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what will happen when all diseases can be cured?

Discussion in 'Medical Students - MD' started by aheyn01, Aug 2, 2006.

  1. aheyn01

    aheyn01 Junior Member
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    Here is a part of me talking that worries about the world as a whole, and where society is headed.

    Already we are learning new breakthroughs to treating diseases, especially cancers etc. Which is great.

    When you think about it, thousands of years ago none of this would have been known. People would have been dying from all sorts of cancer without possibly even knowing what they had. Nowadays, you are seeing figures like 1 in 3 will end up with some sort of cancer - really bad statistics I know.

    The question is this though......society is evolving so quickly, and new breakthroughs are being found all the time - what will happen maybe 50-100 years down the track, when a great deal (if not all in time) cancers can be cured totally?

    It would be a great thought ... but what would happen then? How would medicine - especially to fight diseases and cancer, progress any further?

    I often wonder whether this situation will NEVER be realised, because the big pharmaceutical companies would be out of business - and they would make sure that never happened.
     
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  3. automaton

    automaton drone
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    ... right
     
  4. Law2Doc

    Law2Doc 5K+ Member
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    I wouldn't worry. Infectious things tend to mutate and evolve far faster than cures can be generated. We will always be one step behind, always waiting for that next SARS or bird flu to present itself. It's more likely we will all be wiped out by something yet unknown than that we will generate a cure for all potential threats. The pharmaceutical industry doesn't need to drag its feet to be assured centuries of demand.
     
  5. Ezekiel20

    Ezekiel20 Resident
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    Even if all diseases could be cured, people will still get injured in accidents etc, so EM docs will still have a job.

    However, due to increasingly busier lifestyle and other factors, we seem to be creating new diseases that didn't affect us much some decades ago. Just look at the epidemic of type II diabetes, coronary heart disease etc.

    One thing to also think about is that many 'diseases' are actually degenerative processes. Although there are genetic factors at work, osteoarthritis is largely a degenerative process. What about decreasing function of various organs with ageing, such as kidney, liver, the brain?

    Let's say in 100 years we know how to 'cure' all non-injury, non-degenerative health problems. The problem is you must prevent diseases, rather than wait until the patient presents with symptoms. But how are you going to do this? Screen for 500 diseases in every individual? This would be very 'cost-ineffective'.

    And also the big challenge is, are we going to be able to make poverty a thing of the past? Poverty of course is linked to millions of deaths as we speak, and diseases won't go away as long as it continues.

    My 2 cents
     
  6. WhatUpDoc!

    WhatUpDoc! The Sign Says It All
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    I've always loved the irony that doctors continually work to put themselves out of business :laugh: But all jokes aside, I agree with Law2Doc and his assertion that just as we continue to evolve, the bad guys (parasites, viruses, bacteria) evolve to keep a leg up on us. So basically, the battle will never be won (a.k.a. Red Queen hypothesis... gee I did learn something in undergrad evolution :D ) Not to say that we'll never get a handle on some things (like cancer for example); but trust me, as long as humans roam the earth, there will be something to cure.
     
  7. Law2Doc

    Law2Doc 5K+ Member
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    We will probably never even get a handle on cancer, because it is not one disease, and does not have one cause. We may get a handle on certain kinds of cancer perhaps, but there won't be a single cure or med for all.
     
  8. automaton

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    fear not, dumb people are constantly trying to kill themselves one way or another. half of the entire world have an IQ in the double digits. you can't cure stupidity.
     
  9. mzeroapplicant

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    I agree that the battle won't be won. I think the next two hundred years could actually be worse for parasites, viruses and bacteria. Rapid mutations and more dangerous diseases could be the way some ecosystems respond to human overpopulation. It's important to keep in mind that environmental threats, such as global warming, are also likely to create their own health-related problems.
     
  10. lord_jeebus

    lord_jeebus 和魂洋才
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    Even with cures for everything, you need someone to diagnose disease and to administer treatment, and there will always be room to improve both processes.
     
  11. jonathon

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    When studying genetics, we understand that all diseases and disorder will not be cured. Complex diseases are to complex to fully have them "cured." Even when a mutation arises it can bring about new loci that can be associated with a disorder. Basically, evolution alone will always bring about diseases and disorders.

