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Comment by whalesalad | Hacker News Reader

I thought this was pretty obvious? "Cancer" is not a thing, its a billion different things that happen differently in every single patient.

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Thought I'd include the first line of the article:

> A Cancer Research UK-funded study, published in Cell Genomics, has revealed that prostate cancer, which affects one in eight men in their lifetime, includes two different subtypes termed evotypes.

In some cosmic sense, the number "one billion" and the number "two" are the same, I suppose.

While the parent commenter did exaggerate, they are correct in their idea. You could subclassify cancers all the way down to individual gene mutations, and even then there is heterogeny within the cancer itself.

Medicine tries to draw boundaries where different therapies help differently or where there is different pathophysiology going on. The article was able to draw one such additional boundary. Its relevance is yet to be confirmed with its phenotype or druggability.

I'd guess what they mean is there are two clusters with some clear distinguishing properties, and perhaps some resulting implications for treatment.

it's completely impressive how hackers here are multi-field specialists

I'm always amazed to see all these "well actually" comments on every single post, regardless of the topic :)

and in a year we'll have a new report: "foo bar genomics has revealed that prostate cancer includes 3 new evotypes"

it's all just mutations and there is no upper bound on the number of mutations that can exist

Yes, that's somewhat true, but in practice we have subtypes. As a counterfactual to that assertion, if it were meaningfully a billion different things, then we would need a billion highly precise treatments. Yet, we've managed to do decently with relatively few.

Yes but this is true of nearly every illness, and it’s true of natural phenomena in general, and it’s true of most problems in statistical classification.

But we still like to classify things, because it often has predictive power and informs treatment.

Ok, it’s “obvious”. Now find good drug targets. Yeah, you can’t before you quantify all the “obvious” things. The actual patient data and derived insights are precious.

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