Does practicing medicine require evolution to be true?

Faith & Science Conversation
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First of all, thanks for getting the thread back on topic, as opposed to…whatever this thing had turned into.

Second, I’ll offer a somewhat different perspective to yours, and one that’s a bit comparable to @jpm ‘s thoughts earlier…you know, way back when this thread was on topic. I’d submit that for the vast majority of physicians, evolutionary theory is largely irrelevant. Nor does a lack of acceptance of evolutionary theory mean that one would necessarily be less of a physician as a given.

The practice of medicine really distills down to diagnosing & treating the individual patient, one patient at a time. Whether that individual human being is a product of billions of years of evolution or not is again, largely irrelevant. Unlike veterinarians we physicians treat exactly one species, Homo sapiens, and there are two versions, male & female. The scientific basis of medicine to which you referred is overwhelmingly the product of research done since the mid-20th century. We just don’t draw upon much science that’s older than that. One notable exception would be psychiatry, where the work of guys like Jung & Freud still looms large in some modes of treatment.

Homo sapiens just hasn’t evolved much since the mid-20th century, so again in the treatment of any one patient — and the underlying medical knowledge base guiding a physician towards the most effective treatment — one really isn’t concerned with any broader evolutionary biological processes.

I suspect that I know some fellow physicians who would be YEC advocates. I don’t know for sure, but I base that assumption on where I know some of them go to church. I’d definitely be willing to bet that I know some who would be OEC and/or ID-type sympathizers. None of that would make them bad doctors. I will add, though — as @jpm also mentioned — that more academic/research oriented work in fields like genetics, oncology or infectious disease draws more heavily on evolutionary biology. So there is that.

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I think many of them are bypassing evolution because of it failures and severe limitations. They are working on transgenetics: Creating your own monster, gene by gene.

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also the microbiome, which has become far more implicated in health and disease than previously imagined.

Genomics has also elucidated the remarkable microbiome that coats all human mucosal surfaces with at least as many microbial cells as the number of somatic cells that compose the human body. The most varied microbiome is found in the gastrointestinal tract. The microbiome has co-evolved with animal hosts and protected the host against pathogens, and assisted in digestion of food and in the development of the immune system…
The genome, microbiome and evolutionary medicine

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Evolution’s failures it are all around… Darwin Awards for the many, not the few.

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Evolution, politics, denialism, conspiracism all meet at the bottom.

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Did you read and understand the paper?

Have a look at his suggestions.

The development of cancer traces the following pathway:

1) pathogenic stimulus, (he is presuming physical)

2) chronic inflammation, (what sort of inflammation?)

3) fibrosis,

4) changes in the cellular microenvironment that result in a pre-cancerous niche,

5) deployment of a chronic-stress escape strategy, and

6) a transition from normal cell to cancer cell.

The paradigm proposed here, if proven, spells out a sequence of steps, one or more of which could be interdicted or modulated early in carcinogenesis to prevent or, at a minimum, slow down the progression of many cancers.

Let’s forget his aim to find a cancer treatment, because that is the usual aim.

His argument depends on the notion of cancer as abnormal cells dividing out of control.

So he is assuming that there have to be random mutations and lots and lots of them in the initial stage. However his reasons don’t add up to a normal cell suffering mutations ends up a cancer cells and more than that a clonal variety of cancer cells.

If we look at cancer we find that the mass of abnormal cells dividing out of control, for the greater bulk of solid cancers, actually has all of the characteristics of an organ ! Some researchers call it a novel organ, some a rogue organ, but nonetheless an organ.

It has:

  • a basement / defining membrane ,
  • it develops a blood supply, lymphatic supply and in many cancers even a nerve supply ,
  • It has stem cells ( cancer stem cells ), which give rise to all the other cancer cells (which puts the boot into the clonal evolution suggestion right there) and maybe even all the other cells in the tumor/ organ. Yep, the normal cells, Either that or they are recruited.
  • It has connective tissue with normal cells like fibroblasts and adipocytes . And this connective tissue ranges from 20% of the tumor to as much as 80% of the tumor.
  • AND Immune system cells communicate with all the cells in the tumor as they do in every other organ of the body.

All of this is denied when calling it a mass of abnormal cells.
And if that isn’t enough the cancer cells supposedly have immuno-edited the immune system cells so that the immune system cells don’t recognize them as abnormal cells and kill them. To get this sort of sophistication in cancer cells in a few years (don’t forget children, 2 year olds, even infants can develop cancer), but even in forty or fifty years, it is equivalent to saying fish to man in a mere thousand years.

And the cancer cells have hi-jacked the immune system cells to do their bidding .

To do all these incredible feats it would take many new proteins to be manufactured out of random in the fast lane, if it was ever possible by random, unguided mutations.

A cell dividing out of control cannot become a novel organ.