     
  12. BozoSparky

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    maybe you could write a twilight zone episode about this!

    really, we'll come a long way in the next 100 years...i'm excited. i don't think we will be out-mutated. we'll figure it all out more quickly, and our ability to do so will snowball.
     
  13. Vox Animo

    Vox Animo Runs with Scissors
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    Most people will not be able to afford the cure for everything pills. They are too expensive to research to figure out.

    Stupidity also brings in the bacon for doctors, i don't think a cure from that is in the near future.
     
  14. velo

    velo bottom of the food chain
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    Hate to break it to the OP, but the list of diseases we can "cure" in the strictest sense of the word is pretty damn short.

    That, and you've gotta die of something....
     
  15. Zweihander

    Zweihander Billygoat Gruff
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    You can with vodka! :smuggrin:
     
  16. Zweihander

    Zweihander Billygoat Gruff
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    I read a piece by Jared Diamond once where he was arguing that, strictly speaking, this is not true. His contention was that we actually don't *have* to die of anything -- cells can be immortal, and so organisms could be too. However, it is actually evolutionarily beneficial that species evolve such that individual members of that species die, because this is what allows for generational adaptability.

    In other words, if the individual did not die of disease and age-related degeneration, the species itself eventually would die of failure to evolve.

    edit: to clarify, the implication is that organism death is part and parcel of two things:
    1. genetic instability, which leads to mutations but over time also leads to a deterioration of cell functioning as DNA degrades
    2. clearing the world of individuals with a certain genome to make way for younger individuals with a different genome, allowing genetic change to occur in the species as a whole
     
  17. Vox Animo

    Vox Animo Runs with Scissors
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    Thats just putting a horrible curve on it. Hey at any given time, .7% of the world is drunk (from unciteable random fact website). Thats plenty of business for the op
     
  18. WhatUpDoc!

    WhatUpDoc! The Sign Says It All
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    Hmmm... this seems like a circular argument to me. Evolution only occurs in the face of a certain evolutionary pressure (i.e. cell surface markers on certain parasites change in response to the pressure placed upon the parasite by the host immune system). In the absence of an environmental stimulus, there would be no need for a species to evolve (provided that said species has enough resources to reproduce and somehow all conditions for Hardy Weinberg equilibrium are satisfied). In other words, there would be no need for "generational adaptability" if there wasn't a disease or some other harmful factor (i.e. predation, climate, sterility) that reduced the level of fitness of a given species. I can't imagine how a species would just die out for failure to evolve when there isn't anything around to kill them off.
     
  19. Zweihander

    Zweihander Billygoat Gruff
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    There are plenty of things that can kill a species off other than disease -- new predators (such as humans) and changing environments (such as ice ages) have both been responsible for mass extinctions, and have resulted in the emergence of new species which could live and thrive in the place of former ones.

    I think the point he was making was that this process of adaptation and niche exploitation could not occur if organisms within a species were genetically immutable and physically immortal.

    This is obviously pure speculation and not a scientifically tested theory, but I think it is an interesting way to look at things nonetheless. What's more, I think it does make a lot of sense.
     
  20. austinap

    austinap Senior Member
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    I think we're talking only about degenerative conditions here. I think the point was that there is no *need* for us to die on our own, but we do anyways even without the help of any outside selecting factor. Because we do this, our population has a certain genetic turnover. If we lived forever, that turnover would be nonexistant or extremely slow. By increasing our turnover rate, we can adapt to selective forces more quickly. The argument isn't as circular as it appears.
     
  21. Zweihander

    Zweihander Billygoat Gruff
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    Word. :thumbup:
     
  22. austinap

    austinap Senior Member
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    What you listed are still selective forces. Yes, it does make a lot of sense that we couldn't adapt if we weren't able to adapt. I don't think that's what he was getting at. Even the 'immortal' cells he was referring to will die if you stick them in an autoclave. However, they don't die on their own, as the non-immortal equivalent cell would. This begs the original question: why is it in the cell's benefit not to live forever in the absence of outside influence? If it would be beneficial for the cell to be immortal on it's own time, then cells and animals would have evolved that way (the mutation to make a cell immortal happens quite a bit more frequently, than, say the mutation to make the beginnings of an eye, and animals have developed the eye something like 8 unique times)

    And yes, it is a tested theory. There have been quite a few tests done on natural selection, though I'm too tired to go looking through the literature to find them.
     
