I am from Gloucestershire myself and I never realised that DanBC was from my manor. I could have walked past him in the High Street to never know that he was the owner of a HN handle I recognised and read.
May Dan rest in peace, and in Gloucestershire. There are worse places to spend an indefinite period of time.
There are always people that stop posting on this site and I wonder where they’ve gone. Found a better place to spend their time, perhaps? At least, that’s what I hope for them. I am sure the same is for Dan :( I wish the best to those who knew him well.
The number of people who would cry at my death is ~13 (immediate family including in-laws). Within that, the number of people who would be deeply affected is 5 (kids, spouse, parents). Aside from them, the number of people who would think "wow, weird" on hearing of my death is maybe a couple dozen, and the number within that who would think of me for >20 seconds more than a year from my death is probably less than half dozen.
It doesn't bother me that these numbers are "small."
We have limited familial / personal attention and care to give to others. Either you could spread it thin by becoming a big leader but no personal depth among fans. Or you could increase depth among very few near and dear.
I've thought about that myself, and came to the conclusion that in my case the answer will most likely be no. I can't say I'd be too disappointed though, being missed by a handful of friends and family would already signal a life well lived.
I will miss Dan's comments, and this community was better for his participation.
I'm sure it brings Alexander the Great a lot of comfort knowing he is remembered. I say, enjoy life without optimizing for what happens after you're dead.
Though a little cold, you are correct. "fear is the mind killer", and fear of death or not being remembered is ultimately not a positive thing to hold on to whilst being alive.
With respect to DanBC, whom I did not have the pleasure of knowing very well, I am happy for him that he seems to be celebrated and loved widely - a clear sign of a good person (regardless of how valuable that ultimately might or might not be in the minds of outside observers like myself) who had a positive impact of those he touched throughout his life.
I wish all people who knew him all the best in processing this surely tough to swallow pill. Despite someone having a long-term illness, if you care a lot for someone, it is always seemingly unexpected for it to end. Dealing with a passing of a friend is always difficult, and I hope anyone who misses him, has people to share with good memories of him to process and deal with this in a good way.
May the joyful and kind memories of him serve as pillars of support for those who miss him, to move on and keep him in their hearts.
I can only speak for myself of course, but arguments can be great. Some of the best discussions of my life have been on hn with people who are open-minded, curious, and respectful. In my opinion, this is a great reminder to be those things.
To be clear, I'm not implying that you weren't those things, just making a personal observation.
Honestly shocked (bamboozled) that he wasn't living in SV and a former Yahoo senior eng or whatever by how he wrote. Some people just have strong opinions I suppose. Welp RIP.
Was this a well-corroborated and fact-based opinion, or was it off-the-cuff and handwavey? Podcast answers aren't always totally reliable.
But you mention "the average person," which is really the crux of the matter. Cancer strikes perfectly average people, oftentimes in their 30s or 40s, and hands down death sentences at random. A bad roll of the dice. A stray cosmic ray hit a dividing cell. Who knows? That is what is scary.
Eliminating cancer may perhaps only increase the average lifespan by three years -- though I have my doubts -- but what's much more important is that it would cut down tremendously the number of premature and random-seeming deaths in the prime of life.
The thing is that we are led to believe that cancer just strikes at random, and anecdotally we know of someone that never smoked to get lung cancer that spread everywhere to strike them dead.
Yet we also know it is not quite like that. If you smoke, drink, make sculptures out of asbestos dust, eat processed meats, shoot depleted uranium rounds down at the range and work with radium in a gun sight factory then you probably have stacked the odds.
Now imagine you have an identical twin, maybe not cojoined, but living with the exact same stacked odds. However, you eat a strict diet of highly processed foods and only play tiddlywinks for physical activity. Meanwhile, your twin rides eats a strict diet that is mostly whole food, plant based and gets a lot of physical activity due to a passion for dancing.
One of you is going to be likely to suffer a cardiovascular event before the other and that same person is going to run the risk of catching cancer first.
Now we all know that eating processed foods, maybe with the exception of processed meat, isn't going to 'give you cancer' and neither is playing tiddlywinks. Equally, a few extra antioxidants and a bit of fibre from eating a few more carrots isn't going to spare you from cancer, neither is dancing for that matter. Nonetheless, cardiovascular and gut health is important for reducing cancer risks.
I say this with anecdotal evidence provided by a car dependent relative that chose not to eat a fibre rich diet and now has cancers that I would not wish on anyone, with his digestive tract having to be trimmed from the far end due to cancer.
Because he took the medical route with meaty pies and moderate alcohol levels, his life might only be cut short by three years. However, by then, there will be two decades of extreme medical interventions and a smorgasbord of medications that have to be taken daily. Lifespan is not as important as healthspan and there is much we can do through diet and physical activity to maximise healthspan.
The trouble with my relative is that advice to go absolutely teetotal, stay off the processed meats and to eat fibre (as in vegetables) was not a message that was well received. This advice is in line with WHO recommendations but this can be simply ignored once lifestyle choices have been decided on.
This is getting scarily close to “most people who get cancer only have themselves to blame” which can be a comforting thought if you’re putting in a lot of effort to reduce your own risk of cancer but at the end of the day it’s not true and kind of a shitty thing to say when we’re commemorating someone who fell victim to this horrible disease.
Reduce the odds it’ll get you too as much as you want, you’re wise to do so, but keep in mind it can still get you too and it is never somebody’s own fault.
More importantly, you can (almost) never say that if a cancer patient had done this and that or not done such and so they wouldn’t have gotten sick. You just can’t know and even if you did it’d still be a shit thing to say.
Even if you're correct and cancer is not completely random but rather has clear causative factors, a lot of those factors -- perhaps the majority -- are uncontrollable.
