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Cancer Progress: Much More Than You Wanted To Know (2018)
- PunchTornado 8y agocan't wait to see how much improvement whole genome analysis will bring to patient outcome.
- natalyarostova 8y agoWhen I read this in August it was fascinating. Since then an immediate family member was diagnosed with cancer, and it all feels so much more real and painful :(
- hpcjoe 8y agoHang in there ... I've ridden that particular train[1][2]. You have to be strong, positive for the family member. Know you are not alone, there have been many people who've gone through this, and as I discovered, it helps to talk to them. I am happy to report that as of 29-Dec, we are at 7 years post op. On the 1 year anniversary of when we got the diagnosis, I saw an xkcd strip[3]. That gave me some hope of an eventual return to normalcy. A few years later, I saw one of the followons[4]. Little things like that help. They really do. [1] https://scalability.org/2011/11/ot-it-really-focuses-your-attention-on-the-important-things/ https://scalability.org/2011/11/ot-it-really-focuses-your-at... [2] https://scalability.org/2012/01/ot-what-is-and-what-should-never-be/ https://scalability.org/2012/01/ot-what-is-and-what-should-n... [3] https://xkcd.com/1141/ https://xkcd.com/1141/ [4] https://xkcd.com/1928/ https://xkcd.com/1928/
- samplatt 8y agoCurrently riding the train for my mum who is doing fairly well after ~9 years with one recurrence, and my dad who isn't doing so well @ 4 years and two recurrences. There's another xkcd strip that, while not as optimistic, is just as important: https://xkcd.com/931 https://xkcd.com/931
- dcarmo 8y agoMy mom was diagnosed 1.5 years ago, and the uncertainty of it all is the worst part. It soothes my heart to know I'm not going through this alone.
- hpcjoe 8y agoYou aren't alone. You need to stay strong and positive for her, but you need to be able to talk with others who've tread this path before. Many have.
- natalyarostova 8y ago<3
- hpcjoe 8y agoAnother person who wrote about this stuff, was Richard Feynman. His first wife, Arlene, had non-Hodgkins Lymphoma. He has a fairly long section of "Surely you are joking Mr. Feynman" on this. He talks about what they went through, the antics, and so forth. And he talks about the whole end of life process, as her cancer wasn't one that many people survived in the 1940's. His world view of making every second count, and not sweating the little things was fantastic. Just make every moment count with them, regardless of the prognosis.
- hycaria 8y agoI'm always confused at such comments, considering how variable and different cancer can be (which is discussed in the article by the way), and how vague people seem to like to be about it ; I wish more precise denominations would be the norm. Because when I read such encouragements I imagine them being to say, someone with a pancreatic cancer (who is short term screwed considering the odds), from someone with maybe a breast cancer or prostate cancer (rather common and fairly beatable nowadays). And that feels very odd.
- hpcjoe 8y agoThe message of encouragement is to the family, "you are not alone, and you should reach out to others to help." Regardless if it is easily treatable, or an aggressive terminal cancer. When we went through the process, there was a huge support system for my wife. Basically everyone was telling us positive messages. Some of them were wrong, but this was intended to keep her spirits and hope up. It turns out that you heal better when you have hope. Meanwhile, I had to calm the fears of our then 12 year old daughter, help her to understand what was occuring. Simultaneously, I had to do this for my wife. And her family, and my family. All while dealing with my own worries. It's not just the patient you have to take care of. It's everyone. This is why knowing that others have done this, and survived, is so very important. Knowing that you can talk to them, voice your fears that you dare not do in front of your loved ones ... you need this when you are going through this. Cancer sucks, no matter which one you deal with. I keep getting back to xkcd, as Randall and his wife went through it. Part of his "you are not alone, and it helps you to talk about it" are his strips. All the cancer ones are online along with explanations[1]. I have some favorites, that help me during this process[2][3] and especially [4] which came out last year. Read #4's panel 19 and 20 explanation to understand why this encouragement is so important. [1] https://www.explainxkcd.com/wiki/index.php/Category:Cancer https://www.explainxkcd.com/wiki/index.php/Category:Cancer [2] https://www.explainxkcd.com/wiki/index.php/931:_Lanes https://www.explainxkcd.com/wiki/index.php/931:_Lanes [3] https://www.explainxkcd.com/wiki/index.php/881:_Probability https://www.explainxkcd.com/wiki/index.php/881:_Probability [4] https://www.explainxkcd.com/wiki/index.php/1928:_Seven_Years https://www.explainxkcd.com/wiki/index.php/1928:_Seven_Years
- natalyarostova 8y agoThanks for your comment. I appreciate it :)
- cannonedhamster 8y agoI was diagnosed with Stage 4 cancer in September/October. Basically it aggressively grew within a few months. I can tell you without any doubt that huge advances are coming. I expect a hockey stick in the survival rates based on new understandings of all cancers. We're right on that edge of a manageable disease. Hang in there.
- herodotus 8y agoThis author writes so well. The introduction, in just 169 words, tells you exactly what the article is about. I wish more articles had such good introductions.
