Cure for Cancer = Cure for Aging

I want to start by considering three questions about the War on Cancer that Nixon launched 35 years ago: was it appropriately named, was it a success, and was it well-motivated at the time? You'll see why.

The term "War on Cancer" was a misnomer for a very simple reason: it was essentially imperceptible to most citizens of the nation waging it. The NCI budget hike from $181m in 1970 to $378m in 1972 may sound like a lot of money to you or me, and it doubled again by 1976, but that sort of public expenditure is imperceptible to the U.S. taxpayer.

A war is something that affects a nation profoundly--it's on the news every night, it dominates casual conversation. Above all, it draws a nation together with one common goal, the achievement of which ranks as more important even than that primary determinant of decision-making at all other times, personal wealth, such that people actively embrace tax raises to fund efforts to end the slaughter as soon as possible. The phrase "wartime mentality" exists for a reason: we are different people in wartime.

Cancer is still the #2 killer in the U.S., just as in 1971. You might think that means the War on Cancer was an abject failure. Certainly we've achieved only a fraction of the rate of progress that many senior (and influential) cancer specialists anticipated back then. But suppose we had achieved only half, or a quarter, as much progress as we have? That's where we might be today if Nixon hadn't authorized that new money. And if so, cancer would be the #1 killer in the U.S., having overtaken cardiovascular disease years ago. The war isn't won, but the battles that have been won have saved a lot of lives.

Mainstream expert opinion around 1971 was that cancer could essentially be cured within just five years. Scientifically, this resulted from a grossly oversimplistic understanding of what makes cancer so formidable. As we know well today, the high mutation rate of the trillion cells that make up a large tumor gives it the versatility to outwit pretty much everything that either the body's own defenses or the doctor's ingenuity can throw at it.

But was it time to try, given what we knew?

I claim it was. Not only because of the acceleration (albeit modest) in actual postponement of cancer that we've enjoyed in the decades since, but also because the research has given us a greater understanding of cancer and thereby brought genuine victory closer.

Each of these points is relevant to aging--what can be done about aging, whether we should try harder to do it, and how likely that effort would be to succeed.

The first mistake I want to correct is that aging can't be treated because it isn't a disease. That idea isn't even silly--it's embarrassingly silly.

Aging is a progressive change to the composition of the body, an accumulation of damage caused as a side effect of its day-to-day functioning that increasingly prejudices its ability to continue functioning.

Rusting is a progressive change to the composition of a car, an accumulation of damage caused as a side effect of its day-to-day functioning, that increasingly prejudices its ability to continue functioning. Get it?

An even sillier idea is that the body is not a machine like a car because it has its own self-repair capacity: a moment's thought reveals that that means there are things that would otherwise be aspects of aging (hence requiring repair) but are not because the body fixes them as they happen, so self-repair makes postponing aging easier than it would otherwise be.

Once we realize that combating aging is an engineering problem, no different in essence from maintaining a car, many things become clearer. First, it's actually wrong to focus single-mindedly on preempting the accumulation of damage: we should prevent what we can, sure, but we should also strive to repair damage that has already occurred. Repair is actually easier than prevention, mainly because prevention needs a detailed understanding of the processes by which the damage occurs (which we don't yet have), whereas repair doesn't need that knowledge, just as you don't need to understand the chemistry of rusting to maintain a car.

In fact, we may already know enough to be able to design a panel of therapies that would repair middle-aged bodies well enough to keep them biologically middle-aged or younger for at least a further 30 years. These therapies would be developed (and their efficacy demonstrated) in mice first, possibly within just ten years from now, and in humans possibly within only 15 further years. I know I might be wrong about these time frames--I might be oversimplifying, just as the cancer specialists in 1971 did--but I might not.

That brings me to my final point. Just how likely does success at a given venture, within a given time frame, have to be to justify trying? Clearly that depends on the benefits that would result from success. Rejuvenation therapies that add 30 healthy years to a middle-aged person's lifespan are not the end of the story, because 30 years is an eternity in technology: in that time, it's as good as certain that those therapies will have been improved in their comprehensiveness, enough to confer on those same people a further 50 or more healthy years ? and so on.

Just as vintage cars go on taking part in rallies for as long as their owners take the trouble to maintain them, so we will thereafter be able to maintain ourselves in a perpetually youthful state--mentally as well as physically--and therefore enjoy healthy lives many times longer than at present, ending only when we mistime the speed of that oncoming truck.

That's a pretty big benefit, and one worth fighting a war for, even if we think it'll only be in time for our kids and not for ourselves. More than that: just as the War on Cancer continues unabated (and with intense public support) today, despite the slowness of progress, so a war on aging, once started, will continue until it's won.

Once these therapies are proven in mice, there won't be any need to write articles like this one--humanity will launch a War on Aging as if there were no tomorrow, precisely because without that war there will indeed be no tomorrow for a lot of people whose lives such a war could save. (If you think there's a difference between doubling, or more, someone's potential healthy lifespan and saving their lives, think again--what is saving a life, other than extending it?)

The time for leadership is therefore now, when the situation is not so clear. It'll cost roughly $100m per year for the next ten years to get those mice--that's less than a week's spending on the war in Iraq--and if that money isn't found, it will probably take 20 years to get them. A decade's delay probably translates into at least five years' delay in the arrival of the human therapies, or about 200 million people who will die unnecessarily of aging.

Let's save those lives.

Aubrey de Grey is a biomedical gerontologist at the University of Cambridge, England. His research interests encompass the etiology of all the accumulating and eventually pathogenic molecular and cellular side-effects of metabolism ("damage") that constitute mammalian aging and the design of interventions to repair and/or obviate that damage.

Aubrey is the editor of "Rejuvenation Research", the world's only peer-reviewed journal focused on intervention in aging, and the founder of the well-known Three Hundred Club whose Methuselah Mouse Prize has gained great media attention.

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Posted 09-13-2005 2:26 PM by AubreydeGrey