godfather of surgery

Chapter 1310 Attack and Regulation

"The consensus in the academic community used to be that the war on cancer was a never-ending arms race: we invent new drugs, and tumors evolve drug resistance. But if our theory is correct, the arms race will end."

Yang Ping sounded quite excited.

“This will not be an arms race, but a dialogue. We have finally learned to tell cancer cells in a language they can understand: Your existence is a mistake. Now, correct it.”

Yang Ping discussed the matter with everyone for a long time before leaving the research institute very late.

His mind was still filled with data, models, and patient selection criteria...

I opened the door; a small light was on in the living room. Xiao Su was already asleep, but there was a thermos on the dining table with a note underneath:
"The soup is in the thermos. Goodnight, my professor."

Yang Ping stood in the living room for a long time, holding the note.

Then he tiptoed into the bedroom. Xiao Su was already asleep, and his son was also sleeping soundly in the small bed next to her, holding a dinosaur doll in his arms.

He gently kissed Xiao Su's forehead, then gently stroked the child's hair.

Yang Ping went back to his study and turned on his computer. The screen lit up, displaying the standby interface of the "Life Logic Simulator," which was a dynamically rotating three-dimensional structure of the TIM protein, surrounded by various possible interacting molecules. In fact, this simulator was a simplified version of a digital human.

He entered a password, which brought up the ultimate question he had pondered for a long time but had never written into any formal document:
"If the identity fraud of cancer cells is a 'systematic error,' then what initially caused this error? Is it random noise from gene mutations, or an inevitable manifestation of the inherent fragility of living systems? If we can correct the error, can we prevent it from happening in the first place?"

These issues may extend beyond cancer treatment itself, touching upon more fundamental principles of life, aging, disease, and health.

Medicine itself is about understanding life and ultimately restoring it to its proper, orderly, and beautiful state.

Another draft of a paper has been completed, with a simple title: "A Study on the Mechanism of K Factor-Induced Programmed Death in Tumor Cells Based on Identity Falsehood Hypothesis".

The core hypothesis can be succinctly summarized in three sentences:

Cancer cells evade the endogenous clearance mechanisms of multicellular organisms by abnormally expressing and utilizing TIM superfamily proteins to forge and maintain their "normal cell" identity.

As a high-affinity ligand, factor K undergoes a conformational change by binding to TIM, thereby transmitting a mandatory "identity failure" signal into the cancer cells.

This signal triggers a pre-set but suppressed "order maintenance protocol" within cancer cells through a mechanism that is not yet fully understood, initiating multiple procedural clearance pathways, including apoptosis, immune exposure, and autophagy.

Instead of claiming to have proven anything, the paper proposes a unified framework to explain a large number of experimental phenomena. It devotes one-fifth of its content to detailed data from three decisive cases of childhood osteosarcoma, melanoma, and pancreatic cancer, demonstrating that the role of factor K does not depend on traditional killing mechanisms, but is highly correlated with the activation of "fate checkpoint" genes inherent in cancer cells.

Finally, the paper boldly proposes a prediction that can be verified or falsified:

"If this hypothesis holds true, then theoretically, any malignant tumor expressing TIM can be induced to undergo programmed clearance by designing specific K factor variants. The clearance mechanisms include apoptosis, immune exposure, autophagy, etc., which may depend on the specific connection between the TIM variant and downstream pathways, and thus can be predicted and designed."

Yang Ping revised the paper several times, then poured soup from the thermos, the warm aroma filling the study.

Yang Ping drank the soup, turned off the computer, and went to the bedroom.

A few days later, Yang Ping's new paper was published in the journal "Medicine" hosted by the Sanbo Institute. This new type of journal, which is mainly online and supplemented by print, is very efficient.

Soon, the contact phone of Sanbo Research Institute rang at different times.

News editors from the three major journals, Nature, Science, and Cell, simultaneously sent interview requests.

Yang Ping's paper has been downloaded over 100,000 times—an astronomical number for a highly specialized biology paper.

A renowned systems biologist at MIT wrote on his blog: "If this hypothesis is confirmed, we will usher in a post-targeted era of cancer treatment, where we will no longer just attack a part of a cancer cell, but engage in dialogue with its entire logic of existence."

But the criticism was equally fierce. One Nobel laureate tweeted: "Magnificent imagination, fragile evidence, reducing everything to the underlying protocol of a single cell is almost mystical."

