Whether you are a patient newly diagnosed with cancer, a long-term survivor, or a family member or friend of someone with cancer, you will inevitably delve into the current state of cancer care. You may believe that you have chosen the best treatment option available, but you are likely unsatisfied with the outcomes and yearn for better solutions.
I initially ventured into the field of biology, driven by a commitment to seek improved treatment options for cancer patients I knew. My non-medical background, coupled with extensive experience in the complex fields of atmospheric science and economics, enabled me to develop a straightforward and practical framework for tackling complex scientific challenges during the process of developing a new drug that aligns with the long-term interests of cancer patients. This framework coincidentally aligns with the innovative thinking behind SpaceX's development of groundbreaking reusable rockets.
The complexity of cancer treatment far exceeds that of rocket launches, not because the technology required is more complex, but due to the inherent intricacies of the cancer treatment process itself. However, the paradigm shifts in breaking conventional thinking are remarkably similar in both fields.
In economics, there is a fundamental principle that the provision of public goods is inefficient in the absence of direct involvement by stakeholders. Before Elon Musk founded SpaceX, national space launch services were such public goods. The introduction of profit-motivated companies into the space launch market led to a transformative shift in thinking and the emergence of reusable rocket technology.
In the realm of cancer care, I have observed that patient involvement is minimal, which may be a contributing factor to the globally low quality of cancer treatment. Drawing a parallel, just as Musk applied first principles to achieve cost-effective space launches, allowing SpaceX to dominate 90% of the global space launch market, similar innovative thinking could revolutionize cancer treatment standards.
This book, "Confronting the Cancer Care Plight: Using First Principles to Navigate Your Cancer Journey," is crafted against this backdrop. It encourages cancer patients to actively participate in their treatment process and provides a set of principles based on first principles thinking to help patients achieve the true goal of cancer treatment: to live a high-quality life while effectively combating the disease.
This book was completed in April 2024.

TABLE OF CONTENTS 5
PREFACE 8
PART ONE: FIRST PRINCIPLES IN CANCER TREATMENT 12
1. CANCER TREATMENT LIMITATIONS: SIGNIFICANT PLIGHT IMPACTING PATIENT CARE 13
1.1 Global Cancer Data 14
1.2 Current Cancer Treatment Methods 17
1.3 Decision Paralysis Caused by Healthcare Systems and Medical Research 18
1.4 The Chaos of Overtreatment 20
1.5 Debunking the Myth of "Early Detection, Early Treatment" in Cancer 24
1.6 Patients' Tendency to Not Participate in Decision-Making During Treatment 29
2. FIRST PRINCIPLES AND REDUCTIONISM 32
2.1 What Are First Principles? 33
2.2 The Process of First Principles Thinking and Its Distinction from Reductionism 36
3. HOW TO ANALYZE CANCER TREATMENT USING FIRST PRINCIPLES 42
3.1 Identifying the Real Problem 44
3.2 Breaking Down the Real Problem 45
3.3 Analyzing the Fundamental Components 47
3.4 Reassembling Information 49
PART TWO: THE ESSENCE OF CANCER TREATMENT (CANCER AND AGING IN THE LIFE MODEL) 51
4. THE LIFE MODEL 52
4.1 Constructing a Life model 53
4.2 Treatment or Prevention of Diseases 56
4.3 The Life Model as a Precise Expression of First Principles 58
5. CANCER AS A PART OF AGING 62
5.1 The Connection Between Cancer and Aging 63
5.2 Cancer and Aging in the Life model 65
5.3 Insights from Anti-Aging Strategies for Cancer Treatment 67
6. THE CANCER MODELS 71
6.1 Efficacy (or Inhibition Rate) 76
6.2 Safety 77
6.3 Drug Resistance 79
6.4 Sustainability 82
6.5 Convenience 84
PART THREE: NAVIGATE YOUR CANCER JOURNEY 86
7. CANCER TREATMENT MAP - NCCN GUIDELINES 87
7.1 Content of the NCCN Guidelines 88
7.2 Limitations of the NCCN Guidelines 92
