10 ms·

U.S. cancer death rate drops by largest annual margin ever, report says

142 points by apsec112 7y ago

TurkishPoptart 7y ago
Could it be that people are dying from opioid ODs, suicide, and other means that tragically cut lives short? Cancer risk seems to be a function of time and entropy. The longer someone lives, the more likely I suspect they'll succumb to cancer eventually.
- deleted 7y ago
  [deleted]
- nostrademons 7y ago
  That was my first thought, but the article specifically addresses that. It's due to improved treatments for lung cancer. Take lung cancer out of the data and the death rate improved by 1.4% last year, which is basically the same as the baseline 1.5%/year rate that cancer deaths have been dropping since 1991. If it were due to the opioid epidemic, you also wouldn't see that sustained drop over 3 decades - life expectancy in the U.S. has only been falling for 3 years.
  - markus92 7y ago
    I wonder if this drop can be attributed to the approval of pembroluzimab? Our oncologists speak highly of it and it got to market around the mentioned time period
    - mrosett 7y ago
      Absolutely. They mention immunotherapy in the article, and pembro (aka Keytruda) is the best-selling drug in that class. Another big one that was introduced around the same time is nivolumab (aka Opdivo). Immunotherapy has really transformed certain parts of oncology (including melanoma, which they mention in the article as well), which is why some of the foundational researchers won the Nobel last year.
    - mamp 7y ago
      I think it’s a combination of immunotherapy for melanoma, bladder, renal cell and improved targeted therapy in certain types of lung adenocarcinoma.
  - ip26 7y ago
    Decommissioning coal plants & spinning up natural gas plants could hypothetically help with lung cancer too.
    - dwd 7y ago
      You will see a lot less people dying from respiratory issues. For coal mine workers, stopping further damage to their lungs may reduce the chance of tumors developing in those damaged areas.
    - ekianjo 7y ago
      The most significant variable is newer treatments though because the benefit is so huge compared to previous gold standard treatments that this variable cannot be ignored.
    - hinkley 7y ago
      Long term, sure. Short term, you'd be looking at the link between air quality levels and chronic diseases like COPD, asthma, and congestive heart failure. That might show up as an increase in the number of living people with these conditions.
- ZainRiz 7y ago
  In unrelated news, the US alcohol-related death count has doubled https://www.npr.org/2020/01/08/794772148/alcohol-related-deaths-have-doubled-study-says https://www.npr.org/2020/01/08/794772148/alcohol-related-dea...
- adrr 7y ago
  Cancer rates are declining except for skin cancer. Detection and treatment is getting better.
ZainRiz 7y ago
In unrelated news, the US alcohol-related death count has doubled https://www.npr.org/2020/01/08/794772148/alcohol-related-deaths-have-doubled-study-says https://www.npr.org/2020/01/08/794772148/alcohol-related-dea...
joe_the_user 7y ago
Summary: The death rate from cancer has dropping slowly but surely each year (at about %1.5-%16 rate). This last reported year was largest single percentage drop in that process - 2%. That could also be phrased as 98% of the deaths happened the previous year (2016) also happening that year (2017). Half-full, half-empty, etc. So it's a blip but an encouraging blip. At the same time, the headline makes this sound much more extreme and excite.
- wczekalski 7y ago
  Half-full - If the 2% rate is retained in 35 years the number of cancer deaths will be halved. Considering that 87%[1] of cancer-related deaths happens after 50 it is a very hopeful outlook for young people [1]: https://ourworldindata.org/cancer https://ourworldindata.org/cancer
eagsalazar2 7y ago
With the shift in public perception about keto, carbs, etc maybe we're actually onto something?
- uhtred 7y ago
  You think carbs cause cancer? Oh my, the anti-carb brainwashing is more powerful than I thought. If anything I predict there will be a future upsurge in some cancers (colon etc) if people keep avoiding carbs. We need fiber. Fiber comes from foods that contain carbs.
  - eagsalazar2 7y ago
    Yes people think that.
zerm778 7y ago
thanks trump
xwdv 7y ago
Could someone do some quick math and extrapolate what cancer death rates might be in 2050?
- bluGill 7y ago
  Sure, but it isn't a useful exercise. Presumably there are limits to the current new treatments, once we figure out what those limits are we will hit a new death rate. I expect to see that before 2050. Then we have to wait for the next new treatment. It seems unlikely that there are an infinite number of great treatments waiting to be discovered. Most likely we are asymptotically approaching some non-zero minimum death rate. (note that the function is not linear, and we just saw one interesting step)
youwillsee 7y ago
Their goal is not to cure you, rather keep you alive as long as possible with low quality of life and constant battles.
- rocgf 7y ago
  Sounds like one of the 'they're out to get us' conspiracy theories. But even if I were to indulge in it, you know you can simply pick not to have treatment or pick your type of treatment (up to a certain degree). Nobody is forcing any specific type of treatment.
tempsy 7y ago
It's hard to take this very seriously when the claim is that it's "only" due to advances in the treatment of lung cancer. Given that lung cancer rates are almost surely driven by smoking rates, and that the rate of adults who smoke regularly has dropped significantly over the last couple decades, how could the fact that there are fewer adult smokers not also be a significant factor in declining lung cancer rates? To claim this is only driven by treatment innovation and not public policy changes is wildly misleading.