Radon exposure. Naturally occurring radioactive isotopes or beryllium in your vegetables or water. That virus you fought off a few years ago. That course of cyclosporine you once took. That cosmic ray from the Andromeda galaxy that happened to hit you and scramble some DNA. Many, many other factors. Cancer strikes in ways that seem truly random because many or most of its causative factors have absolutely nothing to do with lifestyle choices.
Exactly. There are definitely people who lead higher risk lives by having exposure to carcinogens, but even that has some randomness to it. I had a family friend that smoked like a chimney his entire life, and died in his late '80s with tar-filled but cancer-free lungs. Another was an x-ray tech in the earlier days before they took nearly as many precautions as they do now to protect the technicians. No cancer.
Contrast this with some aunts and uncles who lived relatively clean lives, and still ended up dying of different cancers. Sure, I don't doubt there is a cause if we dig deep into it, but there's still some randomness.
I hear what you are saying, however, the vast majority of toxins that enter our bodies come through our mouths and out of choice. Some of these toxins, such as alcohol, cigarettes or processed meats are known to be carcinogens.
There is a very different level of dosage involved, that one cosmic ray from outer space that one time is vastly outnumbered by the trillions upon trillions of atoms that could be carcinogenic that come through the mouth, typically on a daily basis, for decades.
The body is pretty good at taking out the trash, including the mutant cells that did not reproduce properly. This goes on all the time. One cosmic ray from outer space might scramble some DNA but your body can deal with that as an isolated incident, the mutated cell(s) just get taken out with the trash.
If you overwhelm this system with too much garbage for the body to deal with then that is a causative factor that was not controlled.
It is helpful to see things this way because it enables a sense of perspective. It is not going to be 'forever chemicals', 'insecticides' or anything like that, you need to worry about. What goes in the mouth rather is what counts rather than these theoretical other things.
This means taking seriously what research in cancer, diabetes and other disease has to say. For cancer there is clear advice on what to avoid, same with diabetes and much else nobody would wish on anyone. It is defeatist to be in denial about this to assume that random cosmic rays play as much a part as the garbage we willingly consume when it comes down to it.
Eh, it's still a numbers game. Changing your chances of contracting terminal cancer in the next 5 years from 1% to 0.5% is still significant.
In this case, the specific percentages are all the significance. When a lot of the factors are controllable and a lot of them are uncontrollable, the most reasonable question is "How much do the controllable factors actually change the odds?"
> Changing your chances of contracting terminal cancer in the next 5 years from 1% to 0.5% is still significant.
Short of quitting smoking, there's almost no way to do that, because you don't know what the factors are or how they're weighed & influenced by individual genetic, immune, and metabolic factors.
> "How much do the controllable factors actually change the odds?"
Not only does nobody know, nobody has the foggiest notion. I've never seen a relevant population-wide observational study that wasn't so full of methodological flaws that you could spend hours picking apart its defects.
Of course we know that there's a set of factors associated with the development of cancer -- like, e.g., long-term exposure to polonium in drinking water -- but there's also a large set of factors that nobody is aware of or which can never be controlled for. To use only the first set -- the set of what we know and can control for -- to accurately estimate the odds of contracting cancer within the next five years is impossible.
Maybe looking at the average is the wrong thing to do. People who die from cancer can be robbed of a lot of years. A couple of other recent cancer deaths I saw on HN:
I find those estimates believable in a narrow interpretation of the question - i.e. if we solve cancer but change nothing else. I would expect a longevity M.D. to understand the spirit of the question and answer accordingly, though. I'm curious which podcast / doc this was?
It's true that solving cancer, heart disease, and even all other similarly deadly diseases, would not automatically mean humans living indefinitely, because there's still cellular senescence to contend with.
Fortunately, we've effectively solved senescence (or at least it seems we're well on our way). Check out the picture of the twin mice from David Sinclair's lab (https://sinclair.hms.harvard.edu/research) - it's hard to believe the two mice were born at the same time...
And if I recall correctly, they didn't even do any sort of telomere modification in that study either... Don't quote me on that. But telomeres are another potent avenue towards >10x extension of life span, and also as it turns out, fairly trivial to lengthen and thereby allow a cell to continue mitosis indefinitely.
The problem to solve is cancer, though. Telomeres limit the number of times a cell can divide by design, and seemingly the purpose of limiting division in the first place is to mitigate risk of developing cancers.
This sounds surprisingly short. Surely the average person with cancer isnt going to live just three additional years?
Went and did a brief lookup (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710558/) - life expectancy is reduced by at least 3 years, even for the oldest patients, and increases significantly as age at diagnosis goes down.
I suppose from the perspective of an 80 year old, curing cancer would in theory increase life expectancies by ~ 3 years, though I wonder how many people die of "old age" but have an undiagnosed cancer of some form contributing.
It's because of the Gompertz mortality law [1]--the probability of dying at a certain age is exponential. If you assume that the mortality of each age-related terminal illness itself follows the Gompertz law, then eliminating any one of those illnesses won't affect the overall life expectancy much, because exponential growth is so powerful. Even if we had cures for all age-related diseases except, say, Alzheimer's disease, the fact that Alzheimer's disease mortality also follows the Gompertz law (probably a reasonable assumption) would lead to lifespans not dissimilar from our present ones.
Essentially, in order to achieve dramatically longer lifespans, we would need to eliminate, or at least significantly slow, all aging-related causes of death.
Lost quality-adjusted life years would be a better measure. Many people survive for many years with cancer, but the quality of life drops significantly.
Most people don't have cancer, so the average lifespan reduction of everyone is going to be quite a bit lower than the average lifespan reduction of people diagnosed with cancer.
My total guess(!) is because relatively few people lose a large number of years to cancer, due to both the median age of diagnosis and long term survival rates of some common cancers being high? (For example, breast cancer has a 75% 10 year survival rate with a median age of diagnosis of 62. Bowel cancer is about 60% and 71 respectively.)