7.3 Steps for Selecting Existing Cancer Treatments in the NCCN Guidelines Using First Principles 95
7.4 The Helsinki Declaration and Off-Label Drug Use 99
8. USING FIRST PRINCIPLES TO DECIDE ON CANCER TREATMENT OPTIONS 103
8.1 Building a Cancer Treatment Analysis Model Using First Principles 104
8.2 Evaluating Existing Cancer Treatments Using a Five-Factor Framework 106
PART FOUR: THE FUTURE DIRECTION OF CANCER TREATMENT 127
9. APPLYING FIRST PRINCIPLES TO INNOVATE CANCER TREATMENT APPROACHES 128
9.1 Innovative Combination Therapies 129
9.2 Transition from Systemic Medication to Intratumoral Injection 135
9.3 Development Directions of Intratumoral Injection Drugs 136
9.4 Introduction to Preclinical Research on a New Intratumoral Injection Drug 139
PART FIVE: FURTHER READING 147
10. MATHEMATICAL MODEL OF LIFE 148
10.1 Model Establishment 148
10.2 Model Validation 151
11. A PRECLINICAL RESEARCH REPORT 160
Intratumoral Delivery of Chlorine Dioxide Exploits its ROS-like Properties: A Novel Paradigm for Effective Cancer Therapy 160
12. MATHEMATICAL MODELS OF CANCER 183
12.1 Establishment of Cancer Development Model 183
12.2 Estimating Model Parameters Using Preclinical Research Data 184
12.3 Mathematical Models of Cancer Treatment 185
ABOUT THE AUTHOR 197

As we journey through life, the specter of cancer looms large, presenting a formidable challenge that many of us may eventually face. When confronted with cancer, our priorities shift dramatically, with life itself swiftly rising to the forefront of our concerns, relegating all else to the background. Our immediate focus narrows to combating this disease. While many adhere strictly to their doctor’s recommendations, selecting treatments reputed for their efficacy and cost-effectiveness, this path is not the sole option. It is crucial to recognize that, although contemporary cancer treatments might appear limited, this does not necessarily reflect on the reliability of medical advice. On the contrary, I believe the reason for the inadequacy in cancer treatment levels is that the entire cancer treatment system does not aim to address the fundamental issues of cancer.
Globally, the data reveals a startling uniformity in cancer treatment technologies across various age groups and nations, suggesting that advancements in systems, economies, and technologies have not significantly enhanced the value delivered to cancer patients. Moreover, there is a pervasive trend of overtreatment within the healthcare system dedicated to cancer care. Standardized clinical guidelines, while providing uniform treatment options, restrict the choices available to both physicians and patients, diminishing the patients' involvement in their own treatment decisions. Consequently, the treatment plans prescribed, though based on these guidelines, may not always align with the patients' long-term interests, particularly in terms of sustaining a quality life. Furthermore, the emphasis on early detection and treatment can also act as a catalyst for overtreatment.
Facing the cancer care plight, as a cancer patient, wouldn't you want to reclaim your voice and break free from this predicament?
Inspired by SpaceX’s revolutionary approach to rocket launch technology, which utilizes reusable components for enhanced cost-effectiveness, we can adopt a similar mindset in cancer care. This approach, known as first principles thinking, championed by Elon Musk, challenges us to discard conventional dependencies on analogies, precedents, and conventional wisdom. Instead, it involves deconstructing complex concepts, problems, or beliefs to their most fundamental components and rigorously examining the core of the issues.
Our lives are governed by various principles, shaped by our values, perceptions, belief systems, and reasoning methods. These principles influence our opinions and allow our brains to employ previously learned conclusions as shortcuts in thinking. Often, we adhere to these principles without questioning their foundational assumptions. While these principles may have been valid at their inception, questioning their relevance today necessitates that we overturn outdated theories and forge new realities for ourselves.
