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Are you saying better to let an car engine seize from lack of oil and repair it vs. simply ensuring that there is enough oil? Or that we should add more and mo

Are you saying better to let an car engine seize from lack of oil and repair it vs. simply ensuring that there is enough oil? Or that we should add more and more firemen and firetrucks without putting in sprinkler systems and fire extinguishers. Better to have a nuclear accident and clean it up than to design nuclear power plants to not have accidents? Really?

Moshe_Silnorin 10y ago
An approach to disease that requires virtuous citizens is unlikely to work. And even if we all stopped smoking and getting fat, we would still die a few years later than we would have otherwise. Prevention just means you slow down your inevitable development of cancer until Alzheimers gets you first. Progress on repairing the human body is vastly more important than "preventing" conditions that are inevitable if you live long enough.
- davidf18 10y ago
  > An approach to disease that requires virtuous citizens is unlikely to work. It's called public health as applied to noncommunicable diseases and it does work. The smoking rate in NYC declined from 21% adults and 21% teens to 14% adults and 7% teens in about a decade through public health policy based on the World Health Organization MPOWER program. Each letter stands for an intervention. Increasing the cost of tobacco through taxation contributes more than half the effect of people quitting and for teens to never start. Banning smoking in public places along with taxation and "hard hitting" anti-smoking ads showing black lungs, etc. contribute most of the effect of getting people to quit or never start. Mike Bloomberg has contributed $600 million and Bill Gates another $125 million to implement the MPOWER program in low- and middle-income countries. More and more communities (Philly, Berkeley, SF, ...) are taxiing sugar-sweetened beverages (SSBs) to shift consumption to water and other low-calorie substitutes. > cervical cancer Male circumcision reduces the spread of HPV. Not so clear HPV vaccine is needed if males are circumcised (also lessens the spread of HIV and other sexually transmitted diseases).
  - kiba 10y ago
    While they are hugely important in improving lifespan, it's not a perfect solution in any case. That's why it's important to have a medical research program along with lifestyle intervention.
epistasis 10y ago
That does not appear to be the analogy that he's making, in any way. The analogy is that even a well maintained car (which we should do anyway) will eventually break down. Cancer is one of the many ways that cells can break down as they age. We do not know how to prevent most cancers. There are some ways to lessen cancer incidence, for example women that have children before 30 seem to have less risk for breast cancer. Does that mean that all women should get pregnant before their 30s? Getting pregnant also brings lots of other risks. We're starting to see cancer vaccines for those cancers that can be driven by viral infection, such as head and neck and cervical cancer. As we learn more about the immune system's involvement in cancer, we may be able to design cancer vaccines that are tailored to a certain person's HLA type that allow the immune system to target some common cancer mutations. The other new, and surprising, directions of cancer prevention that I see researched involve taking medications for long periods of time, which themselves have other side effects. For example, for those at high risk for cancer due to variants in their DNA repair genes, the risk calculation might make sense to take a medication for much of one's life to prevent cancer, but this is only a small small subset of the population. When everybody does the standard cancer prevention techniques: don't smoke and don't get too much UV from the sun, we still have lots of cancer that is going to hit people.

Moshe_Silnorin 10y ago

An approach to disease that requires virtuous citizens is unlikely to work. And even if we all stopped smoking and getting fat, we would still die a few years later than we would have otherwise. Prevention just means you slow down your inevitable development of cancer until Alzheimers gets you first. Progress on repairing the human body is vastly more important than "preventing" conditions that are inevitable if you live long enough.

davidf18 10y ago
> An approach to disease that requires virtuous citizens is unlikely to work. It's called public health as applied to noncommunicable diseases and it does work. The smoking rate in NYC declined from 21% adults and 21% teens to 14% adults and 7% teens in about a decade through public health policy based on the World Health Organization MPOWER program. Each letter stands for an intervention. Increasing the cost of tobacco through taxation contributes more than half the effect of people quitting and for teens to never start. Banning smoking in public places along with taxation and "hard hitting" anti-smoking ads showing black lungs, etc. contribute most of the effect of getting people to quit or never start. Mike Bloomberg has contributed $600 million and Bill Gates another $125 million to implement the MPOWER program in low- and middle-income countries. More and more communities (Philly, Berkeley, SF, ...) are taxiing sugar-sweetened beverages (SSBs) to shift consumption to water and other low-calorie substitutes. > cervical cancer Male circumcision reduces the spread of HPV. Not so clear HPV vaccine is needed if males are circumcised (also lessens the spread of HIV and other sexually transmitted diseases).
- kiba 10y ago
  While they are hugely important in improving lifespan, it's not a perfect solution in any case. That's why it's important to have a medical research program along with lifestyle intervention.

epistasis 10y ago

That does not appear to be the analogy that he's making, in any way. The analogy is that even a well maintained car (which we should do anyway) will eventually break down. Cancer is one of the many ways that cells can break down as they age. We do not know how to prevent most cancers. There are some ways to lessen cancer incidence, for example women that have children before 30 seem to have less risk for breast cancer. Does that mean that all women should get pregnant before their 30s? Getting pregnant also brings lots of other risks. We're starting to see cancer vaccines for those cancers that can be driven by viral infection, such as head and neck and cervical cancer. As we learn more about the immune system's involvement in cancer, we may be able to design cancer vaccines that are tailored to a certain person's HLA type that allow the immune system to target some common cancer mutations. The other new, and surprising, directions of cancer prevention that I see researched involve taking medications for long periods of time, which themselves have other side effects. For example, for those at high risk for cancer due to variants in their DNA repair genes, the risk calculation might make sense to take a medication for much of one's life to prevent cancer, but this is only a small small subset of the population. When everybody does the standard cancer prevention techniques: don't smoke and don't get too much UV from the sun, we still have lots of cancer that is going to hit people.