The problem of controlled cellular growth in a multicellular organism is a really hard problem that evolution has spent billions of generations on, and any cell in any of the dozens of systems that keeps the human body going can potentially escape the normal cell cycle control process and go out of control, leading to cancer. (edit: the fact that so many people lead full lives without coming down with cancer is more remarkable from this view, it's one of the miracles of life).
While the ability to treat cancer using modern technology (especially if it is detected relatively early) has made vast advances, we're also surrounded by and exposed to a wide variety of molecules that can, especially in high concentrations, inflict damage on the cellular control system (a whole lot of proteins, nucleic acids, lipids, cofactors, etc.) and while that damage may be somewhat random in nature, if it happens to hit a key sequence in the cell control DNA you get a cancer cell. You can greatly reduce the prevalance of such carcinogenic mutagens in the food, air, water and soil with suitable regulations but this cuts into profit margins for the producers of various commodities and products who in turn lobby governments to eliminate said regulations (which to be fair may not have been well-designed or implemented).
Yes there are genetic factors which may increase one's cancer risk but these are very complicated and often overemphasized by those who dont't want to see clean air, water, soil, food etc. regulations implemented.
> ...a really hard problem that evolution has spent billions of generations on...
I think it's worth noting that this isn't evolution's "goal". We just need to produce offspring and give them a good start in life such that they are competitively successful. Beyond that, evolution doesn't care.
Even for that, there's a budget. If it's not economical over letting us die and not taking valuable resources from our offspring, then evolution also doesn't care.
That could suggest why longevity in humans (or primates ) was under active selection, as they put a lot of effort into raising the children so you'd expect that cancer in younger people would result in the death of their children, so evolution selects for robust anti-cancer systems (like the human immune system, which is relatively good at detecting and eliminating cancer cells as well as pathogenic bacteria, etc.).
These explanations are however always a bit hand-wavy, eg why do galapagos tortoises live to 150 when they don't seem to do much parental investment?
Yes, a few types are basically a numbers game. We're continuously successfully not getting them every day. But the longer we live and not die of other things, the higher chance there is of losing that game. And we're actually getting quite good and not dying of other things.
Then again, cancer treatments and vaccines are progressing recently, so that's good news.
This sounds good, but it can't be right. There are animals that live centuries. Greenland sharks may live up to 500 years, for example. There are trees that live millenia.
But they aren't human. We don't survive being dessicated and heavily irradiated like a tardigrade or regrow severed limbs like starfish, and we aren't as good at avoiding cancer as some other animals.
not just higher cancer rates, but higher rates of all kinds of aging-related deaths
the advantage of being warm-blooded is that your metabolism is more precise and much faster, but, as james dean quoted willard motley saying, 'live fast, die young'
(being old is a more important risk factor for cancer than anything else i can think of, even smoking and radioactive fallout)
small sharks around greenland, to take an extreme example, are at essentially the temperature of the seawater, about -1.8°. larger sharks could conceivably raise their internal body temperature, but greenland sharks swim very slowly to avoid this even when they are large. so their metabolism is about 16× slower than yours is—both healing and aging processes happen slower. their gestational period is about 8–18 years
Thank you. This is the kind of thing I was looking for. After posting, I also found out that plants are even further in the other direction because their strong cell walls prevent metasticization.
I don't think prolonging the life in a biological body is going to be the winning route. We will have to Star Trek it up and transfer our consciousness to computers. That, or replace parts, maybe even the entirety of our bodies with a machine that can be maintained and repaired rather than age.
You become a lot more aware of it as you get older, and what you see to some degree depends a lot on your socioeconomic status. A big part of it is that we've made so much progress when it comes to heart disease. Most people who go to my hospital are on public insurance, and they're dying more frequently from lifestyle-related diseases (like T2DM which leads to hypertension, chronic kidney disease, and congestive heart failure)
Cancer (outside behavior related cancer like lung cancer) is on the rise.
In spite of better treatments, a twenty year old today is more likely from cancer while in their twenties than at any time before. Each younger age cohort has an increase risk of cancer, and at younger ages.
Cancer deaths overall are still going down though, as the smoking generation still alive goes out.
probably because it's the first, second, or third leading cause of death in every country, depending on how you slice it up, killing about a quarter of everyone
I have two people in my direct circle get and have stage4 lymphoma and adult leukemia this year at the time of their initial diagnosis. Does seem like it is on the rise from my perspective.
TL;DR: Because today, people are regularly living long enough to get it. It's often a good sign to have higher cancer rates -- societies with higher cancer rates are richer, happier, and live longer than those with lower cancer rates.
I mean, cancer is bad. But it's a good sign for society if lots of people die of cancer -- they tend to hit the elderly. Historically, about 80 percent of people who die of cancer are over 50, and that's fairly constant. (Interestingly, the share of cancer deaths that are in people over 70 have been rising, from about 36 percent to 49 percent - that's as a portion of the total.)[1]
The ranking for prevalence of cancer is higher income countries, upper-middle-income countries, lower-middle-income countries, and finally with the lowest rates low-income countries. Since the world is getting richer, it stands to reason that it's likely there will be higher cancer rates (of course, it's not guaranteed; it's possible being European makes you more likely to get cancer, which would explain the higher rankings of high-income countries, which are often European, but not lead to higher numbers elsewhere).[2]
This is borne out individually. Countries with the lowest rates of cancer tend not to be great places to live. Our World In Data has three countries[2] tied for the lowest cancer rates (0.1 percent), Niger, Chad and Benin, which have life expectancies of 62, 53, and 60[3][4] and had happiness scores (self-reported life satisfaction) of 4.56, 4.47, and 4.38 (out of 10; for reference, the world average is 5.27, with numbers for individual countries ranging from 7.74 to 1.72) respectively.[5] The full list of countries with a prevalence of cancer below 0.5 percent is as follows:
Niger, Chad, Benin, Gambia, Somalia, Sierra Leone, Mali, Yemen, Democratic Republic of the Congo, Central African Republic, Cote d'Ivoire, Burkina Faso, Burundi, Liberia, Angola, Guinea, Cameroon Guinea-Bissau, Nigeria, East Timor, Tajikistan, Mozambique, Senegal, Togo, Papua New Guinea, Afghanistan, Ethiopia, Madagascar, Oman, Sudan, Nepal, Kenya, Mauritania, Maldives, Bhutan, South Sudan, Ghana, Vanuatu, Equatorial Guinea, Bangladesh, Tanzania, Solomon Islands, Sao Tome and Principe, Eritrea, Malawi, Rwanda, Laos, India, Uganda, Pakistan, Uzbekistan, Djibouti, Congo, Botswana, Zambia, Kiribati, Lesotho, Algeria, Gabon, Mongolia, Eswatini, Morocco, Comoros, Honduras, Haiti, Samoa, Zimbabwe, Guatemala, Turkmenistan, Myanmar, Kyrgyzstan, Marshall Islands, Namibia, Philippines, Egypt, Cambodia, Indonesia[2]
The happiest of those is Guatemala, at 6.29, and a prevalence of 0.4 percent. But most of them are much less happy. To take a random example (I used random.org to randomize the list and chose the top one and the top six, excluding Sao Tome which had no happiness data), Uganda is at 4.37, and the average of Uganda, Comoros, Turkmenistan, Yemen, and Bhutan is 4.41, nearly a point below the world average.