- db48x 7y ago
  The rate has been declining for years, but this year the decline is larger than expected. They're talking about that increase in the reduction of the rate.
  - tempsy 7y ago
    What's your point? The YoY decline in smoking rates since 1970s is not linear. This stat is effectively meaningless without accounting for the rate of the US pop that develops lung cancer in the first place. If you want to measure treatment effectiveness, then the right measurement is something like '% of US population that develops lung cancer who are effectively treated/cured' and not 'overall cancer death rate'. The fact this headline is so broad when it's really about lung cancer and not all cancers and doesn't account for any factors outside of 'treatment innovation' leads me to believe this was pushed by some healthcare trade group.
    - hirako2000 7y ago
      Thanks for this counter argument. I do wonder why people jump in the comments and drop name pharmaceutical companies and their products.
- deleted 7y ago
  [deleted]
- ekianjo 7y ago
  The claim is not about cancer rates but cancer death rates which is already when you look at people who have cancer.
deleted 7y ago
[deleted]
pcurve 7y ago
For those wondering about lack of e-cigarette mentioning, World Health Org says e-cigarette doesn't help reduce lung cancer for now. https://www.reuters.com/article/us-health-tobacco/who-says-e-cigarettes-smoke-free-products-do-not-help-reduce-cancer-idUSKCN1UL29C https://www.reuters.com/article/us-health-tobacco/who-says-e...
- deleted 7y ago
  [deleted]
- agumonkey 7y ago
  This article is short.. I don't understand how e-cigarettes (granted the liquid is not full of shitty chemicals) can not be an improvement. The carcinogenic compounds were said to come from tobacco combustion byproducts. Theoretically in e-cigarettes.. there's no combustion, only vaporization of nicotine and the liquid. So what's the link ?
  - ChrisRR 7y ago
    I would assume because people who have been smoking for years still have the associated increased risk of lung cancer and it'll take years for the people who are purely vapers to start making a statistical difference
    - agumonkey 7y ago
      the article implies that it's not effective, not even a "not yet" .. it's dangerous IMO
  - deleted 7y ago
    [deleted]
  - hannob 7y ago
    There's no doubt that e-cigarettes are better than normal cigarettes. There's also no doubt that e-cigarettes are worse than no cigarettes. However that doesn't answer the question whether they're an improvement. For that you need to look at what people who use e-cigs would do otherwise. And then it gets really complicated, because you really don't know and can only make estimates. That's why this is a question difficult to answer.
aaavl2821 7y ago
The most effective drugs for lung cancer approved in the last few years are PD-1 and PD-L1 inhibitors. The leading drug is mercks pembrolizumab Here are some of the most widely cited studies of pembro in lung cancer that illustrate its clinical benefit: Open label pembro vs chemo in first line non small cell lung cancer: https://www.nejm.org/doi/full/10.1056/NEJMoa1606774 https://www.nejm.org/doi/full/10.1056/NEJMoa1606774 Development of PD-L1 biomarkers in 495 patient phase 1 study: https://www.nejm.org/doi/full/10.1056/nejmoa1501824 https://www.nejm.org/doi/full/10.1056/nejmoa1501824 Pembro + chemo in lung cancer: https://www.nejm.org/doi/full/10.1056/NEJMoa1801005 https://www.nejm.org/doi/full/10.1056/NEJMoa1801005 Pembro + docetaxel for previously treated lung cancer: https://mdanderson.elsevierpure.com/en/publications/pembrolizumab-versus-docetaxel-for-previously-treated-pd-l1-posit https://mdanderson.elsevierpure.com/en/publications/pembroli...
- semi-extrinsic 7y ago
  Fun fact: you can identify these drugs as Monoclonal AntiBodies due to the suffix -mab. This category has been incredibly successful against a wide variety of debilitating illnesses like autoimmune, cancer etc. My doctor told me that surgery for arthritis is a dying specialisation in medicine, because the new drugs like infliximab are so effective. The discovery of how to produce them got the Nobel Prize in Medicine in 1984, and the more recent discovery of how to tailor them via directed evolution got the Nobel Prize in Chemistry in 2018.
  - acidburnNSA 7y ago
    Apparently that's true for rheumatoid arthritis but osteoarthritis still gets a lot of surgery. Source: my SO the MD.
    - ekianjo 7y ago
      There is no cure for osteoarthritis because it is purely mechanical degradation of joints with aging. You get a lot of pain as your joints disappear. Most of the treatments are symptomatic (strong painkillers) or surgery (replacing joints with prosthetic ones). Very different from RA as a condition.
anovikov 7y ago
Let me offer an easy explanation: normal rates of annual progress in cancer treatment and prevention were compounded by (quite abnormal) decrease in life expectancy. Which naturally makes cancer, which correlates highly with age, less common. Basically, people are dying of meth or fentanyl before they get a chance to get cancer.
- Godel_unicode 7y ago
  This possible explanation is explicitly addressed and debunked in the article as the reason for cancer deaths declining. As has been mentioned elsewhere in the thread, this is about immunotherapy.
rshnotsecure 7y ago
