Can we “cure” cancer?

Also: Guest post from CEO Heike Larson, Eli Dourado AMA

Feb 02, 2023

Should I change the format of this newsletter? Right now I do about one weekly digest that typically includes one longform post on progress, maybe an announcement or two, and a list of links at the end.

Would it be better to split this into two weekly posts? One would have the essay on progress, by itself; a second post each week would have announcements and links.

In this update:

This email digest is now on Substack. If you have a Substack yourself, and you enjoy my writing, I’d love a recommendation—thank you!

Eli Dourado AMA on the Progress Forum

Eli Dourado—whom you might know from his writing on geothermal, supersonic, energy superabundance, or NEPA—did an AMA (Ask Me Anything) on the Progress Forum this week.

Also check out our previous AMAs with Tyler Cowen and Patrick McKenzie.

Can we “cure” cancer?

In an excellent recent essay on “big visions for biology,” Sam Rodriques writes:

Ask most biologists about the cure for cancer, and they will tell you it doesn’t exist: cancer is many diseases that are mostly unrelated to each other, and that all have to be cured one at a time.

Are “most biologists” right about this?

We can get perspective on this from the history of infectious disease. After all, infection was also “many diseases,” with disparate causes (viruses, bacteria, protozoa) and disparate pathways (air, water, food, insects). And yet, while we did not exactly “cure infectious disease” (just ask the 248,544 people who got covid last week in the US alone), we did reduce every major metric of infectious disease by 90% to 99% in wealthy/developed countries:

Overall mortality from infectious disease reduced by 90% in the 20th century alone
Youth mortality (death before age 15) reduced from almost half to well under 1%
Maternal mortality reduced from almost 1% to under 0.01%
Surgical mortality reduced from half or more (for some major surgeries at least) to around 1% to 2%

Infectious disease was not the whole story in all of the above metrics, but it was the biggest factor in all of them.

*US crude mortality rates. Armstrong, Conn & Pinner 1999*

We also eradicated smallpox worldwide and eliminated diseases such as cholera, malaria, and polio from many countries:

Did we have to cure all these diseases “one at a time”? No, not exactly:

Sanitation and hygiene efforts were effective against broad classes of germs: e.g., water sanitation was effective against all water-borne diseases.
Disinfectants and antiseptics, such as bleach, are effective against most if not all germs.
Antibiotic drugs are effective against broad classes of bacteria.
Vaccines do have to be developed one disease at a time—but even here there are general techniques for creating them. In fact, with mRNA technology, we now have a very general technique that can create new vaccines with relatively little adaptation.

Underlying all of this is a theory that explains the basic causal mechanism of infection: the germ theory. The theory alone doesn’t give us everything we need to cure each specific disease: new research is needed to understand the etiology and epidemiology of each one. But the theory does give us a conceptual framework and a set of tools to guide that research. Before the theory, we were able to make limited progress against some diseases; after it, we made much more rapid progress, and the diseases we weren’t able to solve became the exception rather than the rule.

I think we are in the pre-theory stage for cancer. We are able to make progress against some forms of cancer, as we reduced lung cancer by public health efforts against smoking. But we don’t, to my knowledge, have the fundamental theory that we need, and so overall progress is slow. [UPDATE: a commenter with more expertise disputes this characterization, worth reading.]

Infection and cancer are both “many diseases”—but those diseases have something in common. A deeper understanding of cancer will allow us to make much more rapid progress, on more fronts. There won’t be a silver bullet—no single treatment that will cure all cancers. More likely there will be a few major techniques, as with infection we had to develop sanitation, vaccination, and antibiotics; and even within each of those categories, we needed many specific efforts to develop each individual vaccine, antibiotic drug, and sanitation method.

But there is no reason why we can’t do for cancer what we did for infection: reduce it by orders of magnitude and knock it down from a number one cause of death to a much more minor and more manageable threat. And eventually, with more advanced science and technology, perhaps we will be able to truly cure both of them.

Original post: https://rootsofprogress.org/cure-for-cancer

Guest post: Starting the journey

This is a guest post from Heike Larson, who just started full-time as CEO for The Roots of Progress.