Life expectancy is no better; again doing Uganda, Comoros, Turkmenistan, Yemen, and Bhutan, Uganda had a life expectancy of 62.7 years, and the average of them is 66.2, almost 5 years below the world average of 71 (range of typical life expectancy is from 85.9 to 52.5).
Okay, so life expectancy and happiness are both lower for countries with lower rates of cancer, seemingly. What about those with higher rates?
Well, those with cancer rates up to or including 3 percent are as follows: Monaco, Bermuda, Italy, France, Netherlands, Finland, Germany, United States, Australia, New Zealand, Japan, Denmark, Portugal, Greece, Croatia, Spain, Estonia, Canada, Norway, Andorra, United Kingdom, Slovenia, Belgium, Iceland, Switzerland. Monaco comes in at the top, with 5.9 percent with some type of cancer.
Monaco has a life expectancy of 85.9 years, the highest. In the world. There was no happiness data available for it or the runner-up Bermuda, but Italy ranked itself at 6.32.
Of the top five countries in life expectancy that show up on the cancer list at all (Monaco, not Hong Kong or Macao, Japan, Australia, Switzerland, Malta), all of them but Malta show up on the list, and Malta just misses the cutoff (2.9 percent). In happiness (Finland, Denmark, Iceland, Sweden, Israel), Sweden and Israel aren't ranked. Sweden just misses the cutoff at 2.9 and Israel is at 1.6 percent but has a notably much younger population than any of the others.
Again using random.org and taking the top one and then the follow-up four, Monaco came in at number one (data already covered and missing happiness, so excluded), followed by the US, Switzerland, Iceland, Australia, and Italy. The US has a life expectancy of 77.2 years. The average for the five is 82.26, so if it were a country it would be number 21 globally and over TEN YEARS above the world average of 71, above even the Oceanian average (the highest) of 79.4; for happiness, the US is number 18 worldwide excluding ties, ranking itself at 6.72; the average is 6.938, meaning if it were a country it would come in number fourteen including ties and almost two points above the world average of 5.08.
RIP. I note that he had a Twitter thread a month ago where he shared some broad observations about healthcare and ended it with a goodbye: https://x.com/DanBealeCocks/status/1819712155941228853
I'll miss his commentary here, and I'm glad to hear he is celebrated among those who knew him.
May flights of angels sing him to his rest.
I am from Gloucestershire myself and I never realised that DanBC was from my manor. I could have walked past him in the High Street to never know that he was the owner of a HN handle I recognised and read.
May Dan rest in peace, and in Gloucestershire. There are worse places to spend an indefinite period of time.
I'm in Gloucester as well and had no idea.
There are always people that stop posting on this site and I wonder where they’ve gone. Found a better place to spend their time, perhaps? At least, that’s what I hope for them. I am sure the same is for Dan :( I wish the best to those who knew him well.
Makes you wonder whether anyone outside of your immediate friends and family will miss you.
RIP Dan.
The number of people who would cry at my death is ~13 (immediate family including in-laws). Within that, the number of people who would be deeply affected is 5 (kids, spouse, parents). Aside from them, the number of people who would think "wow, weird" on hearing of my death is maybe a couple dozen, and the number within that who would think of me for >20 seconds more than a year from my death is probably less than half dozen.
It doesn't bother me that these numbers are "small."
We have limited familial / personal attention and care to give to others. Either you could spread it thin by becoming a big leader but no personal depth among fans. Or you could increase depth among very few near and dear.
Not everyone reaches that limit.
I've thought about that myself, and came to the conclusion that in my case the answer will most likely be no. I can't say I'd be too disappointed though, being missed by a handful of friends and family would already signal a life well lived.
I will miss Dan's comments, and this community was better for his participation.
I'm sure it brings Alexander the Great a lot of comfort knowing he is remembered. I say, enjoy life without optimizing for what happens after you're dead.
Though a little cold, you are correct. "fear is the mind killer", and fear of death or not being remembered is ultimately not a positive thing to hold on to whilst being alive.
With respect to DanBC, whom I did not have the pleasure of knowing very well, I am happy for him that he seems to be celebrated and loved widely - a clear sign of a good person (regardless of how valuable that ultimately might or might not be in the minds of outside observers like myself) who had a positive impact of those he touched throughout his life.
I wish all people who knew him all the best in processing this surely tough to swallow pill. Despite someone having a long-term illness, if you care a lot for someone, it is always seemingly unexpected for it to end. Dealing with a passing of a friend is always difficult, and I hope anyone who misses him, has people to share with good memories of him to process and deal with this in a good way.