  23. Zweihander

    Zweihander Billygoat Gruff
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    Yes, but that's the point I think -- there ARE selective forces at work, and it is precisely the presence of these selective forces that requires adaptability and generational turnover. As another example of a selective force, if we (being either organisms or individual cells) were all immortal, then eventually we would run into a scarcity of resources which would threaten the population as a whole.

    The example of the autoclave is a different one -- there we are talking about imperviousness to physical damage, which is NOT what I think he was getting at in the least. Even a mountain is not impervious to physical damage. The "death" being discussed here is the natural process a lifeform goes through of aging and physical deterioration, and the contention is that this aging is not demanded by the laws of biology (as erosion of a mountainrange might be demanded by the laws of physics), but rather aging is actually an evolutionary adaptation designed to benefit the species.

    The "untested theory" I was referring to above is not the theory of natural selection, but the theory that organisms need not be mortal. We have proof that single cells can be immortal, yes, but no proof, to my knowledge, that a multi-celled organism can live indefinitely. Hence, Diamond's supposition that aging and "natural death" is merely an adaptation itself *is* purely speculation.
     
  24. WhatUpDoc!

    WhatUpDoc! The Sign Says It All
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    Why yes of course, these would fall under the "harmful factors" category in my original post.

    True, only if assuming that niche exploitation is beneficial to the species as a whole. Again, in the absence of an evolutionary stimulus, evolution would not occur thus adaptation would not occur/be needed.

    I believe that it is an interesting take on the relationship between evolution and the necessity of death, but to presume that immortal organisms would be at a disadvantage because of a dead-end gene pool (especially if there is no threat to the species), seems a bit far-fetched.
     
  25. Zweihander

    Zweihander Billygoat Gruff
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    Why does it seem far-fetched? Also, given that environments change over time due to shifting landmasses, changing climates, and depletion of natural resources, how can we even envision a world in which there are no selective forces?

    What I'm trying to say is, I think it is a given that selective pressure acts in some way on species, even if that pressure is exerted over millions of years. Because this is true, we are asked to entertain the idea that organisms *must* be able to evolve in order to keep up with a world that *will* inevitably change around them, and so "immortality" is paradoxically a negative trait for the species to have.
     
  26. austinap

    austinap Senior Member
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    As a reply to the OP, I don't think it's ever going to be a problem for doctors. If we cure all diseases, then our population will bloom. If our population blooms, it's the perfect petri dish for emergent diseases to get a strong start. End of problem. It's a constant push and pull, and neither of us will ever win. People will always be dying, it just depends on what from.

    Here's what I think might be a more realistic question: are we really doing ourselves a lot of good by curing anything and everything we're able to? Sure, it's great for the families, and I sure as hell want to have access to the cure for any disease I may get, but as humans is it really that good for us? We all are going to die eventually, but if we can cure all our diseases, then (ironically), we're going to be on average a lot less comfortable than we are now for several reasons. We can't sustain our per capita consuption if we double our population. It just can't happen. We're already at a population beyond sustainable by this planet (it's estimated than about 50% of the photosynthetic potential of the earth's land is already either being used or otherwise ruined by humans [from roads, buildings, etc...]), and most people aren't living by first world standards. If we all aspire to first world standards and we cure all of the diseases (or even a few of the really big ones), then we'll push ourselves well beyond sustainability and as things run out people will be dying in terrible ways and in unequaled numbers. Is it really better to avoid disease now in favor of starvation and war a few years down the road?

    As a hypothetical example, imagine that in some country 20% of the children die of a certain disease before they're 10. Because this has been going on for some time, it has become customary for every woman to have on average 4 children (some die of other things too, etc.) in order to maintain their population. Now, imagine that we cure that disease. Now, not only is that population going to soon be 20% bigger because of the children saved, but now all those saved girls are going to start having their four kids like everyone else. This starts an exponential growth. Sure, eventually they'll realize that it isn't a good idea to have 4 kids per couple anymore, but there's a lag period there, and in that time things can get seriously out of control. There's no question that our population will eventually limit itself, its only a question of if it's planned and on our terms or not.
     
