by ayushkhaitan3437

I am attaching the receipt of my donation to Effective Altruism below:

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I also donated $50 for the treatment of students recently affected by violence in India, and $20 to Ben Wideman’s fundraiser on Facebook.

Moreover, like every other month, I donated $20 to ArXiv. That brings it to a total of $270, like every other month.

I recently read a book on cancer research, for which I wrote a review. I’m attaching it below:

Is cancer a disease that’s as old as human civilization, or is it a fairly recent affliction? Can mobile phones cause cancer? How exactly do cancer drugs work? Why are intuitive operating procedures like excising cancerous tumors largely unsuccessful in curing cancer? The author, Siddharth Mukherjee, answers all these questions and more in his page-turner, “The Emperor of All Maladies”. 

Cancer is not an external disease. It is written in our very genetic code. Whenever cells split in two, errors or mutations in genes almost always creep in. As cells keep dividing, the number of mutations slowly build up. Mutations may also be caused by external carcinogens like tar, radioactive materials, etc. Eventually, when we have mutations in certain genes (which are around 13 in number on average), the body is afflicted with cancer. If we find a way to stop these mutated genes from wreaking havoc, probably by “blocking” their protein pathways, we can cure cancer. Simple enough, right? 

No. This discovery was thousands of years in the making. The first written records of cancer that we have are from the Egyptian civilization. Imhotep, a famous Egyptian medical practitioner, wrote down a classification of medical afflictions. All such afflictions had cures written beside them. Breast cancer was the only one with “no known cure”. A famous Egyptian princess cured breast cancer by having her breasts removed. Galen, a well known doctor, thought that cancer is caused by the excess of “dark humours” in the blood, and that it can be cured by bleeding patients out. These explanations were characteristically misguided. But that was because people in the ancient times didn’t really understand biology, and modern practitioners would do much better, right? No. Modern practitioners caused their own modern havoc, which ended up taking the lives of perhaps hundreds of thousands of cancer patients. All because of misguided science. 

Around the turn of the 20th century, “radial masectomy” was suggested as the ultimate cure for breast cancer. Remove breast cancer by removing the breasts themselves. Later proponents of this school soon became even more deranged, and started removing large parts of the chest cavity from beneath the breasts. It sounded pretty convincing- if you excise the cancerous region, you’ve healed the patient! However, these patients, already disfigured for life, would almost always relapse. Despite this, radial masectomy was the modus operandi for treating cancer for more than 50 years. 

Another approach- poison the cancerous cells. This approach became known as chemotherapy. Pump in enough poison, in the form of X-rays, mustard gas, etc into the body, and you can kill the cancer cells. Simple. However, how will these poisons differentiate between cancer and regular cells? Doctors invented ad hoc mechanisms for avoiding killing regular cells- focus the X rays and poisons only on the cancer cells, insert external bone marrow into the patient after chemotherapy so that new healthy cells can be regenerated after the indiscriminate killing caused by chemotherapy, etc. However, although this technique still continues to the present day, on its own it has seen very little success. Coupled with a “cocktail” of other drugs, chemotherapy can be successful in patients whose cancers are not very advanced, but it reeks of being a “makeshift” cure instead of an actual, permanent one.

Physically remove cancer cells. Poison cancer cells. Patients still relapse and die. What are we missing? Is cancer a disease caused by viruses that can be cured by the right vaccine? Medical research has had a lot of success curing diseases caused by viruses. Think small pox, polio, etc. Hence, if cancer was virus-caused, we have a shot (pun intended). There was also lots of evidence of a cancer virus- a particular type of cancer cell always had a certain virus in it. Correlation is obviously causation. Any attempts to smother the virus theory of cancer were subverted by this simple example. Explain why this virus is always there. This stalled cancer research for decades. 

However, it was eventually discovered that viruses only carried the already mutated genes from inside the nucleus to the cytoplasm. These types of viruses are called retroviruses, and their discovery overturned medical “facts” that had been taught in medical schools for centuries. This discovery led us to understand that cancer had a genetic cause, and that we had to build molecules that could go bind to aberrant genes, rendering them ineffective. This is the current direction that cancer research has taken, and we’ve had lots of success with treating certain kinds of cancer. Other kinds of cancer are still, however, violently lethal. This hints at the fact that cancer is not one disease, but a variety of wildly varying diseases, although erroneously classified under one umbrella. 

One aspect of scientific research that was indeed revelatory for me was that in the 1950s, the American government pumped millions of dollars into cancer research, although we didn’t really have a fundamental understanding of the biology of the cancer cell. Scientific labs were expected to work like , with strict deadlines, accountability, fixed hours, etc. However, despite the money, resources and manpower allotted, most of this research was misguided. The truly useful insights were obtained by researchers working in isolation, outside of this “industry”, who were not necessarily trying to cure cancer, but just trying to discover cool facts about the human body. This throws shade on the Indian government’s scientific policy in recent years, which has reduced funding for all kinds of “useless” research, like Math and Physics, and pumped most of the available funding into things like medical research, development of weapons, etc. As history tells us again and again, most scientific achievements of mankind stem from the ability to do “directionless”, curiosity-driven research, and not research with a pre-defined agenda. Governments without an understanding of this are often in the way of scientific achievement. 

Mukherjee ends the book on a fairly sombre note. Although we’ve had a lot of success in defeating cancer, cancerous genes sometimes mutate, and the drugs that were being used to attack them become useless. This constant mutation and ability to survive comes from evolution- the thirst that organisms have to survive despite all kinds of odds. Hence, “we need to keep running to stay in the same place”, ie keep discovering new drugs to fight never ending battles with constantly mutating genes. The battle with cancer may never really be won. Our cures however may successfully prolong life, and that has to be thought of as a victory in itself. 

“The Emperor of Maladies” is much more than a “Biography of Cancer”. It explains, in full gory, disheartening and sometimes uplifting detail, why scientific research is hard, and why civilization has not been able to solve its most pressing problems for thousands of years. And how a focus on experimentation, instead of untested “intuitive” hypotheses, paved the way for substantial scientific achievement in the last century. It is a highly recommended book on science.