May the joyful and kind memories of him serve as pillars of support for those who miss him, to move on and keep him in their hearts.
RIP Dan. Thanks for your contributions to HN and mental health communities.
that's too bad.
I enjoyed his commentary, even if often it seemed that he didn't enjoy mine -- I'll miss the perspectives.
Dan’s sister here. Came to see what people were saying. Thank you to those who shared true feelings, memories and condolences.
To those of you who took the discussion in your self-serving tangential rants, wow! “Know your audience” might be advice you could take to heart.
More links:
https://q.health.org.uk/community/directory/dan-beale-cocks/ https://www.instagram.com/dan.bealecocks/ https://www.threads.net/@dan.bealecocks https://mastodon.social/@DanBC https://www.youtube.com/@danbealecocks4344 https://www.pinterest.co.uk/danbc/ https://www.quora.com/profile/Dan-Beale-Cocks https://soundcloud.com/dan-beale-cocks https://en.wikipedia.org/wiki/User:DanBealeCocks https://spoutible.com/DanBC https://tildes.net/user/DanBC
Terrible news. If it’s important to you, reminder to let someone know to let HN know if you pass away.
I'm so sorry to hear about this.
Rest in peace, Dan. Like many other, more important ones, this place too will feel different, lesser, knowing you aren't around anymore.
To some extent, a person continues to live in his affairs, intellectual work and the memory of people.
His last post here “ Be interesting to see if climbers like it - I'd love to see Wide Boys testing it out.”
Makes you think what your last will be.
Whatever it is it’ll live on in some legacy database till bit rot finally takes it.
Oh no. Man I had so many arguments with this guy. I didn’t know he was dying.
I can only speak for myself of course, but arguments can be great. Some of the best discussions of my life have been on hn with people who are open-minded, curious, and respectful. In my opinion, this is a great reminder to be those things.
To be clear, I'm not implying that you weren't those things, just making a personal observation.
Rest in peace Dan.
Also Tildes, I believe: https://tildes.net/user/DanBC
RIP.
Tildes has a remembrance post for Dan: https://tildes.net/~talk/1iv0/remembering_danbc
Honestly shocked (bamboozled) that he wasn't living in SV and a former Yahoo senior eng or whatever by how he wrote. Some people just have strong opinions I suppose. Welp RIP.
I hate and fear cancer so much.
Why does it seem like so many are dying of cancer :(
On some podcast a longevity doctor asked the host to estimate how much longer the average person would live if we eliminated/cured cancer.
The answer was about three years. Eliminate heart disease? Another three years. Eliminate both? About five years.
https://en.wikipedia.org/wiki/Memento_mori
Was this a well-corroborated and fact-based opinion, or was it off-the-cuff and handwavey? Podcast answers aren't always totally reliable.
But you mention "the average person," which is really the crux of the matter. Cancer strikes perfectly average people, oftentimes in their 30s or 40s, and hands down death sentences at random. A bad roll of the dice. A stray cosmic ray hit a dividing cell. Who knows? That is what is scary.
Eliminating cancer may perhaps only increase the average lifespan by three years -- though I have my doubts -- but what's much more important is that it would cut down tremendously the number of premature and random-seeming deaths in the prime of life.
The thing is that we are led to believe that cancer just strikes at random, and anecdotally we know of someone that never smoked to get lung cancer that spread everywhere to strike them dead.
Yet we also know it is not quite like that. If you smoke, drink, make sculptures out of asbestos dust, eat processed meats, shoot depleted uranium rounds down at the range and work with radium in a gun sight factory then you probably have stacked the odds.
Now imagine you have an identical twin, maybe not cojoined, but living with the exact same stacked odds. However, you eat a strict diet of highly processed foods and only play tiddlywinks for physical activity. Meanwhile, your twin rides eats a strict diet that is mostly whole food, plant based and gets a lot of physical activity due to a passion for dancing.
One of you is going to be likely to suffer a cardiovascular event before the other and that same person is going to run the risk of catching cancer first.
Now we all know that eating processed foods, maybe with the exception of processed meat, isn't going to 'give you cancer' and neither is playing tiddlywinks. Equally, a few extra antioxidants and a bit of fibre from eating a few more carrots isn't going to spare you from cancer, neither is dancing for that matter. Nonetheless, cardiovascular and gut health is important for reducing cancer risks.
I say this with anecdotal evidence provided by a car dependent relative that chose not to eat a fibre rich diet and now has cancers that I would not wish on anyone, with his digestive tract having to be trimmed from the far end due to cancer.
Because he took the medical route with meaty pies and moderate alcohol levels, his life might only be cut short by three years. However, by then, there will be two decades of extreme medical interventions and a smorgasbord of medications that have to be taken daily. Lifespan is not as important as healthspan and there is much we can do through diet and physical activity to maximise healthspan.
The trouble with my relative is that advice to go absolutely teetotal, stay off the processed meats and to eat fibre (as in vegetables) was not a message that was well received. This advice is in line with WHO recommendations but this can be simply ignored once lifestyle choices have been decided on.
This is getting scarily close to “most people who get cancer only have themselves to blame” which can be a comforting thought if you’re putting in a lot of effort to reduce your own risk of cancer but at the end of the day it’s not true and kind of a shitty thing to say when we’re commemorating someone who fell victim to this horrible disease.
Reduce the odds it’ll get you too as much as you want, you’re wise to do so, but keep in mind it can still get you too and it is never somebody’s own fault.
More importantly, you can (almost) never say that if a cancer patient had done this and that or not done such and so they wouldn’t have gotten sick. You just can’t know and even if you did it’d still be a shit thing to say.
> Yet we also know it is not quite like that.
Oh, come on.
Even if you're correct and cancer is not completely random but rather has clear causative factors, a lot of those factors -- perhaps the majority -- are uncontrollable.