This absolutely should be taken with a grain of salt. First realize that these statistics are calculated via an entire field, known as “medical statistics” not surprisingly, that has enormous controversies inside of it. Using a variety of mathematical calculations and formulas, they arrive at something called the “average death rate” that is supposed to massage out the differences between geographic regions and populations to determine the final number. Devra Davis, Ph.D., M.P.H., wrote about this to tragic degree of detail in her book “The Secret History of the War on Cancer”. For background she was Director of the Center for Oncology at the University of Pittsburgh Cancer Institute and is still also a Professor of Epidemiology there. The cancer death rate has not budged that much in 40 years. Survivability has extended, absolutely, and that is worth something, but not more than a few years. Compared to AIDS, a disease also without a real cure but that has extended survivability by decades this is unacceptable. The amount of brilliant researchers driven out of the field, the failure of the Susan G Komen foundation to invest in actual research (this can be seen as more of a problem with the nonprofit industrial complex though and not per se cancer research), the null hypothesis requirement failures at NIH, and just the general climate of unethicalness and neoliberalism that began emerging in the mid 1970’s are all blamed, and there is truth in most of those arguments. There is an old joke about how many white upper middle class cancer patients does it take to screw in a light bulb? Two, one to do it, and the other to write a book about it. I go back and forth about whether that joke is inappropriate, and Mark Nepo is one such person who falls into that category but has written moving essays about the experience, but every time I read Barbara Ehrenreich’s “Cancerland” it makes me incredibly bitter. And I say that as a person who really likes Tony Robbins for the most part but who still is disgusted by the whole forced optimism cure through hope that the entire industry has turned into in lieu of actual breakthrough achievements. The fact that the latest and even somewhat exciting area of research in cancer treatment is the investigation on the role and use of viruses, a soviet innovation that has been investigated by the Russians since Stalin was alive even though they were mercilessly mocked for decades for this, is just tragic.
- tanner6 7y ago
  > Compared to AIDS, a disease also without a real cure but that has extended survivability by decades this is unacceptable. AIDS is a single disease, cancer is not. AIDS in fact pretty much causes certain types of cancer, so those are more survivable on account of their incidence decreasing. The same goes for certain types of cancer. There are a number of cancers that are better treated or prevented today than 40 years ago (like cervical cancer and all the HPV cancers). On the other extreme you have pancreatic cancer. But overall frankly you don’t know what you’re blabbering about and seem to be conflating political arguments (the book you mention was a thesis about health policy and prevention, it didn’t somehow disprove that we have very treatment advancements today that we did not have 40 years ago) with some very explainable trends in cancer incidence and mortality. Where’s your contribution to cancer treatment, nerd.
aSplash0fDerp 7y ago
I personally think that part of the reductions are coming from foreign healthcare screenings (off the books) and/or a combination of early term options). The cost for treatment [1] may have some considering alternate options for screenings and treatment after seeing someone elses experience/ordeal beforehand or reading about first-hand accounts online. [1] https://www.aarp.org/money/credit-loans-debt/info-2018/the-high-cost-of-cancer-treatment.html https://www.aarp.org/money/credit-loans-debt/info-2018/the-h...
- robbiep 7y ago
  The reductions are absolutely coming from new treatments in particular immunotherapy. When I started Med school 19 years ago the average survival of metastatic melanoma was 6 months, it is now closer to 5 years (ie basically remission). Many other cancers (including lung, which this article pinpoints as being the main driver in falls over the last 12 months) are now benefiting from the second and third generation of these drugs
DrAwdeOccarim 7y ago
If you're interested in hearing a counter point to these types of medical "press release" articles, I can't recommend enough following Vinay Prasad on Twitter. Here is his thread about this report: https://twitter.com/VPrasadMDMPH/status/1215081457854468096 https://twitter.com/VPrasadMDMPH/status/1215081457854468096
chiefalchemist 7y ago
Don't mean to be a killjoy, and perhaps this is stating the obvious for the HN crowd but this doesn't mean the broader rate of cancer is down; but that medical treatment has improved. The latter being more lucrative than prevention (at least for the med community). I'd also like to mention, that these are deaths limited to cancer. Death is attributed to something else this stat will be affected. This is, in theory, you can "survive" cancer but die from something related to that condition and it won't count as a cancer death. I'd liken it, somewhat, to war. Yes, less soldies are dying. But survival comes at a cost. No arms. No legs. Mental and emotional wounds. Etc. I'm not knocking the progress with cancer; only providing some necessary context that's often missing. <added> The point is, beating up data is easy. Be mindful of what you might be looking at, especially if the outcomes are good for an industy's well-being. </added>

