred then it would probably not be the main problem and would be considered to be under control. So as death rate drops, the cancer control rate would need to continue to improve. I think that would be somewhat satisfactory control. Good control would be less than 0.1% of deaths that were still occurring.

    www.who.int/cancer/en/
    More than 11 million people are diagnosed with cancer every year. It is estimated that there will be 16 million new cases every year by 2020. Cancer causes 7 million deaths every year—or 12.5% of deaths worldwide.

    [Posted by: Brian Wang at January 22, 2007 10:58 AM]

    Posted by: Jim Thomason at January 22, 2007 2:25 PM

    It seems to me that many of the things that cause aging are essentially ways to limit the effects of cancer, at least for long enough for us to breed and raise children. If we can "cure" cancer, even to the somewhat limited extent envisioned in the initial post, would that then enable us to be more ambitious (for lack of a better word) in initial anti-aging strategies.

    I mean that there would seem to be avenues of research with the potential to significantly lengthen the aging process that might not be feasible because the increased cancer risks would outweigh the potential benefits. If we essentially eliminate those risks...

    [Posted by: Jim Thomason at January 22, 2007 2:25 PM]

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