Radon exposure. Naturally occurring radioactive isotopes or beryllium in your vegetables or water. That virus you fought off a few years ago. That course of cyclosporine you once took. That cosmic ray from the Andromeda galaxy that happened to hit you and scramble some DNA. Many, many other factors. Cancer strikes in ways that seem truly random because many or most of its causative factors have absolutely nothing to do with lifestyle choices.
Exactly. There are definitely people who lead higher risk lives by having exposure to carcinogens, but even that has some randomness to it. I had a family friend that smoked like a chimney his entire life, and died in his late '80s with tar-filled but cancer-free lungs. Another was an x-ray tech in the earlier days before they took nearly as many precautions as they do now to protect the technicians. No cancer.
Contrast this with some aunts and uncles who lived relatively clean lives, and still ended up dying of different cancers. Sure, I don't doubt there is a cause if we dig deep into it, but there's still some randomness.
I hear what you are saying, however, the vast majority of toxins that enter our bodies come through our mouths and out of choice. Some of these toxins, such as alcohol, cigarettes or processed meats are known to be carcinogens.
There is a very different level of dosage involved, that one cosmic ray from outer space that one time is vastly outnumbered by the trillions upon trillions of atoms that could be carcinogenic that come through the mouth, typically on a daily basis, for decades.
The body is pretty good at taking out the trash, including the mutant cells that did not reproduce properly. This goes on all the time. One cosmic ray from outer space might scramble some DNA but your body can deal with that as an isolated incident, the mutated cell(s) just get taken out with the trash.
If you overwhelm this system with too much garbage for the body to deal with then that is a causative factor that was not controlled.
It is helpful to see things this way because it enables a sense of perspective. It is not going to be 'forever chemicals', 'insecticides' or anything like that, you need to worry about. What goes in the mouth rather is what counts rather than these theoretical other things.
This means taking seriously what research in cancer, diabetes and other disease has to say. For cancer there is clear advice on what to avoid, same with diabetes and much else nobody would wish on anyone. It is defeatist to be in denial about this to assume that random cosmic rays play as much a part as the garbage we willingly consume when it comes down to it.
Eh, it's still a numbers game. Changing your chances of contracting terminal cancer in the next 5 years from 1% to 0.5% is still significant.
In this case, the specific percentages are all the significance. When a lot of the factors are controllable and a lot of them are uncontrollable, the most reasonable question is "How much do the controllable factors actually change the odds?"
> Changing your chances of contracting terminal cancer in the next 5 years from 1% to 0.5% is still significant.
Short of quitting smoking, there's almost no way to do that, because you don't know what the factors are or how they're weighed & influenced by individual genetic, immune, and metabolic factors.
> "How much do the controllable factors actually change the odds?"
Not only does nobody know, nobody has the foggiest notion. I've never seen a relevant population-wide observational study that wasn't so full of methodological flaws that you could spend hours picking apart its defects.
Of course we know that there's a set of factors associated with the development of cancer -- like, e.g., long-term exposure to polonium in drinking water -- but there's also a large set of factors that nobody is aware of or which can never be controlled for. To use only the first set -- the set of what we know and can control for -- to accurately estimate the odds of contracting cancer within the next five years is impossible.
Maybe looking at the average is the wrong thing to do. People who die from cancer can be robbed of a lot of years. A couple of other recent cancer deaths I saw on HN:
Walter Ehmer died at 58 https://news.ycombinator.com/item?id=41490388
Jake Seliger was also known on HN died around 40: https://news.ycombinator.com/item?id=41201555
I find those estimates believable in a narrow interpretation of the question - i.e. if we solve cancer but change nothing else. I would expect a longevity M.D. to understand the spirit of the question and answer accordingly, though. I'm curious which podcast / doc this was?
It's true that solving cancer, heart disease, and even all other similarly deadly diseases, would not automatically mean humans living indefinitely, because there's still cellular senescence to contend with.
Fortunately, we've effectively solved senescence (or at least it seems we're well on our way). Check out the picture of the twin mice from David Sinclair's lab (https://sinclair.hms.harvard.edu/research) - it's hard to believe the two mice were born at the same time...
And if I recall correctly, they didn't even do any sort of telomere modification in that study either... Don't quote me on that. But telomeres are another potent avenue towards >10x extension of life span, and also as it turns out, fairly trivial to lengthen and thereby allow a cell to continue mitosis indefinitely.
The problem to solve is cancer, though. Telomeres limit the number of times a cell can divide by design, and seemingly the purpose of limiting division in the first place is to mitigate risk of developing cancers.
This sounds surprisingly short. Surely the average person with cancer isnt going to live just three additional years?
Went and did a brief lookup (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710558/) - life expectancy is reduced by at least 3 years, even for the oldest patients, and increases significantly as age at diagnosis goes down.
I suppose from the perspective of an 80 year old, curing cancer would in theory increase life expectancies by ~ 3 years, though I wonder how many people die of "old age" but have an undiagnosed cancer of some form contributing.
It's because of the Gompertz mortality law [1]--the probability of dying at a certain age is exponential. If you assume that the mortality of each age-related terminal illness itself follows the Gompertz law, then eliminating any one of those illnesses won't affect the overall life expectancy much, because exponential growth is so powerful. Even if we had cures for all age-related diseases except, say, Alzheimer's disease, the fact that Alzheimer's disease mortality also follows the Gompertz law (probably a reasonable assumption) would lead to lifespans not dissimilar from our present ones.
Essentially, in order to achieve dramatically longer lifespans, we would need to eliminate, or at least significantly slow, all aging-related causes of death.
[1]: https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_o...
Keeping the body alive is a low bar.
Lost quality-adjusted life years would be a better measure. Many people survive for many years with cancer, but the quality of life drops significantly.
Most people don't have cancer, so the average lifespan reduction of everyone is going to be quite a bit lower than the average lifespan reduction of people diagnosed with cancer.