It has been shown in mouse models that unless you transplant cancer stem cells, you cannot get a cancer tumor to develop.

Carcinogens applied to lab animals give rise to tumors but none are metastatic. So can the tumors formed really be called cancers when they are really on transformed cells and do not have the characteristics of an organ?

They use artificial means and then have the audacity to call it a study of metastasis:

“ Metastases can be established in mice either by injecting cancer cells into organs or the bloodstream, or by using animals genetically engineered to spontaneously develop tumors that then metastasize on their own. Injected cells may come from mutated cell lines, spontaneously grown animal tumors, or cancerous human tissues .” Of Mice and Metastasis

Metastasis requires many complex programs to take place. Firstly EMT, which is seen in many other areas such as tissue regeneration. It then requires a MET at the site of metastasis to get the mobile cells to become fixed again. This is more complexity that we see in embryogenesis. Furthermore exosomes are passed to immune system cells to prepare the new site. Then the immune system cells and some stromal cells escort the cancer stem cells to the new site.

The only way that cancer can develop in the body, is if the body makes the changes deliberately. This means deliberate changes to bring about the new phenotype of the cancer stem cell.

Deliberate changes mean that cancer is a nocebo effect .

Cancer is the fly in the ointment as far as evolution is concerned because changes and processes that are highly complex give rise to a new novel organ. And none of it is through random mutations.

I am not convinced at all by your Biologos article of looking at genetic differences and the patterns. These do not say that there is any evolution taking place. The only common ancestor, if we are to use the terminology, is a blueprint formula, the DNA in some general form, which can then give rise to all the forms of life on earth by applying the right variables.

It is not just a matter of looking at the genetic bases. We need to take into account that there is huge, highly intelligent programs in life processes. A gene is controlled and regulated by transcription factors secreted by other cells. And they are also affected by controlling elements down stream of a particular gene to be transcribed. How much a gene is transcribed, for how long etc., can make the difference between the various types of limbs of different life forms. There is huge complexity and high sophistication, which points to teleology and creation is the only possible means by which it could have all come into being. Goddunit.

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Yes. Did you read it?

It says it is a hypothesis, correct? Don’t you reject ideas if they are hypotheses?

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The cancer clonal evolutionary theory is a hypothesis. So yes, reject it.

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The “new paradigm” you are pushing is a hypothesis, is it not?

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The new paradigm I and a colleague are putting forward has enough evidence in the literature that we are confident we may not need to do anymore work. As you are wanting to call the cancer clonal evolutionary theory, which really rests on the two hit hypothesis, doesn’t have any real evidence, then my new paradigm is surely a theory, not a hypothesis.

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It is described as a hypothesis, is it not?

It does have real evidence.

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It has been brought to my attention that my irony meter is defective as evidenced by my reply to the foregoing.

My apologies Dale.

We still agree on much.

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There is enough in the biomedical scientific literature to put forth a new paradigm as a theory. And that is what we will do.

Now as far as real evidence for the cancer clonal evolutionary theory. I don’t see any. The clones are all created by cancer stem cells. The p53 gene is being named as a tumor suppressor but that is only because of the limitations of the biomedical paradigm, IMO. If we see the body as a machine, and more particularly believe there is only the body and nothing else, i.e., its a meat robot, then it is logical to go to “damage” or “miscopied gene” when we see changes. But there is also spontaneous remission of cancer. I had a spontaneous remission from stage 4 ovarian cancer that had metastasized to the cervix, uterus, bowel and both lungs. I had a spontaneous remission about 8 months after the doctors were saying “nothing we can do for you”, since they found high blood sugars as well, i.e., type 2 diabetes. And I can tell you 100%, there was no immune system wiping it out. If it was there would have been massive inflammation. There was none. I had other episodes of cancer after that but only the first one was diagnosed by doctors. So I can only talk here about that first episode.

The p53 gene is altered in many ways depending on what the body wants to do. There are changes in wound healing and tissue regeneration. There are changes where the body is trying to wall off an insult it cannot eliminate such as asbestos or in some cases a virus. This requires transformed cells and different conditions to normal.

In cancer there is no uncontrolled cell proliferation. If there was people would have tumors the size of infants in just 9 months. They don’t. The body alters the p53 gene in about 50 to 60 % of cancers because there is an ongoing need to increase the size of the tumor from time to time. It is not a continuous situation. So where the gene is returned to normal or better to say to the usual for regular conditions, after wound healing, it is maintained in an altered state in cancer over time.

The problem lies in not understanding why a person’s body will develop cancer. What is the nocebo effect and under what conditions does it come about? And furthermore under what conditions is it reversed and cleared away?