142 points by apsec112 7y ago

Could it be that people are dying from opioid ODs, suicide, and other means that tragically cut lives short? Cancer risk seems to be a function of time and entropy. The longer someone lives, the more likely I suspect they'll succumb to cancer eventually.

deleted 7y ago
[deleted]
nostrademons 7y ago
That was my first thought, but the article specifically addresses that. It's due to improved treatments for lung cancer. Take lung cancer out of the data and the death rate improved by 1.4% last year, which is basically the same as the baseline 1.5%/year rate that cancer deaths have been dropping since 1991. If it were due to the opioid epidemic, you also wouldn't see that sustained drop over 3 decades - life expectancy in the U.S. has only been falling for 3 years.
- markus92 7y ago
  I wonder if this drop can be attributed to the approval of pembroluzimab? Our oncologists speak highly of it and it got to market around the mentioned time period
  - mrosett 7y ago
    Absolutely. They mention immunotherapy in the article, and pembro (aka Keytruda) is the best-selling drug in that class. Another big one that was introduced around the same time is nivolumab (aka Opdivo). Immunotherapy has really transformed certain parts of oncology (including melanoma, which they mention in the article as well), which is why some of the foundational researchers won the Nobel last year.
  - mamp 7y ago
    I think it’s a combination of immunotherapy for melanoma, bladder, renal cell and improved targeted therapy in certain types of lung adenocarcinoma.
- ip26 7y ago
  Decommissioning coal plants & spinning up natural gas plants could hypothetically help with lung cancer too.
  - dwd 7y ago
    You will see a lot less people dying from respiratory issues. For coal mine workers, stopping further damage to their lungs may reduce the chance of tumors developing in those damaged areas.
  - ekianjo 7y ago
    The most significant variable is newer treatments though because the benefit is so huge compared to previous gold standard treatments that this variable cannot be ignored.
  - hinkley 7y ago
    Long term, sure. Short term, you'd be looking at the link between air quality levels and chronic diseases like COPD, asthma, and congestive heart failure. That might show up as an increase in the number of living people with these conditions.
ZainRiz 7y ago
In unrelated news, the US alcohol-related death count has doubled https://www.npr.org/2020/01/08/794772148/alcohol-related-deaths-have-doubled-study-says https://www.npr.org/2020/01/08/794772148/alcohol-related-dea...
adrr 7y ago
Cancer rates are declining except for skin cancer. Detection and treatment is getting better.

