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A scientific article by Dr. J. James Frost, MD, PhD, MBA, entitled Cancer’s Intelligence, was published in the International Journal of Unconventional Computing. In a novel take on an intriguing topic, Dr. Frost examines the question and implications of cancer possessing intelligence. He addresses the matter from first principles: what is intelligence and what can be intelligent? He continues by juxtaposing the intelligence of the oncologist against the intelligence of the cancer. Does cancer more often win its match against the oncologist and the body’s own innate defenses, as the result of its greater intelligence, and what does it in fact mean for cancer to be intelligent?
Dr. Frost is a Johns Hopkins Professor emeritus of Radiology and Neuroscience who was a pioneer of molecular imaging at Johns Hopkins in the 1980s. Over subsequent decades he developed and expanded molecular imaging research and clinical applications in the brain and other body regions. In part as a result of his friendship and work with the late Johns Hopkins Professor and cancer expert Dr. Donald S. Coffey and the Brady Urologic Institute, Dr. Frost developed a new interest in cancer. He explored subjects including the clinical problems of cancer treatment and cancer’s makeup at its most foundational level. Frost tells this story in the article Two minds create a third: an exploration of the universe, cancer, and symmetry with Donald S. Coffey. Perhaps the most significant output of this collaboration was a seminal 2017 article that advanced our understanding of cancer at its most basic level, Symmetry and symmetry breaking in cancer: a foundational approach to the cancer problem. This general approach to understanding cancer ultimately led to Cancer’s Intelligence, which further explores a foundational assessment of cancer: what is the origin of the actual cancer phenomena we observe and experience?
A central aspect of this work looks at cancer’s ability to compute its ingenious and, typically, effective response to the oncologist’s attempts to eradicate it. Computation is major feature of intelligence that is investigated in the field of computational intelligence. By way of detailed analysis, Dr. Frost draws a comparison between the computational features of cancer and the computational abilities of humans, the animal world, and even microscopic structures like bacterial swarms and beakers of reacting molecules. One common manifestation of human computational intelligence is recreational game play, including the most challenging games of chess, go, and poker. A series of recent publications on artificial intelligence for Texas hold’em poker caught Dr. Frost’s eye and led him to contemplate how intelligent a human must be to be an expert poker player and by analogy, how intelligent an oncologist needs to be to beat cancer. Poker is one of the most complex games we know, with 10 followed by 160 zeros possible games between two players. Each player’s hidden cards are a key feature, unlike chess where both players see the full information on the board in front of them. More scientifically stated, the information is asymmetric between two players in poker and symmetric in chess. In the case of cancer, most of its cards are hidden: the oncologist attempts to uncover them with molecular marker profiling, radiographic imaging and other technologies. If the game against cancer is anything like the poker example, an oncologist would need to possess extremely high intelligence to win in a game with cancer.
Another facet of poker that intrigued Dr. Frost is bluffing. Bluffing, a form of deception, exists throughout the natural world. Every day, humans and animals conceal the truth and mislead others with false signs and signals. For example, birds will fake a broken wing so as to appear vulnerable to predators, leading them away from its nest until the bird can safely fly away. The question of whether cancer bluffs is one that Dr. Frost examines, looking at dormant periods of cancer growth – when confronted with an onslaught of chemotherapy and radiation – only to restart even faster growth once the oncologist ceases therapy, believing the cancer to be controlled. Is there a parallel to be drawn between bluffing in poker and bluffing in cancer’s game with the oncologist? Dr. Frost goes further, assessing both artificial intelligence algorithms for human game play, and whether they might be used to aid the oncologist.
Finally, the article tackles the structure and operation of cancer’s own internal computer. As cancer must compute in order to be intelligent, Dr. Frost examines the definition of computation and what entities are capable of it. In short, most anything can compute, from knots on a string, to the computer on a desk, to swarms of bacteria, to flasks of interacting DNA molecules. In fact, all that we see around us is the result of different facets of computation, extending back to the Big Bang and the origin of the universe. But back to earth and cancer: the central ambition is to better understand cancer’s “intrinsic” computation, including the mix of computation and memory allocation. To what degree does cancer store information regarding past successes and failures against the oncologist, and how does it use this information and memory to compute new escape strategies in its next encounter? Dr. Frost addresses the structure of cancer’s computer, how information might be stored in the cancer cell, the cancer cell network, and in the external microenvironment around the cancer.
Combining the two concepts of complex game play’s artificial intelligence and intrinsic cancer computational intelligence, Dr. Frost offers his thoughts, and a potential roadmap, for further theoretical and experimental research. We must advance our knowledge and understanding of cancer’s internal game strategy, memory, and bluffing plays; measure the power of cancer’s computer and understand what level of computation the oncologist will need to counter it; develop and adapt human game play’s artificial intelligence to improve game play strategies against cancer; and identify the deceptive bluffing plays that lead to cancer’s dormancy and quiescence, in turn rendering it relatively immune to many therapies.
These and several others signposts in Dr. Frost’s paper lay a new groundwork for a foundational understanding of cancer with the ambition of helping the oncologist to play a winning game. Supplementing his intelligence with new artificial intelligence tools will result in a significant advance in the battle against cancer’s intelligence. So argues Dr. Frost in this groundbreaking and optimistic article, in which he concludes:
“The concepts summarized in this article squarely juxtapose the current cancer paradigm and the conditions for progress to a foundational level of understanding cancer and its intelligence. This new knowledge would necessarily lead to the development of novel measures to disrupt or reverse the cancer process. The road will be long and broad, requiring many disciplines to seamlessly stream together. It cannot be bypassed. The stakes are too high.”