Three days later, the storm intensified, with discussions about clinical trials of K therapy intertwined with discussions about Yang Ping's hypothesis.

“This is more than just effective,” a senior oncologist said in a television interview. “It’s a game-changer for some of the deadliest cancers. It’s a completely new concept, the ultimate treatment for cancer.”

“This line of thinking is very correct. I didn’t expect him to be able to propose such a complete hypothesis. After human cells become abnormal, the normal process should be that they are cleared by the immune system. The reason why the tumor is not cleared is because it disguises itself. Now, factor K can force it to reveal its true form, so the body’s ability to clear abnormal cells will be demonstrated.” Another cell biologist expressed his surprise.

The supply of K therapy soon fell short of demand.

Factor K has a complex manufacturing process and limited production capacity. Healthcare systems in many European and American countries have begun discussing prioritizing its use, and insurance companies are urgently assessing coverage options. On the black market, rumors suggest that a single dose of Factor K is being sold for as much as $500,000.

All of this has brought the spotlight to the originator of the theory—Yang Ping and the Sanbo Research Institute he leads.

The first group of visitors was a joint delegation from the Broad Institute of Harvard and MIT, consisting of six world-leading cancer genomicists and systems biologists. They came with dozens of pointed questions and planned a three-day academic exchange.

Yang Ping did not receive them in the conference room, but instead led them directly into the laboratory.

“The theory is on paper, the evidence is here.” He pointed to the high-throughput surface proteomics platform, the cryo-electron microscopy room, and the single-cell sequencer that were in operation. “You can ask questions about any part of the process and view any raw data.” The first day was filled with heated debate. An MIT professor fundamentally questioned the concept of “underlying protocols”: “That sounds like teleology. Evolution doesn’t presuppose ‘protocols,’ only the mechanisms left by natural selection.”

Yang Ping pulled up data on embryonic development: "In vertebrate limb development, if a finger bud cell is mispositioned, it will be eliminated through a specific apoptosis procedure. Isn't this a pre-set 'protocol'? When a tadpole transforms into a frog, the tail cells die in an orderly manner. Isn't this a pre-set 'protocol'? The complexity of multicellular organisms requires cells not only to grow, but also to know when to stop growing, when to change their identity, and when to self-eliminate. Aren't the logical frameworks of these procedures written into developmental programming?"

"But that's related to cancer."

“Cancer hijacks these very processes that maintain normal tissues.” Yang Ping showed a comparison of TIM expression in embryonic and cancerous tissues. “The TIM family is involved in cell identity definition and boundary formation during embryonic development. Cancer cells reactivate and misuse this system.”

The debate continued late into the night. But the next day, when the delegation witnessed firsthand the dynamic conformational changes of TIM captured by cryo-electron microscopy and the synchronous activation of "apoptotic preparatory component" genes after K factor treatment in single-cell data, the doubts began to turn into in-depth discussions.

On the third day, as they parted, the head of the delegation, a Nobel laureate known for his rigorous standards, shook Yang Ping's hand and said, "I still don't completely agree with your philosophical framework, but I can't deny the chain of evidence you've presented. The path you've taken is unique; please continue on it. We will try to replicate some of the key experiments in our own laboratory."

This became a common pattern for subsequent visitors: they came with doubt and left with shock.

The academic community's enthusiasm is just the beginning; the real pursuit comes from families directly threatened by cancer, especially those with wealth and resources.

The administrative office of the Sanbo Institute began receiving a deluge of emails. They came from ancient European families, Middle Eastern royalty, Silicon Valley upstarts, and Asian conglomerates. The messages were largely the same: willingness to donate any amount, with the sole request being to ensure a family member received K-therapy treatment or participated in the latest clinical trials. This was a much stronger response than when K-therapy was first launched.

The institute has set up a dedicated team to handle these requests, strictly adhering to medical and research ethics, but the pressure is ever-present.

A private jet belonging to an American tech tycoon landed directly at Nandu Airport. His chief medical officer arrived at Sanbo with complete medical records and offered to donate $100 million to establish a joint research center, hoping to design a personalized K factor for his terminally ill wife.

“We understand how you feel,” Song Ziming explained patiently, “but developing a personalized K-factor takes time and must follow a research process.”

“Money is not the issue, time is,” the other party stated bluntly. “She may only have a few months left. We are willing to take all the risks and sign any waiver documents.”