  27. WhatUpDoc!

    WhatUpDoc! The Sign Says It All
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    That may be true for every species except humans, but with our higher level consciousness and ability to manipulate our surroundings, I believe we could actually get away with immortatlity (provided that a major natural disaster does not wipe everyone out Noah's Ark style). But my original assertions were based on ZERO selective forces in the environment and as you mentioned, that is a highly unlikely scenario on earth.
     
  28. RxnMan

    RxnMan Who, me? A doctor?
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    Don't worry, docs will still have a job, because people will always do stupid things.
     
  29. Callogician

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    Granting an unlikely trend of significantly improved health care and standard of living within the next 100 years, I suspect that we would see a new "high-end" health market focused on cosmetics and fitness.
     
  30. AmoryBlaine

    AmoryBlaine the last tycoon
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    100 years ago we didn't really worry about cancer. Why? Because we had infectious disease to kill us. I don't think cancer is too much of a hot-button issue in Sub-Saharan Africa either...

    If we "beat" cancer like we have (basically) beaten bacteria then the increase in life expectancy will only bring on new challenges to medicine. Maybe it will be neurodegenerative stuff like Alzheimer's?

    There is a really interesting field in cardiology now that is basically adults who have had massive cardiac defects repaired as adults.

    See how this is going....
     
  31. Zweihander

    Zweihander Billygoat Gruff
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    We have in no way, shape, or form "beaten" bacteria.
     
  32. Dunce

    Dunce Senior Member
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    took the words right out of my mouth.
    I think that "frightening" is a more accurate word to describe the current situation with so many bugs/diseases teetering on the edge of resistance.
     
  33. georgia_md

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    Good point. New strains of bacteria seems to be popping up every now and then. Maybe medical treatment will be less invasive in the future, with introduction to new pharmaceuticals.
     
  34. jonathon

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    Let’s get scientific and think logically in this discussion now.

    Cancer has been around every sense the days of the dinosaurs. If cancer was one disease (which we all here know it’s not), cancer would have been done away with a long time ago for as many millions and millions of dollars that has been spent for cancer research. What needs to be done, and I think it’s finally come to this stage, is researching cancer pathway by pathway. Therefore, treatments for cancers should be done on a pathway by pathway basis. There is a new cancer genome project going on (can’t think of the correct name at the moment) to study the underlying mechanisms of cancer development.

    Some forms of cancer can already be cured by a complete blood transfusion or by using hematopoietic stem cells. However, not all forms of cancer can be cured. This is due to some forms of cancer being caused by viruses and bacteria (i.e. breast cancer). Also, there will always be some forms of skin cancer around because of the social identity of being hot looking with a tan during the summer.

    I don’t study cancer that much, but from what I know, if p53 has a downregulator that becomes mutated it can lead to dysfunctional mechanisms of p53. As a result, when a cell becomes stressed by some environmental cause, cancer could possibly develop.

    What is more important, as much as it sucks to hear it, is not really the “cure” for cancers, but for the ability to prolong the onset of disease and prolong the health of the individual. Should the prolonging health of a baby have more precedence then the prolonging the health of an elderly person?

    When talking about catastrophic viral outbreaks, humans lack the ability currently to be on the same level understanding the evolution of viruses compared to how fast some RNA viruses can mutate. Take the yearly flu for example. We humans have yet been able to develop a vaccine that is able to do away the common cold. Yes scientists have the genome of many viruses and bacteria sequenced, but that is only the starting stage. Many decades of research has to take place to understand the function of the genes and the proteins. Then comes the time for vaccine development. By the time scientists can understand the function of a virus, the chances of the gene to have already evolved is there.

