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> The last innovation was the invention of chemotherapy. Um.. immune therapies, targeted genetic therapies, TIL therapies... all kind of a big deal. Sorry, yo

by noam87 10y ago

> The last innovation was the invention of chemotherapy. Um.. immune therapies, targeted genetic therapies, TIL therapies... all kind of a big deal. Sorry, you don't know what you're talking about. And rates say nothing about efficacy / quality of treatment. (And even when new treatments are not more effective, often the side effects are much milder (to non-existent): getting an extra three years sick and in pain, vs getting them as your normal self is a huge difference) Edit: what I mean by that is that rates of incidence say nothing about how effective the treatments are. It can both be true that rates are going up (say, due to air pollution) and that treatments are more effective. --- Reply to comment below: again, you are wrong. Jesus, stop. One example: Ipilimumab and PD-1 inhibitors have a ~20% effectiveness rate against melanoma, a cancer that was considered a sure death sentence just 15 years ago. Some patients have not had any recurrence in a decade, they seem cured, which was unheard of before. And targeted drugs like dabrafenib buy most patients an extra 6-18 months, almost side effect free. With more of these coming out, it seems like soon it'll be possible to cycle patients even longer (some combos already are known to extend their effect). This doesn't qualify as "major"? The ability to reprogram our immune system to kill cancer cells, or to reprogram pathways in faulty cells?

SteveCoast 10y ago
I'm sorry I should have said the last _major_ innovation that made any difference. All the things you mention are innovations, they just haven't really changed average mortality numbers, which is what I care about. Edit: the parent post changed their argument to being about 'efficacy' or quality of care. Personally, I prefer a cure to a high-quality and effective 3 months in hospital then death. Thus I focus on the mortality statistics. Edit again: quote: > This doesn't qualify as "major"? The ability to reprogram our immune system to kill cancer cells, or to reprogram pathways in faulty cells? I'd define major as some large change to average mortality from cancer. The same way heart attacks are now vastly more survivable, or we don't get them in the first place. For example, in another comment, someone linked to the NIH's numbers https://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=75 https://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid... They show from 1975 to 2007 incidence of cancer going from 400 per 100k to 461 (e.g. up). I'd define a major improvement as that going to 200 or 100 per 100k people (e.g. down). The 5-year survivability has gone up for the same reason incidence went up, early detection. Yes, there are specific therapies that improve things 20% here or there for certain very targeted groups. I hope I am in one of those groups if I ever get cancer, but again the averages haven't changed much at all, especially when compared to other chronic disease.

by noam87 10y ago

SteveCoast 10y ago

I'm sorry I should have said the last _major_ innovation that made any difference. All the things you mention are innovations, they just haven't really changed average mortality numbers, which is what I care about. Edit: the parent post changed their argument to being about 'efficacy' or quality of care. Personally, I prefer a cure to a high-quality and effective 3 months in hospital then death. Thus I focus on the mortality statistics. Edit again: quote: > This doesn't qualify as "major"? The ability to reprogram our immune system to kill cancer cells, or to reprogram pathways in faulty cells? I'd define major as some large change to average mortality from cancer. The same way heart attacks are now vastly more survivable, or we don't get them in the first place. For example, in another comment, someone linked to the NIH's numbers https://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=75 https://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid... They show from 1975 to 2007 incidence of cancer going from 400 per 100k to 461 (e.g. up). I'd define a major improvement as that going to 200 or 100 per 100k people (e.g. down). The 5-year survivability has gone up for the same reason incidence went up, early detection. Yes, there are specific therapies that improve things 20% here or there for certain very targeted groups. I hope I am in one of those groups if I ever get cancer, but again the averages haven't changed much at all, especially when compared to other chronic disease.