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Mar 14, 2008

ABC of science

A - IS for agnosticism. Science is agnostic by its very nature. All true scientists are agnostic by implication or inference. We know as much as we can, based on analysis of the data available to us. Data that fit a mathematical model.

Ultimate causes are unknowable. A related word is positivism. We cannot know more than what we know. We don’t speculate and we are not metaphysicians or soothsayers. It is true that something not proven today, for example, meridians in the human body, may one day be fait accompli. All we say is that all the extant data show that meridians do not conclusively exist.

B - is for bravery. It is courage in the face of prejudice. Evolutionary biology, a subset of scientific knowledge, riles many. It is the study of the web of life. All life forms are interconnected in geography and in history. The brave and courageous post-Darwinians (and I count myself as one of them) sometimes face an onslaught of invective even in today’s enlightened world. Oncology is part of biology. Cancer can be studied in evolutionary terms. In fact, it is very rewarding to study it that way.

C - is for count, calibrate and calculate. Measurements and mathematics matter a lot in science. (See D for more.) C is also for change. Scientific knowledge is ever changing. It is provisional. New data generate new theories. Theories are subjected to repeated experiments. When the findings of such experiments converge and corroborate each other, the theories become fact. Sometimes what we accept as fact needs revision in the face of new data. Science is not cocky. We go back to the drawing board and start all over again.
C is also for critical thinking. We exalt critical thinking but are we prepared to accept where critical thinking will lead us?

D - is, of course, for data. We collect lots of data whether we study the cosmos or cancer. Tied to data is measurement. We make lots and lots of measurements. And we subject these measurements to mathematical and statistical calculations. As I always tell my patients, if it is not measurable (as in most of the claims of traditional and complementary medicine), it isn’t science.

E - is for experiment. Every assertion about how the universe works is subjected to experiment. When we think of experiments, we think of mixing chemicals in the laboratory to verify the validity of chemical equations. We feed different compounds to laboratory rats to see their effects on the rats’ physiology (this is to be done within the strictest guidelines on animal experimentation). But even free will and consciousness are subjects of scientific inquiry today. (This is also tied to B for bravery as free will and consciousness are prickly to many people when approached scientifically.) E is also for evidence. From experiments (or clinical trials in the context of cancer medicine), we make conclusions. We discuss these conclusions thoroughly and eventually we make recommendations. For example, guidelines on how to treat early breast cancer are published every year.

F - is for fallible. (See also C for change.) Science never purports to be the ultimate truth. It approximates the truth. If you like mathematics, science can be likened to the asymptote. Science is fallible in the way that religion is not.

G - is for guru. We think of Copernicus, Galileo, Darwin, Einstein, Watson and Crick who laid the foundation of today’s science. We now have Hawking, Dawkins and Pinker. But big names and personalities are not important in science. There is no place for cults or worship of deities. We are all smaller than the grandeur of the science we know and the science that we pursue.

H - is for intellectual honesty. If there is one thing that science is and ought to be, it is intellectual honesty.

And finally O. (I to Z except O later.) Oncology is but a subset of science. It is the study of the nature and treatment of cancer. It is firstly based on the accepted body of knowledge of the structure and function of the human body. This knowledge is built up over the eons. Experiments are conducted on animals and human cells and tissues. Finally when a drug is identified that may possibly work in cancer patients, it is subjected to clinical trials. We conclude from these trials that this new drug is superior to our previous standard treatment. We then use this drug in our daily practice. This laborious process is driven by intellectual honesty.

Oncologists then make recommendations and guidelines for cancer treatment (provisional of course). Next year, we may change our minds based on newer and more robust data. This flexibility goes to show the innate strength and humility of science.

Oncology, for all its “failings”, is good and true science.

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