My journey as CEO for The Roots of Progress starts this week—yet in a way, it started at least four decades ago. I grew up in West Germany, a country that after the Second World War saw massive progress, with living standards and opportunities similar to those in the US. Yet I also saw what happens when progress is missing: my family regularly visited our relatives in East Germany. After crossing the heavily fortified border (where our car was searched on the way in lest we smuggle in books with prohibited ideas) 10-year-old me experienced a bleak world. In the East, coal dust lay heavy in the air, my cousin stood in line for hours to get a bottle of ketchup, and our relatives waited 10 years (!) to get a rickety car made of plastic, without any modern safety features. I remember crying tears of relief after crossing the border in the other direction (our car searched again, this time to make sure we didn’t smuggle out any citizen of the East). How fortunate was I to live in the flourishing West, and to not be imprisoned in the stagnation of the East!

So when I saw the CEO role posted last summer, I reached out to Jason right away. With my experience growing up in divided Germany, this part of the post just rings so true: “The progress of the last few centuries—in science, technology, industry, and the economy—is one of the greatest achievements of humanity. But progress is not automatic or inevitable. We must understand its causes, so that we can keep it going, and even accelerate it.”

Progress isn’t automatic—and as a parent, I want my children, and all children, to grow up and live in a world where we continue and accelerate it. I want them to see that humans are problem solvers, that the challenges we face today can be solved just like ingenious humans, working together, solved the problems of the past. And more than that: I want us to inspire kids to become the next generation of problem solvers. At my last company, Mystery Science, our ultimate goal was to ensure that “the next generation of children grow up and see that it’s an amazing world we live in, full of possibility and wonder—and that they develop the ability to figure things out for themselves.” In a way, I see part of my mission here at ROP to provide these kids with more inspiration, by showing that progress is real and desirable.

Our multi-year goal at ROP is to build a thriving progress movement, working with many others who share similar goals. We’ll need to build a team, both at ROP and as a network of like-minded travelers taking on different parts of the movement’s efforts.

In my 25+ year career, I’ve been involved in building and growing organizations in diverse fields, from personal aviation to schools to ed tech. I love bringing together talented, can-do people and empowering them to do great work. I’ve learned how important it is to create a strong culture that supports the mission, and look forward to building that type of culture here. I also have seen how good operational systems can remove friction and make it possible to do high-impact work and have fun doing it.

Building ROP from an impactful blog to an organization that leverages the ideas of progress into a movement—one that not just tweaks things at the margin but changes the culture—is a great challenge. It’s work that requires both strategic thinking and detail-oriented execution. I’ve tackled similar challenges at previous roles and it’s exactly the type of challenge I love (and people I’ve worked with think I’m pretty good at it).

As Jason shared in his welcome email to me on my first day, we’re embarking on a huge journey together: we’re setting out to create a new philosophy of progress for the 21st century and to build a movement to establish it. It’s a huge quest, and I’m counting on fellow travelers to join us for mutual support.

Setting out on this journey this week, here’s what I see as our first initial steps:

Near term (next few weeks): I know I have a lot to learn! I’ve done a lot of reading in the last few months. I’d love to directly tap into the expertise of others now. I’m planning to go on a listening tour, to talk with people who are active in the progress movement and adjacent spaces (intellectuals, organizational leaders, foundations and donors with an interest in the space). I’m also eager to meet people who run related programs, especially programs that can help us shape our career accelerator for progress intellectuals (e.g., fellowship programs, grant programs, internships), even if these programs are in totally different fields. If you feel this describes you and you’re up for a call, email me.

Medium term (by summer): create and launch a v1 prototype of a career accelerator for progress intellectuals. This program will take the form of a limited-time fellowship for anyone who demonstrates strong writing talent and has an ambitious career goal in progress studies. The fellowship will help them take their careers to the next level by providing money, coaching, marketing and PR support, and connection to a network. Our vision is that in ten years, there are hundreds of progress intellectuals who are alums of our program and part of our network, and who are where they are in their careers thanks to our support. To figure out the details, I’m looking to talk with current and aspiring progress intellectuals. So if you fit that description and are up for a zoom chat, email me.

Once we have a more developed plan, we’ll of course be raising more funding to support this plan, provide the fellowships, and build the team. If you’re a potential (or current) donor, reach out and I’ll make sure to keep you posted.

My email is heike@rootsofprogress.org.

Over lunch on my first day, I read a blog post arguing that a key way to fight off doomerism is to show how humanity has solved problems before and the potential for doing so again: “We must learn to tell better stories about humanity. Celebrate humankind and all of our achievements, and share this with your children.”

A progress movement built around a core of solutionism, humanism, and agency will do just that. That’s the mission and work I dedicate myself to. As Jason concluded his welcome email to me: Let’s go make some progress!

Original post: https://rootsofprogress.org/heike-larson-intro