    HIV is mutating at a rate where scientists are not able to develop a valuable vaccine fast enough to do away with HIV. Some drugs have been developed to prolong the time a person has AIDS, but not cured AIDS. What I fear is, if AIDS is cured some day we will see a huge population growth. Right now many people are afraid to have sexual intercourse with an unknown individual because of the fear of contracting HIV. If there becomes an over-the-counter drug a person can take to prevent the transmission of HIV, then more people will have sexual intercourse with strangers… possibly leading to more one night stand pregnancy’s. As it is right now, AIDS is the “silent” killer of many millions of people around the world.

    The most efficient way to prevent passing on of genetic diseases is to have genetic screening done. Even with doing this, there will always be the chance of genetic diseases being passed on to new generations.

    What is not understood with trinucleotide repeat neurodegenerative diseases is the unknown mechanisms of how and why the trinucleotide repeats continue to expand every generation.

    I have always thought over the last few years is if we humans were to come to a point where we are able to prolong the onset of diseases that can last a persons whole life, then the population on this planet will swell to a point where our recourses will become obsolete. Therefore, humans will need to start exploring about living on different planets (i.e. the moon and Mars). When doing this there will be brought about new diseases and disorders that we have not yet encountered because of the different environmental pressures that will be put onto our genetic makeup and chemical reactions.

    As we all know, we humans were once animal hunters and have now moved to where we sit on our buts all day long (for most jobs anyways). As a result, we have become a fatter species. Thus, leading to complex diseases like diabetes, some forms of cancer, inflammatory diseases, obesity, restless leg syndrome, etc. We have yet been able to adapt to our new life style as a whole species. I suspect by the time we humans have adjusted to our new life style, we will have already been started to force a change of our lifestyle again and brining on new problems.

    When a vaccine has been able to cure a viral or bacterial disease, we already have experienced vaccines to not work with due time. Wasn't there a story a couple of months ago where the CDC said that some common infection in children will no longer be givin medication for? I think it deals with the ear but can't remember.

    I have always believed the best way to fight diseases is to use our immune system and not bring in so many foreign substances.
     
  35. Zweihander

    Zweihander Billygoat Gruff
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    jonathon -- I haven't heard anything about infectious diseases being related to breast cancer. Do you have any references?


    Thanks.
     
  36. AmoryBlaine

    AmoryBlaine the last tycoon
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    A. That's why I said "basically" and...
    B. We have basically beaten bacteria for now. Yes yes, I know all about MRSA and VRE but the fact of the matter is that we have a well-stocked arsenal of antibiotics and we vaccinate against some of the really nasty stuff (infantile H. flu etc). An observer looking ahead from the turn of the century would marvel at our dominance of the microbial world. I didn't say it was total, but it is impressive. Only Flu/Pneumonia and Sepsis make it on to the top 10 causes of death in the U.S. If you add them together they still don't kill as many people as trauma does.* Do you know anyone personally who has died as a direct result of a bacterial illness?

    *(http://www.cdc.gov/nchs/fastats/deaths.htm).
     
  37. AmoryBlaine

    AmoryBlaine the last tycoon
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    I don't even know what that means. I am not downplaying the danger of multi-drug resistant organisms but I would like to see some data that supports the claim that bugs are "teetering" on the "edge" of anything at all.
     
  38. Zweihander

    Zweihander Billygoat Gruff
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    Yes. And I've had many patients who almost died, and some who were left permanently the worse for their infection. We are not even "basically" winning the battle against bacteria -- we're like the Little Dutch Boy, and antibiotics are the finger in the dam.

    You are right that we are much better off than we were before the advent of antibiotics, but have some perspective. Bacteria have been infecting and killing us for thousands of years. A fifty-year stay in that pattern hardly counts as dominance -- I'd say we've "won" when we have a sustainable method of keeping bacterial infections and resistant organisms at bay.
     
  39. cbgray

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    'Breast cancer virus' found
    http://news.bbc.co.uk/2/hi/health/3159593.stm
     
  40. Frank Hardy

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    Human beings will destroy themselves long before doctors become obsolete.
     
  41. Zweihander

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    Ho dang! :eek:

    Thanks for the reference dude. This is the second time in a week there has been some infectious etiology for a common condition that I was never aware of -- the other being Hep C-related encephalopathy. Who knew? :confused:
     

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