Years ago I saw evidence that startled me because like you I leant at university about genetic changes as in congenital conditions that were set for life. It ain’t so. In the year that I was struggling to overcome the cancer I had gone to a Chinese herbalist. At the herbalist’s shop I saw a man about my age, 40 odd at the time, and he had skin that resembled a reptile’s skin with scales all over it. I felt sorry for him.

Then my appointment day changed and I didn’t see him for maybe six months. When I saw him again I didn’t recognize him but I thought I’d known him from somewhere and I kept looking at him to try and remember. Finally when there was only he and I in the waiting room he came and sat next to me and said “you don’t remember me?” I apologized and said “I know you from somewhere, but I can’t remember.” He said you know me from here. Then he revealed that he was the man with the reptilian skin. His skin was now smoother than mine. My jaw dropped. I never would have believed it having not seen it.

I think for both him and myself the herbs were nothing more than an anchor for the ideas that the condition we suffered could go away and we regain our health. The ideas we entertain and to which we may react are the critical factors. So remarkable genetic changes can come into being and be reversed again. But to get to that place we need a new medical and indeed scientific paradigm. Materialism is not all that there is and we are not meat robot where chemicals drive the show. We are conscious beings and we affect the fleshy garment that we don in this physical realm. “Affect” meaning right down to the genetic level.

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It’s a hypothesis. You claimed you reject hypotheses.

Cancerous cells have p53 mutations. How is that not evidence?

Evidence? How does the body specifically mutate the p53 gene in different tissues for different functions?

Tissue differentiation doesn’t require mutations.

Do you think herbs can produce the same mutation in all the cells in your body?

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You are trying to put words into my mouth. No, I don’t reject hypotheses". I reject a hypothesis being put forward as a theory.

A hypothesis is only a provisional explanation. It requires research and finding that support it before it can become a theory.

Cancerous cells have p53 mutations BUT that doesn’t say that they are random mutation nor that there is uncontrolled cell growth and the cause of the cancer…

Here is a paper with mutant p53 seen in aging. It is seen in “the light of evolution”. Why does it happen? And is it random?

Outcompeting p53-Mutant Cells in the Normal Esophagus by Redox Manipulation - ScienceDirect

This is the reason for Darwin and the cell cycle proteins that regulate it.

Cancer is characterized by uncontrolled proliferation resulting from aberrant activity of various cell cycle proteins; therefore, cell cycle regulators are considered attractive targets in cancer therapy.

Cell cycle proteins as promising targets in cancer therapy (nih.gov)

Under normal conditions tissues and organs develop by cell division and cell differentiation, which requires epigenetics. But cell and tissue remodeling requires changes in genetics. For example dysplasia. But they are seen as leisions. The reason for their existence is unknown, which is why they are seen as abnormal. There is altered genetic expression. Some of it is changes in the activity of cell cycle . proteins. So there may be changes in the cell cycle.

The view is changing. Posted on June 18th, 2019 by Dr. Francis Collins

Here:

“ By analyzing genetic information collected throughout the bodies of nearly 500 different individuals, researchers discovered that almost all had some seemingly healthy tissue that contained pockets of cells bearing particular genetic mutations. Some even harbored mutations in genes linked to cancer. The findings suggest that nearly all of us are walking around with genetic mutations within various parts of our bodies that, under certain circumstances, may have the potential to give rise to cancer or other health conditions.”

Study Finds Genetic Mutations in Healthy Human Tissues – NIH Director’s Blog

So why is that happening? Too easy to say “random” and “genetic errors”, but are they? No one seems to want to ask “why would the body develop a cancer?” And the reason is the funding will suddenly dry up.

Herbs don’t create mutations and I thought I made that clear. The herbs acted as an anchor or in other words a placebo. Sure the herbs had a good effect on my overall health, but not the reason for the spontaneous remission. I saw signs of my body moving into spontaneous remission of the cancer before I got to Sydney, but didn’t recognize it at the time. For instance when I left Cairns to get a second opinion in Sydney, I had been coughing up a reddish brown phlegm, which I thought was due to my smoking and nicotine. The doctors later said that it would have been blood due to the lung cancer. It vanished by the time I got to Brisbane about a month’s driving because we zigzagged down Queensland and NSW going a long way inland. So heaps more than the 1,700km if we went straight down the coast. I was still smoking like a chimney at the time. So why did that happen? The doctors had no answer. They just looked at me blankly. It didn’t add up with what they were taught at medical school. I can’t blame the doctors. They have to follow the required guidelines.

I would say that there was a reversal to genetic changes, which helped bring about the spontaneous remission of all the cancer. The herbs had nothing to do with it.