- gregschlom 8y agoAgreed. Worth checking his other posts as well, he has some fantastic articles on a wide variety of subjects.
- Robotbeat 8y agoThis alone makes me want to click on that article. None of that "these first couple paragraphs are filler until we actually start talking about the topic, and even then you're still lost until about 2/3rds of the way through."
- misrab 8y agoRather than starting with some personal anecdote contrived for some sort of empathy, as is the common style these days! Thank you.
- weinzierl 8y agoAmateur writers often mix up journalistic with literary writing. Both has its place but when people can't make up their mind they end up producing a chimera. Their writing doesn't follow an inverted triangle principle while at the same time it fails to build an arc of tension. The lede is buried somewhere in the middle. Pervasive SEO advice is also to blame. "Google loves long-form" is the common mantra. Just add a personal anecdote at the beginning to reach the target word count.
- Cthulhu_ 8y agoI don't blame them on the one hand, because truly neutral and impersonal journalism (think Reuters) look soul-destroying to write - if you're the creative kind. But people working for real news agencies (not the ones dependent on fluff) have to stick to facts and impersonal, unopinionated stories.
- bsder 8y ago> The only contrary data point I can find is this study of laryngeal cancer, which finds worsening stage-specific survival rates for high-stage laryngeal cancer since 1977. I seem to recall someone theorizing that the increased prevalence of oral sex is responsible by putting HPV deeper into the throat and thereby increasing the prevalence of throat cancers. HPV vaccinations should cause a corresponding down tick shortly if that is true.
- faltad 8y ago> Recent data suggest that individuals that come to the disease from this particular cause have a significant survival advantage,[20] as the disease responds better to radiation treatments than tobacco caused disease. From Wiki + https://www.mdanderson.org/newsroom/2010/06/hpv-positive-tumor-status-indicates-better-survival-in-patients-.html https://www.mdanderson.org/newsroom/2010/06/hpv-positive-tum... It does seem indeed that there is more prevalence of laryngeal cancer due to HPV however according to that link above, it should not worsen survival rates but rather make them better, wouldn't it?
- asdfasgasdgasdg 8y agoWell that's fantastic news, and I'm glad to hear it. I expect we will more or less beat cancer someday, and heart disease too. Probably long after I'm gone, but I'm happy for future generations that will no longer have to fear this scourge. (Assuming we don't wipe ourselves out some other way first.)
- sanxiyn 8y agoWe now (since 2015) have approved PCSK9 inhibitors. We didn't know about PCSK9 until 2003. Gene to drug in 12 years! Yes, it's very exciting and I am very hopeful about heart disease.
- SmellyGeekBoy 8y agoThe sad thing is that most instances of cancer and heart disease are down to diet and lifestyle. We already have the "cure" to these conditions, but people won't take care of themselves.
- sanxiyn 8y agoNo, we can barely convince people to take prescribed drug; we don't have effective intervention to change diet and lifestyle. If we had effective intervention to change people's diet, that would qualify as "cure" and would be a great boon; we don't.
- mac01021 8y agoIs that really true? I mean, it might well be true that most people could live an extra 20 years with a suitable change of diet and lifestyle. But even if that's the case, isn't everyone going to die of cancer or heart failure at the end of those extra 20 years?
- cannonedhamster 8y agoNo, you're absolutely incorrect that most cancer is down to lifestyle. As someone with cancer, I don't smoke, I never really drank, there's no history in my family for my type of cancer, and I haven't eaten meat in years. I've exercised more than the average person. Most cancer is due to dumb luck. The only cancers we know of that are attributable to lifestyle are basically lung cancers. Breast, Colon, Pancreatic, Stomach, Leukemia, etc. are all just dumb luck or family history. You obviously didn't read the article. We're only better at things we know how to screen for. Survival rates in Asia for Stomach cancer are significantly better than the US because they have regular screenings for it. The typical cases are salty diets, but Americans still get this even though we've changed our diets. There's no "cure" for cancer as of yet, you can't even guarantee prevention. It's a combination of genetic damage and an immune system that gets prevented from stopping the proliferation of cancer cells because the cells mask themselves as healthy cells. In effect cancer is an immune disease, but that's not fully accurate. Saying it's down to lifestyle is like telling people who got the plague they should have just moved. We have barely more understanding about cancer causes than doctors at the time did about disease.
- dannykwells 8y agoI think "the War on Cancer" is a great teaching moment for technologists: be careful with huge promises that millions latch on to: they won't forget, and when you fail, it will be (very, very) hard to win their trust back (thus, in the case of cancer, the continued fallacious narrative which the author so nicely deconstructs that we aren't making progress on cancer)
- nonbel 8y agoI always thought this plot: https://slatestarcodex.com/blog_images/cancer_tobacco.jpg https://slatestarcodex.com/blog_images/cancer_tobacco.jpg Looked eerily similar to this one: https://i.ibb.co/cLbTRfM/nuctest.png https://i.ibb.co/cLbTRfM/nuctest.png Source for nuclear test data: https://www.armscontrol.org/factsheets/nucleartesttally https://www.armscontrol.org/factsheets/nucleartesttally And before there were nuclear tests, there was a big fad to expose yourself to radiation early in the 1900s: https://www.popsci.com/scitech/article/2004-08/healthy-glow-drink-radiation https://www.popsci.com/scitech/article/2004-08/healthy-glow-... Is the argument that the nuclear tests, etc had zero effect on lung cancer rates? If not, what was it?
