How crypto could come to cure cancer

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Before I get cancelled for a clickbait headline in this week's hot take, let me be absolutely clear — crypto (more specifically 'Web3') is going to enable incredibly powerful network effects over the next decade.

What that means in plain English is the power to bring together a bunch of strangers, with their combined energy and funding, around a shared mission.

We are already seeing that play out with dozens of communities focused on less serious goals, but I believe we are on the verge of seeing exponentially more good come from network effects being applied to some very worthy missions.

But curing cancer? Zack, you have to be kidding. Right now that same powerful "network effect" you're talking about is being used to create Web3 communities like the one called "CryptoDickbutts." Surely, you can't be serious.

I am serious (and please don't call me "Surely.") In this week's newsletter, we're taking a deeper look at what's going on with one of the most exciting aspects of the nascent Web3 world — where community network effects are starting to be applied to the world of medical research. It's called "Decentralized Science," or "DeSci" for short.

Source: Getty Images

In order to understand what is at play here and why it could lead to a cure for cancer — let's first start by defining what I'm talking about when I say "Web3" or "network effects."

If Web1 was the beginning of the internet, which only allowed users to "read" static web pages, Web2 is the age we've known for the last decade. "Read/Write allowed us all to edit web pages and interact with them on Facebook, Reddit, and the like. In the age of Web3, we're talking about unlocking read/write/own. That allows users the ability to not only interact, but also own their interactions directly and jointly. It enables entirely different incentive structures.

Again, it might be easiest to use a dumb example — but an important example. You might recall that story from last year about a group of friends who had a crazy idea to group their funds to buy the last surviving copy of the U.S. Constitution at auction. It started as a joke, but ballooned into an internet sensation to raise more than $40 million dollars. The project, called Constitution DAO, eventually failed to win the Sotheby's auction, but it still proved what could be possible in this brave new world.

I, myself, contributed funds to Constitution DAO. Anyone could contribute and earn tokens that represented a quasi-ownership stake in the project. In the case of this DAO, or Decentralized Autonomous Organization, the ownership stake wasn't an actual piece of the Constitution itself, but it was voting rights over what the group would have decided to do with it (where it would be stored, etc.)

When the group failed to buy the Constitution, contributors had the right to redeem the funds they contributed in ethereum (the crypto used to buy into the project) or $PEOPLE tokens (the tokens that represented to ownership stake in the DAO.) Interestingly, the price of $PEOPLE token would come to increase 10-fold in a matter of weeks. Why?

Well, one reason is people like speculating on stuff in crypto. Yes, the "Greater Fool Theory" is one often cited by crypto detractors who say the whole thing is just someone buying something with the hope of selling it to a greater fool later on at a higher price. I won't deny that goes on a lot, but just entertain the other reason for a second ...

Maybe, the other reason was that Constitution DAO had just attracted a lot of money and a lot of attention to become the talk of crypto town. It was covered by Today, and other mainstream outlets. When it looked like it was going to be able to raise enough to be a serious bidder in the auction, it drew in even more money. In a world fueled by momentum, that momentum could have been used in a lot of different ways. And because it had attracted a community of a lot of smart and possibly wealthy individuals, that meant something. On the internet, the value of community carries shocking importance. Even off the internet, that much is obvious.

Ok, but what does that have to do with cancer?

Alright, this is maybe where I might couch my hot take ever-so-slightly. Cancer research has been incredibly well-funded for years, and plenty of top institutions have already made incredible advances in the fight against the second-leading cause of death. But there are some specific cancers, that are incredibly hard to fight and aren't common enough to attract the level of research required to make meaningful strides. This is where Web3 becomes incredibly important — not just for curing cancer, but for any uncommon medical ailment.

This becomes incredibly obvious when you think about incentive structures in Big Pharma vs. the incentive structures of a community around a shared medical advancement. Just look at how America's opioid crisis began: Doctors were paid to prescribe unnecessary painkillers. Their incentive structure didn't prioritize patient outcomes. It prioritized profits.

And look, I'm not saying that's always going to be the case. But, it's really not quite hard to see why America's pharmaceutical industry in particular is really messed up. In other countries, it would be laughable to see so many pharma commercials that end with "Ask your doctor about Drug X, or Drug Y."

I'll give you one specific example that will be incredibly obvious to any 20-something male who has ever been battered by the advertisements about hair loss. There are two drugs you can turn to: Finasteride or minoxidil. Finasteride was originally FDA-approved to shrink prostates in men. When a side effect of hair growth was discovered, Merck sought FDA approval for that use as well, but there were problems.

Finasteride has been shown to cause severe and sometimes permanent side effects in some men, including a total loss of erections or a link to suicidal thoughts. In other countries, regulators added those warnings, in the U.S. the FDA did not until patients sued. The data hinted these side effects are more common than what Merck initially reported. Merck also moved to seal documents that would have revealed exactly what they knew. Their incentive is to protect drug sales, not necessarily patients. Hims, Roman, and other Finasteride sellers also sell erectile dysfunction pills and anti-depressants so even if patients become impacted by side effects, they stand make even more money.

And yet, as dangerous as Finasteride looks on the surface, a less side-effect prone option is often overlooked. Minoxidil is the active ingredient in Rogaine. It has been used for hair loss forever, and it’s cheaper than Finasteride but because it’s off-patent, there is not a huge incentive for drug companies to show it could be a much safer treatment option for some patients. As the New York Times recently highlighted, a double-blind placebo trial would once and for all prove it’s a less risky treatment option, but who would want to pay for it?

“There is no incentive to spend tens of millions of dollars to test it in a clinical trial. That study truly is never, ever going to be done," one doctor quoted in the article said. But if patients could pool their money together to fund better treatments for their problems, wouldn’t they? I certainly would. And if people on the internet can raise $40 million in a couple of weeks to buy the Constitution, I'm fairly certain even more can be raised for certain medical problems.

Before the internet, it was difficult to even find others suffering from the same ailment — let alone work together on the solution. But in the case of DeSci, some groups are already leading the charge on community-owned research projects. Love, a DeSci project that boasts the former Vice President of Immuno-Oncology at AstraZeneca, is already forging a new path forward for "people-powered pharma."

Again, it might not be the case that DeSci comes to replace all medical research. That traditional model works for a lot of general solutions in medicine. But for bringing together marginalized communities around a shared goal, Web3 technology is unlocking a powerful wave that's just beginning. It's not as far fetched as you might think to see a community-owned project soon making the strides to find a cure for rare types of cancer.

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