HOW TO ANALYZE CANCER TREATMENT USING FIRST PRINCIPLES
Correcting Reductionism, Seeking a Cure for Cancer
In discussing cancer, our precise understanding is at the cellular level rather than the more microscopic molecular level. Contrarily, modern medicine's pursuit of complex fields like molecular biology or genetics often demands in-depth research. Unless a certain level of complexity is achieved, such studies may not gain peer recognition, even though they could significantly aid in addressing real-world medical issues.
The current landscape of cancer treatment and research faces the challenge of overly pursuing technical complexity at the expense of practicality. By reexamining the causes and progression of cancer through the lens of first principles, we can develop more concrete treatment strategies at the cellular level.
Analyzing cancer treatment using first principles allows us to break down the problem into basic facts and principles, and then build reasoning and solutions based on these foundations. This approach helps us break free from traditional thought patterns and experiential limitations, finding more innovative and effective treatment methods.
Of course, due to strict regulations in the medical field, innovative treatment methods not approved by regulatory bodies cannot be applied clinically. Cancer patients themselves also struggle to push for the approval of new treatments. However, we can still use first principles to select suitable and approved therapies that meet our treatment goals.
1. Identifying the Real Problem
Cancer is a disease marked by the uncontrolled growth and spread of malignant cells that invade and gradually destroy healthy tissues and organs, potentially leading to death. Thus, the essence of cancer treatment is to eliminate these malignant cells to stop their growth and spread, while also safeguarding healthy cells to prolong the patient's life with quality.
In the medical field, there is a viewpoint that truly curing cancer requires a deep understanding of its causes and main contributing factors. Proponents believe that understanding the origins of the disease not only helps in evaluating existing treatments but could also guide the development of more effective strategies.
However, when determining how to tackle cancer, we do not necessarily need a complete understanding of all the reasons behind its occurrence and its main triggers. Similar to car repairs, knowing the cause of a malfunction may not directly aid the repair process, as the methods are often straightforward and uniform, typically involving the replacement of damaged parts. The same logic applies to cancer treatment; our primary focus should not be on exploring why cells lose control over growth but rather on how to eliminate malignant cells to prevent their growth and spread, while protecting healthy cells to extend the patient’s life with quality. This approach is more direct and practical, potentially better suited for addressing the urgent and complex medical challenge of cancer.
2. Breaking Down the Real Problem
Identifying the real issue in cancer treatment is straightforward: we need the most effective methods to eliminate cancer cells while protecting healthy ones, ultimately extending the patient's quality of life. However, a deeper analysis of this issue requires a more comprehensive approach. We can start with the following basic elements:
Nature of Cancer: Cancer is a disease caused by abnormal cell growth, often rooted in mutations and uncontrolled growth of cellular genetic material.
Treatment Goals: The primary goal is to eliminate or inhibit the growth of abnormal cells to prevent the spread and recurrence of cancer, thereby extending the patient's quality of life.
Treatment Methods: Current methods include chemotherapy, radiation, surgery, and targeted therapy. Different strategies are employed depending on the type and stage of cancer.
We can break down the problem of cancer treatment into more specific questions:
1) How can we accurately identify and locate cancer cells for targeted treatment?
2) Can we develop new treatment methods that intervene based on specific characteristics of cancer cells?
3) How can we maximize treatment effectiveness while minimizing side effects and the risk of damaging healthy cells?
4) The ultimate goal of cancer treatment is to extend the patient's quality of life, not just to eliminate cancer cells. Are current treatment methods aligned with this goal?
Clearly, these questions center on how to effectively eliminate cancer cells and extend the patient's life with quality.
Numerous issues exist in current cancer treatments, both in the development of new therapies and in the clinical application of approved treatments. Firstly, most cancer therapies listed in treatment guidelines focus on the patient's short-term benefits. Secondly, the majority of cancer treatments, especially drug therapies, are related to genetic mutations and targets. Their effects are primarily at the molecular level below the cell, and they do not linearly correlate with effective cancer cell elimination, rendering them ineffective in many cases. Thirdly, new cancer therapies focus on complex and cutting-edge technologies, pushing simple and practical treatments out of the options for cancer care. Fourthly, guided by these guidelines, doctors tend to overtreat patients.