Yang Ping ultimately participated in the meeting in person. He did not promise treatment, but agreed to allow the team to analyze the TIM characteristics of the patient's tumor samples and include them in the validation cohort of the "Life Logic Simulator". "If the theoretical prediction has a suitable strategy and complies with ethical review, we will consider it, but this is not a deal, this is scientific exploration."

When the other party left, they left a check for fifty million US dollars as an unconditional research donation. "Whether or not it cures my wife, please continue your research. You may be the hope of many people."

In the midst of this storm, Yang Ping did something that surprised many people: he published a paper in the medical journal he founded that had absolutely nothing to do with cancer.

The paper is titled "Medicine as Dialogue: A Philosophical Turn from an Adversarial Model to a Systemic Repair Model".

This is an interdisciplinary intellectual essay that integrates medical history, philosophy of science, and systems theory. Yang Ping argues that modern medicine has long been dominated by the "war metaphor": disease is the enemy, drugs are the weapons, and treatment is the battle. While this metaphor is powerful, it has its limitations; it can lead to overtreatment, neglecting the body's self-healing abilities, and placing patients in a passive position.

The underlying mechanism of K therapy suggests another possibility: medicine as a dialogue with the body's systems, mobilizing the body's powerful life mechanisms.

"When a doctor uses antibiotics, he is introducing external aid to kill bacteria; but when he uses factor K, he is sending a message that the cancer cell's 'identity operating system' cannot ignore. The former is external intervention, while the latter is the awakening and correction of the system's internal logic."

The ideal form of medicine may not be the most powerful external attack, but rather the most precise internal regulation, helping the body restore its inherent balance and repair capabilities.

The article cites the traditional Chinese medicine concept of "strengthening the body's resistance and eliminating pathogens," the modern immunology concept of balance, and the "self-organizing criticality" in complex systems theory. Yang Ping does not belittle traditional therapies but proposes an integrative perspective: in some cases, "war" is needed (such as acute infections), while in others, "dialogue" is required (such as with chronic diseases and cancer).

The concept of war is attack, while the means of dialogue is mediation.

"The reason why cancer is so difficult to treat may be that it is not an invasion by an external enemy, but a logical rebellion of its own system. The way to quell the rebellion is not necessarily a more violent attack, but a more precise regulation. In biology, this means restoring the normal function of the cell's identity and order maintenance system."

The impact of this philosophical article unexpectedly surpassed that of the biology paper. It was reprinted in full by The New York Times, made into a BBC documentary, and sparked widespread discussion in the field of medical humanities.

A renowned medical ethicist commented: "Dr. Yang Ping reminds us that medicine is not only a science, but also a skill and a philosophy. While pursuing technological breakthroughs, we should not forget that the essence of treatment is to help life return to its proper state, not just to eliminate abnormalities."

The Sanbo Institute's recruitment email receives hundreds of resumes every day from top postdoctoral fellows and young professors from Harvard, Stanford, Cambridge, and Heidelberg, who are willing to take pay cuts to join. Yang Ping's schedule is packed with interviews, so he has to delegate most of the initial screening to Song Ziming and Tang Shun.

Attack, adjust!
Yang Ping leaned back in his office chair, pondering the two words repeatedly. The basic knowledge from the book "Traditional Chinese Medicine" he had read kept coming to mind.

Adjust, adjust, adjust!

Isn't this exactly the philosophy of Traditional Chinese Medicine?

However, in ancient times, our ancestors used herbs from the agricultural era to achieve this goal on a macro level, while we now use biological science to achieve this goal at the cellular level.

The methods may differ, but the underlying principles are the same. The ideas our ancestors gave us are so advanced, but we have never paid attention to them.

Traditional Chinese medicine is a great treasure trove, and Yang Ping finally understands this now.

Ultimately, the way to conquer tumors is not through attack, but through regulation. Yang Ping felt that he had found a way out. Not only in the treatment of tumors, but also in many other diseases, such as hypertension and diabetes, this concept might be able to cure them.

He was extremely excited. The modernization of Traditional Chinese Medicine (TCM) and its integration with Western medicine have actually been on the wrong track. True integration means using modern medical technology to realize the principles of TCM. Modern medicine excels in technology, while TCM is advanced in its concepts. It's just that in ancient times, TCM had no choice but to use natural plants, animals, or minerals to achieve this goal.

Now, this can be achieved using various advanced technologies such as biochemistry, genetics, and cell biology.

(End of this chapter)