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Heredity and adaptation are evolution. You do not need to know anything about electricity or semiconductors to use a computer, but they are integral to how a computer works. Likewise, in practicing medicine, you do not have to consider how people came to be the way they are. If you do not take into account the evolution of bacteria and viruses, then inappropriate treatments can promote the evolution of antibiotic resistance and other problems. But medical research makes significant use of evolution. What animals will be the best models to use? If human genetics and function reflected separate creation, there would be no reason to expect any particular animal to have a greater or lesser similarity in any particular way. Evolution, however, tells us that other primates will be most similar, with rodents not far behind. But it also tells us that there will be similarities in the core functioning of cells across all life. If separate creation were true, there could easily be no particular similarity between how bacteria function and how our cells function.

As already mentioned, evolution in bacteria and viruses, and in other parasites, is extremely important for medicine. The fact that antibiotic resistance existed before medicine discovered antibiotics does not change the fact that antibiotic resistance is evolving all the time, especially when medical or veterinary practice carelessly overuses antibiotics as a substitute for good preventative measures or as a placebo. These days, evolution of predators is less of an issue for medicine. Also, predator-prey evolutionary arms races tend to be somewhat slower than parasite/pathogen-host, because the latter tends to be controlled by direct molecule to molecule interaction whereas the former is more about sizeable physical attributes unlikely to change significantly with alteration of a single DNA base.

Evolution also helps explain the functions of features. We should expect there to not be many areas of DNA or body features that have no use at all; those tend to get lost over time, though it can be slow. But we have many aspects that make sense only in light of an evolutionary model. Getting goose bumps doesn’t help you when you are cold or scared. But it was useful in furrier ancestors, where fluffing up fur would help keep them warm and make them look bigger. Learning to cook has decreased our need for strong jaws and big teeth, but changes in those have not been completely coordinated, much to the profit of orthodontists. We can get scurvy because a key gene in our vitamin C synthesis pathway has mutated, and the dysfunctional mutation is shared across monkeys and apes. There’s no sense in a common designer putting the same junk sequence separately into different organisms, if we assume that the intelligent designer has more intelligence and more care for the quality of the outcome than Microsoft. The course of development starts with more generic features and some structures are formed, then broken down again as an embryo matures. All of these fit well with using an evolutionary method of creation, but not with separate creation.

“Evolution News” is actually “Antievolution Claims”, not an unbiased source nor particularly reliable. Regardless of your particular sympathies, you should be aware that citing it will not make you sound credible.

Evolution is slow, and does not have any particular reason to go where we might want (except in artificial selection), so it is quite true that genetic modification is a much quicker route to achieve a specific goal. But that has nothing to do with the question of how we got to where we are.

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Cancer occurs ultimately because of mutations in cells that disrupt the regulation of cell growth and division. The development of tumor seed cells reflects the occurrence of certain mutations, for example. There are myriad particular types of cancer. Mutagens such as high-energy radiation and various chemicals promote the occurrence of cancer. Often, the working together of effects from multiple mutations is key. The body has a number of defenses to prevent cells from getting out of line, so there is strong evolutionary pressure selecting against cancer - only the cancers that are able to evolve ways to avoid those defenses will be successful and spread. Of course, that “success” is short-lived in the vast majority of cases, as the cancer’s successful spread leads to the demise of the host; only a few transmittable types of cancers are known, and all so far are in animals (dogs and Tasmanian devils are the best-known, but recently a number of possible examples have been found in marine invertebrates). Cancer cells make use of genetic features that evolved to be a part of normal cell function. Also, cancer most often takes a while to have its effects, so animals have a decent chance of reproducing before it takes effect. As a result, there is not much evolutionary pressure against genetic susceptibility to cancer in old age.

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Forgive me, I may be off topic or hitting my own soap box… but this just caught me again how common and problematic this equivocation is… across numerous posts (not just yours, Phil)… thus I find myself pleading that folks might recognize the equivocation that is used here, however unintentional… and why it is so important to clarify terms, and why, however often i am chided for it, some term such as “Darwinian evolution” or “Macroecolution” or the like is so critical to use.

Can I humbly point out again that Ken Ham, Michael Behe, AIG, everyone at Discovery Institute, etc., etc., etc., all believe “evolution” in the sense that the term is being predominately used here, when it is relevant to infectious disease, cancers, genetics, antibiotic resistance, viral mutations, congenital diseases, and any other such application in medicine?

e.g., might I point out that Michael Behe has put significant work in examining the evolution of malaria, it’s acquired resistance, and thus its relation to medicine and control of that infectious disease?

Can I ask, then, in this context of belief in evolution as it relates to medicine, and given how the term is being tossed around here across various posts without qualification…

Does Michael Behe believe in “evolution”?

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Well, it is certainly possible to accept parts without accepting the whole. Of course, no scientist believes in evolution, but they do hold that it is the best explanation put forth for the observed data.

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Because IDists break it into smaller pieces or that it can be discussed at various discrete levels does not mean that it is not a unified whole, and thus not an equivocation.