ZainRiz 7y ago

In unrelated news, the US alcohol-related death count has doubled https://www.npr.org/2020/01/08/794772148/alcohol-related-deaths-have-doubled-study-says https://www.npr.org/2020/01/08/794772148/alcohol-related-dea...

joe_the_user 7y ago

Summary: The death rate from cancer has dropping slowly but surely each year (at about %1.5-%16 rate). This last reported year was largest single percentage drop in that process - 2%. That could also be phrased as 98% of the deaths happened the previous year (2016) also happening that year (2017). Half-full, half-empty, etc. So it's a blip but an encouraging blip. At the same time, the headline makes this sound much more extreme and excite.

wczekalski 7y ago
Half-full - If the 2% rate is retained in 35 years the number of cancer deaths will be halved. Considering that 87%[1] of cancer-related deaths happens after 50 it is a very hopeful outlook for young people [1]: https://ourworldindata.org/cancer https://ourworldindata.org/cancer

eagsalazar2 7y ago

With the shift in public perception about keto, carbs, etc maybe we're actually onto something?

uhtred 7y ago
You think carbs cause cancer? Oh my, the anti-carb brainwashing is more powerful than I thought. If anything I predict there will be a future upsurge in some cancers (colon etc) if people keep avoiding carbs. We need fiber. Fiber comes from foods that contain carbs.
- eagsalazar2 7y ago
  Yes people think that.

zerm778 7y ago

thanks trump

xwdv 7y ago

Could someone do some quick math and extrapolate what cancer death rates might be in 2050?

bluGill 7y ago
Sure, but it isn't a useful exercise. Presumably there are limits to the current new treatments, once we figure out what those limits are we will hit a new death rate. I expect to see that before 2050. Then we have to wait for the next new treatment. It seems unlikely that there are an infinite number of great treatments waiting to be discovered. Most likely we are asymptotically approaching some non-zero minimum death rate. (note that the function is not linear, and we just saw one interesting step)

youwillsee 7y ago

Their goal is not to cure you, rather keep you alive as long as possible with low quality of life and constant battles.

rocgf 7y ago
Sounds like one of the 'they're out to get us' conspiracy theories. But even if I were to indulge in it, you know you can simply pick not to have treatment or pick your type of treatment (up to a certain degree). Nobody is forcing any specific type of treatment.

tempsy 7y ago

It's hard to take this very seriously when the claim is that it's "only" due to advances in the treatment of lung cancer. Given that lung cancer rates are almost surely driven by smoking rates, and that the rate of adults who smoke regularly has dropped significantly over the last couple decades, how could the fact that there are fewer adult smokers not also be a significant factor in declining lung cancer rates? To claim this is only driven by treatment innovation and not public policy changes is wildly misleading.

db48x 7y ago
The rate has been declining for years, but this year the decline is larger than expected. They're talking about that increase in the reduction of the rate.
- tempsy 7y ago
  What's your point? The YoY decline in smoking rates since 1970s is not linear. This stat is effectively meaningless without accounting for the rate of the US pop that develops lung cancer in the first place. If you want to measure treatment effectiveness, then the right measurement is something like '% of US population that develops lung cancer who are effectively treated/cured' and not 'overall cancer death rate'. The fact this headline is so broad when it's really about lung cancer and not all cancers and doesn't account for any factors outside of 'treatment innovation' leads me to believe this was pushed by some healthcare trade group.
  - hirako2000 7y ago
    Thanks for this counter argument. I do wonder why people jump in the comments and drop name pharmaceutical companies and their products.
deleted 7y ago
[deleted]
ekianjo 7y ago
The claim is not about cancer rates but cancer death rates which is already when you look at people who have cancer.

