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Comment by mistrial9 | Hacker News Reader

> we could consider engineering humans to be cancer free

following until you get to that.. there are multiple mechanisms in the body that can result in "cancer" .. its an end result, not the cause. The jump to "we can engineer this out" is exactly what a reader would expect from an investment-and-profit medical company.

There are untold numbers of small poisons and behavioral habits that are known to increase cancer inducement in humans.. all of which could be addressed, but there is little profit in prevention.

Overall, I am taking the time to write this because a rush to genetic engineering is something that might behave like cancer itself over time.

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>> a rush to genetic engineering is something that might behave like cancer itself over time.

Can you elaborate on this? To me, it seems perfectly reasonable that a directed and intentional process of man-made engineering could blow the random process of evolution out of the water, both in timescale and in effectiveness. For example, there's not really an evolutionary advantage to eliminating geriatric cancer: kids have been made, genes have been passed, in all likelihood multiple generations down by the time old-age related illnesses develop. Yet, we want to live longer, and live better lives during that time, so we can take the reigns and address what evolution couldn't.

What's the quote, "in their speed to find a solution, they never slowed down to think if they should"?

There are plenty of examples of humans rushing to market something they think works one way but upon a much longer study, the results are something much worse than if we had not instead. Heavy use of asbestos, heavy use of lead in fuel, paint, etc.

Genetically modifying anything just sounds like the most obvious of things that should be studied for much much longer than whatever the first company looking to profit is wanting.

Agree, this is something that would take centuries probably. The most plausible way to do it would be including extra copies of TP53 under appropriate regulation. This has been done in mice and they seem fine. Unfortunately, it would need to be done in larger animals progressively to show safety, which would take 20 - 30 years for a full lifecourse study in primates (unfortunate because we are experimenting on primates). Even longer if their lifespan is increased.

After that, we would be left with a conundrum, which is the ethics of modifying the germline of an embryo. I don't know what the solution is there. Maybe it could be justified in families with an elevated risk of cancer, or Mars colonists for whom any sort of cancer will be a death sentence. Another option would be an as yet uninvented way to edit the genome, but provide an 'Undo' function to reverse the edit, say by giving some small molecule.

Frankly, no. People are dying right now. Like, everyone, of one thing or another. The situation is an emergency, even if all we've ever managed is ten millennia of triage. That is the default, that is the background. Weigh the risks, sure, but don't act like choosing to do nothing is without cost. We should study genetic engineering just as much as we need to, as best as we can tell, and no more.

Less morbid, there are many more substances we "rushed to market" and worked out fine. Should antibiotics still be unavailable, banned even, to complete longitudinal trials? Chemotherapy and radiation "sound like the most obvious of things that should be studied for much longer". Thank God that didn't prevent us from using them to save hundreds of thousands of lives. Hell, asbestos was used for way longer than any of that stuff, didn't make it any safer.

Frankly, no. Buildings are burning with people dying inside right now. The situation is an emergency, even if all we've ever managed is ten millennia of triage. That is the default, that is the background. Weigh the risks, sure, but don't act like choosing to do nothing is without cost. We should study asbestos just as much as we need to, as best as we can tell, and no more. In the meantime we need to fireproof all buildings with asbestos.

Edit: /s (If that wasn't obvious.)

We did weigh the risks. We did study asbestos. And we as a society made an informed decision that the risk of asbestos outweighed the risk of buildings catching on fire.

I don't understand the point you were trying to make here. Why shouldn't we invest effort to research a technology that might mitigate the 2nd leading cause of death in the developed world?

People are talking about prevention vs treatment of cancer, yet, asbestos was a cause of cancer, so by eliminating it, we eliminated a vector of cancer. That's preventative. We as humans, have become so "smart" with all of the things we can create that while not truly understanding the long term effects. We know we've screwed ourselves in the past (even fairly recently) with our cleverness, yet we continue to be surprised when it happens again.

Modifying the source code of humans is like the new hire thinking they can make the code so much faster because they don't know how the section code they are working on is used by the larger system as a whole. All they see is that there's an apparent bug in the section they are viewing now. Never mind the sections of code that have programmed workarounds for that specific bug, and will now break downstream because the buggy returns are no longer present. So how do we know if these kinds of workarounds in the human genome are also not present?

> Modifying the source code of humans is like the new hire thinking they can make the code so much faster because they don't know how the section code they are working on is used by the larger system as a whole. All they see is that there's an apparent bug in the section they are viewing now. Never mind the sections of code that have programmed workarounds for that specific bug, and will now break downstream because the buggy returns are no longer present. So how do we know if these kinds of workarounds in the human genome are also not present?

We know for a fact the current code base is full of bugs and convoluted workarounds due to the original coder having no idea what they were doing. While we may not yet know the best way to refactor the code, it undoubtedly needs to be refactored.

> There are plenty of examples of humans rushing to market something they think works one way but upon a much longer study, the results are something much worse than if we had not instead. Heavy use of asbestos, heavy use of lead in fuel, paint, etc.

All this just means is that progress of science and technology has some qualities similar to natural evolution: namely, there's a bit of trial and error. It's not, however, a condemnation - not unless you can propose a way humanity could do even better.

All the cases you listed is something we've developed, discovered problems with, overcome and mastered in scope of couple generations. Were natural evolution to guide humans through their interactions with lead and asbestos, we'd still be dying in pain from exposure a thousand years from now, because evolution takes time and doesn't care that you're conscious.

> What's the quote, "in their speed to find a solution, they never slowed down to think if they should"?

Sure, but it's neither here or there. If you saw someone running away from a lion, would you throw this line towards them? Perhaps they should slow down and consider if they're not better off being eaten?

I grant you that this is a seemingly extreme opinion. It is however my conclusion form thinking about this problem for a long time. I work inside this field, and see people suffering terribly from cancer every day, both physically and psychologically. I think we are overly focused on treating established disease, and not focused enough on preventing cancer. The end game, in my opinion, is making ourselves more resistant to cancer.

The most difficult version of this is modifying the germline. There could be other less extreme versions, for example giving young adults a long lived population of genetically modified immune cells that persist and eliminate pre-neoplastic or neoplastic disease. A more advanced version of this would be introducing a new type of cell lineage that exceeds the limitations of immune cells (for example specific modes of recognition, and restriction to certain anatomical compartments), and delivering it as a therapeutic. But modifying the germline is the only way to really get the incidence approaching zero, I think.

I hope however there is some easier, quicker way... for example if we discover unknown viruses actually cause a lot more cancer than we thought.

> I think we are overly focused on treating established disease, and not focused enough on preventing cancer.

You should see the warnings we put on cigarettes.

Warning Label: "May cause birth defects"

Bill Hicks: "I found my brand!"

In this case, not sure of the label's use in this conversation.

I think you're confusing the warning California requires on products with traces of lead on them with the warnings that are required in every state on cigarettes.

I think you may be confused on who Bill Hicks was.

Living healthily is very important, but unfortunately can only help to a certain extent. Humans just get cancer.

Screw this disease and screw nature; the misery it causes is just too much. There is a way to get rid of cancer, and the sooner this is achieved, the better. There are protocols to help proceed carefully and ethically.

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