OK, one more thing and then I will leave you alone, I promise. But your research is legit, so maybe you can answer this for me (my PI was really confused by my question, and didn't have a real answer -- it could also be because this is a stupid question):
Isn't it weird that the accumulation of so many random mutations results in the same step-wise trajectory of benign-to-malignant (i.e. proliferation -> vascularization -> ability to chew up the EC matrix -> no need to adhere for survival)?
I mean, what are the odds... it's like rolling hundreds of dice hundreds of times, counting the dots each time, and still every time ending up with the same cumulative number. And then having that number equal a metastasis.
(I'm drooling)
You may be gone, or not, but maybe you will read this....
It isn't weird because it doesn't work exactly as you state. Yes, in every instance where it works that way, it works that way. However, you are discounting all of the times when the trajectory flows another way. So many random mutations result in benign tumors that never attract attention, or that are cleared / corrected by the immune system, or that fail to vascularize adequately and fizzle out, or.. or.. or.. Everyone is always having neoplastic events. The ones that develop into cancer are the outliers.
Using your analogy above, of rolling dice... if you roll a pair of dice 100 times and add up the numbers, probability suggests that you are going to have a number between 600-800. Sometimes the dice rolled 6s and 7s, sometimes a mutation like 2 or 12 popped up, but probability averaged those out. Let's call that normal. If you repeat that experiment 100 times, almost all of the time, the numbers will be in the normal range. Sometimes, they might be between 400-600 or between 800-1000. Those represent low grade neoplasms, that we can easily treat, if they don't spontaneously resolve.
If you keep rolling the dice, sooner or later, you will have a set that comes up between 200-400 or 1000-1200. Let that represent the malignant changes you describe above. It is rare, and it took a lot of aberrant events to develop. But every time it happens, it is because that is how the dice rolls happened to work out. Those are the ones that you notice, that get attention. An emergent order from randomness triggers your pattern matching brain to focus in, and confirmation bias is born.
You flounced out decrying the quality of the conversation here... but I suggest that hold yourself responsible for the quality of the conversations that you start and participate in. If you want the great minds of SDN to join you in intellectual stimulation, you gotta carry your share. You asked an interesting question and got a thorough and thoughtful answer.... in a thread that you started by poking a stick at the way other people choose to use the forum. I am trying to impart to you that SDN, like medical school, and every other thing in your life, is exactly no more or less than what you make of it. Please think on that. If you run around trying to find everything where you want it to be, you will be looking for a long time. Try focusing more on how you can make what you are seeking, right where you are, in each moment. You will have a much more successful and fulfilling experience of life.
Also, there is a great book you should read. You Are Not So Smart. Don't be offended by the title, please. It isn't a passive aggressive insult... it is a book that helps you think about thinking and about the unexamined cognitive biases that get in everyone's way:
Amazon product ASIN 1592406599
And thanks to you, I just learned about the sequel: You Are Now Less Dumb. I will go buy it now.