My total guess(!) is because relatively few people lose a large number of years to cancer, due to both the median age of diagnosis and long term survival rates of some common cancers being high? (For example, breast cancer has a 75% 10 year survival rate with a median age of diagnosis of 62. Bowel cancer is about 60% and 71 respectively.)
Three years would be an amazing amount of precious time with a loved one. I know this.
This reminds me of a video I saw on HN yesterday: https://www.youtube.com/watch?v=CJkWS4t4l0k
The problem of controlled cellular growth in a multicellular organism is a really hard problem that evolution has spent billions of generations on, and any cell in any of the dozens of systems that keeps the human body going can potentially escape the normal cell cycle control process and go out of control, leading to cancer. (edit: the fact that so many people lead full lives without coming down with cancer is more remarkable from this view, it's one of the miracles of life).
While the ability to treat cancer using modern technology (especially if it is detected relatively early) has made vast advances, we're also surrounded by and exposed to a wide variety of molecules that can, especially in high concentrations, inflict damage on the cellular control system (a whole lot of proteins, nucleic acids, lipids, cofactors, etc.) and while that damage may be somewhat random in nature, if it happens to hit a key sequence in the cell control DNA you get a cancer cell. You can greatly reduce the prevalance of such carcinogenic mutagens in the food, air, water and soil with suitable regulations but this cuts into profit margins for the producers of various commodities and products who in turn lobby governments to eliminate said regulations (which to be fair may not have been well-designed or implemented).
Yes there are genetic factors which may increase one's cancer risk but these are very complicated and often overemphasized by those who dont't want to see clean air, water, soil, food etc. regulations implemented.
> ...a really hard problem that evolution has spent billions of generations on...
I think it's worth noting that this isn't evolution's "goal". We just need to produce offspring and give them a good start in life such that they are competitively successful. Beyond that, evolution doesn't care.
Even for that, there's a budget. If it's not economical over letting us die and not taking valuable resources from our offspring, then evolution also doesn't care.
That could suggest why longevity in humans (or primates ) was under active selection, as they put a lot of effort into raising the children so you'd expect that cancer in younger people would result in the death of their children, so evolution selects for robust anti-cancer systems (like the human immune system, which is relatively good at detecting and eliminating cancer cells as well as pathogenic bacteria, etc.).
These explanations are however always a bit hand-wavy, eg why do galapagos tortoises live to 150 when they don't seem to do much parental investment?
There must be other evolutionary pressures that change cancer resistance as a side effect.
Having grandparents around to care for the young would allow for more procreation.
Yes, but only to a limit. The resource cost in ensuring longevity must be less than the benefit provided in caring for the young.
Because if nothing else gets you, cancer risk rises as you get older. At some point it gets you, I guess.
Yes, a few types are basically a numbers game. We're continuously successfully not getting them every day. But the longer we live and not die of other things, the higher chance there is of losing that game. And we're actually getting quite good and not dying of other things.
Then again, cancer treatments and vaccines are progressing recently, so that's good news.
This sounds good, but it can't be right. There are animals that live centuries. Greenland sharks may live up to 500 years, for example. There are trees that live millenia.
Turns out they have lower mutation rate which helps them. Their chances are much lower, but still not zero. https://www.monash.edu/news/articles/sharks-cancer-secret-al...
But they aren't human. We don't survive being dessicated and heavily irradiated like a tardigrade or regrow severed limbs like starfish, and we aren't as good at avoiding cancer as some other animals.
And some animals are worse. Dogs, for example, are most likely to die from cancer. They also get cataracts decades earlier than humans do.
You're supporting my point. The reason we suffer from this is not solely probabilistic. There are many other factors.
being warmblooded is a huge disadvantage for longevity
Can you expand on that subject? What are the traits of warm blooded species that lead to higher cancer rates?
not just higher cancer rates, but higher rates of all kinds of aging-related deaths
the advantage of being warm-blooded is that your metabolism is more precise and much faster, but, as james dean quoted willard motley saying, 'live fast, die young'
most of the causes of aging are unwanted chemical reactions; https://www.cell.com/action/showPdf?pii=S0092-8674%2813%2900... is a highly-cited paper reviewing what we knew about the causes of aging 11 years ago. chemical reactions of all kinds follow the https://en.wikipedia.org/wiki/Arrhenius_equation which makes them happen about 2–3 times faster per 10° temperature rise
(being old is a more important risk factor for cancer than anything else i can think of, even smoking and radioactive fallout)
small sharks around greenland, to take an extreme example, are at essentially the temperature of the seawater, about -1.8°. larger sharks could conceivably raise their internal body temperature, but greenland sharks swim very slowly to avoid this even when they are large. so their metabolism is about 16× slower than yours is—both healing and aging processes happen slower. their gestational period is about 8–18 years
Thank you. This is the kind of thing I was looking for. After posting, I also found out that plants are even further in the other direction because their strong cell walls prevent metasticization.
happy to help! another weird thing is how rare cancers of the skeletal muscles are
That is interesting. I'm currently obsessed with exercise physiology. I might look into that.
Probably constant generation of reactive oxidizing chemicals from the higher metabolism needed to maintain body temperature.
I don't think prolonging the life in a biological body is going to be the winning route. We will have to Star Trek it up and transfer our consciousness to computers. That, or replace parts, maybe even the entirety of our bodies with a machine that can be maintained and repaired rather than age.
You become a lot more aware of it as you get older, and what you see to some degree depends a lot on your socioeconomic status. A big part of it is that we've made so much progress when it comes to heart disease. Most people who go to my hospital are on public insurance, and they're dying more frequently from lifestyle-related diseases (like T2DM which leads to hypertension, chronic kidney disease, and congestive heart failure)
https://www.clubvita.net/us/news-and-insights/top-charts-23-...
Cancer (outside behavior related cancer like lung cancer) is on the rise.
In spite of better treatments, a twenty year old today is more likely from cancer while in their twenties than at any time before. Each younger age cohort has an increase risk of cancer, and at younger ages.