First principles thinking encourages us to embrace a new mindset, recognizing when traditional methods become obsolete. This shift in thinking eschews conventional wisdom, cuts through dogma, and challenges our own beliefs. While first principles thinking and traditional reductionism both emphasize deconstructing problems into their elemental parts, they differ in their applications and impacts. First principles thinking focuses on controlled, thoughtful examination at a foundational level, whereas reductionism often reduces problems to a microscopic scale. This distinction allows first principles thinking to provide more profound and innovative solutions to complex issues like cancer treatment, enabling us not only to better understand the nature of cancer but potentially to uncover more effective treatments.
In the realm of modern medicine, which often remains entrenched in a reductionist approach, applying first principles thinking is crucial. For cancer, this means thinking at the cellular rather than the molecular level, which is often the focus of cutting-edge research in molecular biology or genetics. By reevaluating the causes and processes of cancer through first principles and developing treatment strategies at the cellular level, we can utilize mathematical models to ensure logical completeness and accuracy, provided the input data and model settings are correct.
In this book, I introduce a life model that simplifies life into a mathematical framework, helping us pinpoint the primary factors and processes impacting life. By applying the life model, we can perceive cancer as a manifestation of aging, encapsulating the essence and treatment methods of the disease. I believe the life model exemplifies a precise application of first principles in disease management.
We address cancer using a first principles approach, following a structured process: identifying the issue, breaking it down, analyzing its fundamental components, reassembling the information, and using life models as tools for reasoning. We've further developed a cancer model consistent with these principles, leading us to the best strategies for combating cancer—a comprehensive framework for evaluating cancer therapies. Our optimal cancer treatment plan includes combinations or legal variations of approved therapies, in compliance with existing medical regulations. We discuss experimental treatments only in the context of potential future advancements in cancer care. Through this book, I aim to encourage cancer patients to actively engage in their treatment decisions and assist them in making the best choices under current conditions.

Living long enough almost inevitably brings you face-to-face with cancer, with the lifetime risk of developing it nearing 20%. This certainly makes cancer seem like a common occurrence. However, once diagnosed, many people feel the looming shadow of death, filled with fear and anxiety. At this point, you might find yourself focusing solely on treatment, with everything else taking a backseat.
In such circumstances, choosing the right doctor and treatment plan becomes crucial. You have the option to passively follow your doctor's recommendations or actively seek out the treatment you believe is most suitable. Understanding the current state of modern cancer treatments can help you make more informed decisions and find a treatment plan that is both scientifically sound and tailored to your personal situation.
1.1 Global Cancer Data
In 2022, nearly 20 million new cases of cancer were reported worldwide, with 9.7 million people dying from the disease. Looking at data from the United States, there has been a noticeable decline in cancer mortality over the past 20 years, suggesting significant advancements in American cancer treatment technologies. However, a different perspective might reveal a less optimistic situation.
For example, in 1999, 560,000 people died from cancer in the U.S., with a death rate of 201 per 100,000 people. By 2022, the number of deaths had increased to 600,000, but the death rate per 100,000 people had dropped to 181, indicating only a 10% decrease in the mortality rate. This suggests that despite technological progress, the actual impact on extending the lives of cancer patients may not be as significant as hoped.
Moreover, while the U.S. is often seen as a leader in cancer treatment, its cancer mortality rate does not stand out significantly on the global stage. U.S. cancer mortality rates are lower than some developed countries but are comparable to China's and higher than those of Brazil, India, and Indonesia—three developing nations. After adjusting for age, the cancer mortality rates in most countries worldwide typically range from 80 to 100 per 100,000 people, with only minor differences between countries, except for India, which is slightly lower.
These statistics indicate that despite substantial investments in cancer treatment, the U.S. has not achieved a correspondingly low mortality rate. This may mean that compared to some developing countries with less advanced medical conditions, U.S. cancer treatment technologies do not have a significant advantage. This situation reflects a common challenge in the global field of cancer treatment: how to more effectively utilize existing resources and technologies to truly improve the survival rates and quality of life for cancer patients.