- sanxiyn 8y agoThe usual strategy is to control for smoking. If nuclear test rate correlates with lung cancer rate, but does not correlate with non-smoker lung cancer rate, nuclear test is not causing lung cancer. Epidemiology is a field of study about how to do this right. One of the great achievement of humanity in the 20th century was advance of epidemiology.
- nonbel 8y ago>"The usual strategy is to control for smoking. If nuclear test rate correlates with lung cancer rate, but does not correlate with non-smoker lung cancer rate, nuclear test is not causing lung cancer." I'm not really concerned with whether there is, or is not, a correlation, I already know there is a correlation. I am concerned about: How much of the increase in lung cancer incidence we see in the data could be accounted for via exposure to radiation from nuclear tests? I doubt it is zero, but it could be relatively negligible I suppose. The timing of it does overlap quite well though.
- cbkeller 8y agoThis is missing their point: you can distinguish the two potential causes by comparing lung cancer incidence rate through time for smokers versus non-smokers. If nuclear tests are a significant factor in lung cancer rate, we should still see a correlation between lung cancer incidence and nuclear test frequency when looking at people with no exposure to cigarette smoke. If the correlation in the general population just a coincidence, we should not.
- sulam 8y agoI'm not sure I buy the logic of ignoring improved detection when it comes to survival chances. As the article and pretty much everyone else tells you, early detection is the key to a better prognosis in most cancers. If all malignancies proceeded to stage IV before detection, survival rates would be very low despite the medical advances we've made. Successfully treating a cancer, usually indicated by being cancer-free 5 years post-treatment, is not discussed in this article at all and seems like it would provide some evidence for or against cancer treatment getting better from the perspective that matters most -- the likelihood that a diagnosed cancer will kill you.
- SideburnsOfDoom 8y agoI would have thought that smoking cessation and earlier detection are - in a sense - medical advances? Medicine pushed for these, as the most effective ways of fighting cancer. And it's working. The same will hopefully happen to air pollution in cities, as a public health problem.
- onetimemanytime 8y agoon the "negative" side: we're living longer so odds of cancer increase, and we're obese. Or close to /above it.
- toper-centage 8y agoThe same will also happen due to diet changes in the next years. More and more people are severely cutting back on meat intake, specially smoked and processed meats, and it will likely have an impact on a multitude of types of cancer down the road.
- Cthulhu_ 8y agoWhich types are caused by which meat though? I haven't seen a strong correlation between the two (unlike smoking and cancer). The charts on that article don't really show much change in most types of cancer over the past 50 years, despite changing diets and a higher availability of meat and processed foods.
- SideburnsOfDoom 8y agohttps://www.theguardian.com/society/2015/oct/26/bacon-ham-sausages-processed-meats-cancer-risk-smoking-says-who https://www.theguardian.com/society/2015/oct/26/bacon-ham-sa...
- davinic 8y agoIt's not meat, it's sugar -- specifically fructose. See Dr. Robert Lustig's important work on this topic.
- salex89 8y agoAs someone who has quite unsettling health anxiety and somewhat of a cancer-phobia, these articles kinda calm me. But what doesn't calm me are usually the comments because it seams that cancer is really all around me, and it's just around the corner, just waiting to snatch me. I don't have any cases in my closer or further family, but I'm frightened I'm going to be the one... The 1-in-2 statistics doesn't soothe either...
- neuronic 8y agoI have 1000s of moles and get checked once a year. I live in crippling anxiety that one they, melanoma will pop up and I won't notice early enough. So I get your fear _very_ well. All we can do is to reduce the probability by causing less DNA damage through all the various means. Even then, pure chance can still strike because this is what life is at its core: a cumulation of (seemingly?) random chance events.
- salex89 8y agoYep, I have quite some moles myself and get them checked. Although, thanks to the place I live in, I don't get too much UV exposure and try to protect myself well. That's the thing, I'm not too frightened by the things I can control, it's those that do not have so much prevention, such as pancreatic or leukemia... I think I did some permanent damage to my psyche by just reading too much about those things and too much statistics. Sometimes I see myself as just a number when reading these articles. Don't get me wrong, I'm going to therapy and I'm not depressed. Just scared :) .
- yolodeveloper 8y agoI wonder how widespread was cancer in, say 17-18th century. Obviously there would not be much technology do diagnose it, but still, if someone has any references, that'd be of interest.
- cannonedhamster 8y agoIt would be by necessity less of a killer as people didn't live as long. The average age of death in those times was late thirties, far lower than the common age of cancer in the mid to late 60s. Keep in mind that sanitation, food preparation, medical science, and clean water were all huge advances in life spans and general health. The PBS series "How We Got to Now" is a great resource for the huge advances in health made in the 19th and 20th centuries.