The root of these issues lies in the medical community's (including both researchers developing therapies and doctors administering treatments) misplacement of the basic components of cancer treatment, attempting to treat cancer by manipulating molecular-level variables. However, molecular-level therapies have led to many unpredictable phenomena. Breaking down the problem of cancer treatment to the cellular level is appropriate, but positioning the basic components at the genetic or even molecular level introduces complexities far greater than the problems it solves. The transmission of effects from genes to cells is not linear, and currently, humans cannot effectively regulate cell behavior by adjusting genes. Therefore, in addressing cancer treatment, we should focus on the fundamental components at the cellular level, including cancer cells, normal cells, and the immune system.
3. Analyzing the Fundamental Components
At this stage, we begin by posing the following questions:
1) What is the current level of cancer treatment? In reality, it is not very high.
2) Does relying on current medical research help develop better cancer treatment plans? In fact, this task is extremely challenging because reductionist thinking still prevails in the medical community.
3) In the existing healthcare system, do doctors always adopt the best interest of the patients? Not necessarily, it is largely a random process, and overtreatment is a significant issue.
4) In the existing treatment options, can cancer patients choose the plan that maximizes their long-term benefits? Due to a general lack of necessary scientific knowledge, patients are easily influenced by the healthcare system, and most mistakenly believe that the doctor's decision is optimal.
In the section on the current state of cancer treatment, we have identified two basic facts: First, the level of cancer treatment does not vary significantly between countries, and the outcomes in developed countries with advanced medical technology are not superior to those in developing countries. Second, the existing medical system tends to overtreat and does not prioritize the long-term interests of cancer patients.
The root cause of these facts is that the existing medical system does not address the real issues we identified earlier, or that the current cancer treatments are not the best solutions to the cancer problem.
From several typical first principles cases, we know that traditional solutions have not brought significant improvements over a long period. This is where the first principles become particularly important. They challenge conventional habits and views, break down problems, and start with the most basic elements, using fundamental laws to build a comprehensive analytical model. This is a deductive logic process that ensures the correctness and completeness of the analytical model. Ultimately, through this new analytical model, we can find the real answers to the problems. We find that existing cancer treatments have not brought significant improvements; therefore, we need to use the laws of disease to construct a comprehensive analytical model above the cellular level. Current technology allows humans to directly manipulate cells and accurately predict outcomes. By focusing on the cellular level as the fundamental component of cancer issues, we establish a solid foundation for the next steps. This approach is logically sound and reduces as much uncertainty as possible in the cancer treatment process.
4. Reassembling Information
At the cellular level, the characteristics of cancer cells include uncontrolled growth. For solid tumors, cancer cells cluster together, generate their own blood vessels to supply nutrients, and usurp the physical space of normal cells while evading the immune system's surveillance. There are many methods to eliminate cancer cells, but the most effective treatment is often the simplest. It is also necessary to consider the side effects of the treatment. With this information, we can be selective, choosing the existing cancer treatment method that most efficiently addresses our problems. Furthermore, we are not limited to one method; we might choose multiple therapies and combine them into a comprehensive treatment plan.
As a cancer patient reading this section of the book, you might use first principles to analyze the treatment plan your doctor has given you, or to explore other treatment options your doctor hasn't mentioned. However, applying first principles is not so straightforward; it requires more information for validation and understanding, enabling even those without extensive medical knowledge to navigate their cancer treatment journey using first principles.
Building an analytical model based on first principles is crucial. It uses self-evident laws and the most basic components to construct a framework for cancer treatment. In this book, I propose a life model that links cancer and aging, where part of the analysis will use the logical completeness of mathematics to address issues like treatment principles and resistance in cancer. This approach simplifies the complex problem of cancer treatment.
I believe that through mathematical models, we can construct a comprehensive framework for evaluating cancer treatments. While first principles themselves are a way of thinking and do not directly lead to advances in cancer treatment technology, we can use the comprehensive evaluation framework built on first principles to guide patients in choosing the best treatment options that are truly beneficial for them. Researchers can also use this framework to develop innovative cancer treatments.