Cancer deaths overall are still going down though, as the smoking generation still alive goes out.
probably because it's the first, second, or third leading cause of death in every country, depending on how you slice it up, killing about a quarter of everyone
To be a little more precise, roughly 1 in 6 deaths are due to cancer. It’s the second leading cause after heart diseases, which are 1 in 3.
I have two people in my direct circle get and have stage4 lymphoma and adult leukemia this year at the time of their initial diagnosis. Does seem like it is on the rise from my perspective.
Because they are.
TL;DR: Because today, people are regularly living long enough to get it. It's often a good sign to have higher cancer rates -- societies with higher cancer rates are richer, happier, and live longer than those with lower cancer rates.
I mean, cancer is bad. But it's a good sign for society if lots of people die of cancer -- they tend to hit the elderly. Historically, about 80 percent of people who die of cancer are over 50, and that's fairly constant. (Interestingly, the share of cancer deaths that are in people over 70 have been rising, from about 36 percent to 49 percent - that's as a portion of the total.)[1]
The ranking for prevalence of cancer is higher income countries, upper-middle-income countries, lower-middle-income countries, and finally with the lowest rates low-income countries. Since the world is getting richer, it stands to reason that it's likely there will be higher cancer rates (of course, it's not guaranteed; it's possible being European makes you more likely to get cancer, which would explain the higher rankings of high-income countries, which are often European, but not lead to higher numbers elsewhere).[2]
This is borne out individually. Countries with the lowest rates of cancer tend not to be great places to live. Our World In Data has three countries[2] tied for the lowest cancer rates (0.1 percent), Niger, Chad and Benin, which have life expectancies of 62, 53, and 60[3][4] and had happiness scores (self-reported life satisfaction) of 4.56, 4.47, and 4.38 (out of 10; for reference, the world average is 5.27, with numbers for individual countries ranging from 7.74 to 1.72) respectively.[5] The full list of countries with a prevalence of cancer below 0.5 percent is as follows: Niger, Chad, Benin, Gambia, Somalia, Sierra Leone, Mali, Yemen, Democratic Republic of the Congo, Central African Republic, Cote d'Ivoire, Burkina Faso, Burundi, Liberia, Angola, Guinea, Cameroon Guinea-Bissau, Nigeria, East Timor, Tajikistan, Mozambique, Senegal, Togo, Papua New Guinea, Afghanistan, Ethiopia, Madagascar, Oman, Sudan, Nepal, Kenya, Mauritania, Maldives, Bhutan, South Sudan, Ghana, Vanuatu, Equatorial Guinea, Bangladesh, Tanzania, Solomon Islands, Sao Tome and Principe, Eritrea, Malawi, Rwanda, Laos, India, Uganda, Pakistan, Uzbekistan, Djibouti, Congo, Botswana, Zambia, Kiribati, Lesotho, Algeria, Gabon, Mongolia, Eswatini, Morocco, Comoros, Honduras, Haiti, Samoa, Zimbabwe, Guatemala, Turkmenistan, Myanmar, Kyrgyzstan, Marshall Islands, Namibia, Philippines, Egypt, Cambodia, Indonesia[2]
The happiest of those is Guatemala, at 6.29, and a prevalence of 0.4 percent. But most of them are much less happy. To take a random example (I used random.org to randomize the list and chose the top one and the top six, excluding Sao Tome which had no happiness data), Uganda is at 4.37, and the average of Uganda, Comoros, Turkmenistan, Yemen, and Bhutan is 4.41, nearly a point below the world average.
Life expectancy is no better; again doing Uganda, Comoros, Turkmenistan, Yemen, and Bhutan, Uganda had a life expectancy of 62.7 years, and the average of them is 66.2, almost 5 years below the world average of 71 (range of typical life expectancy is from 85.9 to 52.5).
Okay, so life expectancy and happiness are both lower for countries with lower rates of cancer, seemingly. What about those with higher rates?
Well, those with cancer rates up to or including 3 percent are as follows: Monaco, Bermuda, Italy, France, Netherlands, Finland, Germany, United States, Australia, New Zealand, Japan, Denmark, Portugal, Greece, Croatia, Spain, Estonia, Canada, Norway, Andorra, United Kingdom, Slovenia, Belgium, Iceland, Switzerland. Monaco comes in at the top, with 5.9 percent with some type of cancer.
Monaco has a life expectancy of 85.9 years, the highest. In the world. There was no happiness data available for it or the runner-up Bermuda, but Italy ranked itself at 6.32.
Of the top five countries in life expectancy that show up on the cancer list at all (Monaco, not Hong Kong or Macao, Japan, Australia, Switzerland, Malta), all of them but Malta show up on the list, and Malta just misses the cutoff (2.9 percent). In happiness (Finland, Denmark, Iceland, Sweden, Israel), Sweden and Israel aren't ranked. Sweden just misses the cutoff at 2.9 and Israel is at 1.6 percent but has a notably much younger population than any of the others.
Again using random.org and taking the top one and then the follow-up four, Monaco came in at number one (data already covered and missing happiness, so excluded), followed by the US, Switzerland, Iceland, Australia, and Italy. The US has a life expectancy of 77.2 years. The average for the five is 82.26, so if it were a country it would be number 21 globally and over TEN YEARS above the world average of 71, above even the Oceanian average (the highest) of 79.4; for happiness, the US is number 18 worldwide excluding ties, ranking itself at 6.72; the average is 6.938, meaning if it were a country it would come in number fourteen including ties and almost two points above the world average of 5.08.
[1] https://ourworldindata.org/grapher/cancer-deaths-by-age
[2] https://ourworldindata.org/grapher/share-of-population-with-...
[3] Rounded to the nearest whole number
[4] https://ourworldindata.org/grapher/life-expectancy
[5] https://ourworldindata.org/grapher/happiness-cantril-ladder
Microplastics?
Fuck Cancer. RIP.
Totally off topic HN implementation observation, as of this writing:
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