deleted 7y ago

[deleted]

pcurve 7y ago

For those wondering about lack of e-cigarette mentioning, World Health Org says e-cigarette doesn't help reduce lung cancer for now. https://www.reuters.com/article/us-health-tobacco/who-says-e-cigarettes-smoke-free-products-do-not-help-reduce-cancer-idUSKCN1UL29C https://www.reuters.com/article/us-health-tobacco/who-says-e...

deleted 7y ago
[deleted]
agumonkey 7y ago
This article is short.. I don't understand how e-cigarettes (granted the liquid is not full of shitty chemicals) can not be an improvement. The carcinogenic compounds were said to come from tobacco combustion byproducts. Theoretically in e-cigarettes.. there's no combustion, only vaporization of nicotine and the liquid. So what's the link ?
- ChrisRR 7y ago
  I would assume because people who have been smoking for years still have the associated increased risk of lung cancer and it'll take years for the people who are purely vapers to start making a statistical difference
  - agumonkey 7y ago
    the article implies that it's not effective, not even a "not yet" .. it's dangerous IMO
- deleted 7y ago
  [deleted]
- hannob 7y ago
  There's no doubt that e-cigarettes are better than normal cigarettes. There's also no doubt that e-cigarettes are worse than no cigarettes. However that doesn't answer the question whether they're an improvement. For that you need to look at what people who use e-cigs would do otherwise. And then it gets really complicated, because you really don't know and can only make estimates. That's why this is a question difficult to answer.

aaavl2821 7y ago

The most effective drugs for lung cancer approved in the last few years are PD-1 and PD-L1 inhibitors. The leading drug is mercks pembrolizumab Here are some of the most widely cited studies of pembro in lung cancer that illustrate its clinical benefit: Open label pembro vs chemo in first line non small cell lung cancer: https://www.nejm.org/doi/full/10.1056/NEJMoa1606774 https://www.nejm.org/doi/full/10.1056/NEJMoa1606774 Development of PD-L1 biomarkers in 495 patient phase 1 study: https://www.nejm.org/doi/full/10.1056/nejmoa1501824 https://www.nejm.org/doi/full/10.1056/nejmoa1501824 Pembro + chemo in lung cancer: https://www.nejm.org/doi/full/10.1056/NEJMoa1801005 https://www.nejm.org/doi/full/10.1056/NEJMoa1801005 Pembro + docetaxel for previously treated lung cancer: https://mdanderson.elsevierpure.com/en/publications/pembrolizumab-versus-docetaxel-for-previously-treated-pd-l1-posit https://mdanderson.elsevierpure.com/en/publications/pembroli...

semi-extrinsic 7y ago
Fun fact: you can identify these drugs as Monoclonal AntiBodies due to the suffix -mab. This category has been incredibly successful against a wide variety of debilitating illnesses like autoimmune, cancer etc. My doctor told me that surgery for arthritis is a dying specialisation in medicine, because the new drugs like infliximab are so effective. The discovery of how to produce them got the Nobel Prize in Medicine in 1984, and the more recent discovery of how to tailor them via directed evolution got the Nobel Prize in Chemistry in 2018.
- acidburnNSA 7y ago
  Apparently that's true for rheumatoid arthritis but osteoarthritis still gets a lot of surgery. Source: my SO the MD.
  - ekianjo 7y ago
    There is no cure for osteoarthritis because it is purely mechanical degradation of joints with aging. You get a lot of pain as your joints disappear. Most of the treatments are symptomatic (strong painkillers) or surgery (replacing joints with prosthetic ones). Very different from RA as a condition.

anovikov 7y ago

Let me offer an easy explanation: normal rates of annual progress in cancer treatment and prevention were compounded by (quite abnormal) decrease in life expectancy. Which naturally makes cancer, which correlates highly with age, less common. Basically, people are dying of meth or fentanyl before they get a chance to get cancer.

Godel_unicode 7y ago
This possible explanation is explicitly addressed and debunked in the article as the reason for cancer deaths declining. As has been mentioned elsewhere in the thread, this is about immunotherapy.

rshnotsecure 7y ago

This absolutely should be taken with a grain of salt. First realize that these statistics are calculated via an entire field, known as “medical statistics” not surprisingly, that has enormous controversies inside of it. Using a variety of mathematical calculations and formulas, they arrive at something called the “average death rate” that is supposed to massage out the differences between geographic regions and populations to determine the final number. Devra Davis, Ph.D., M.P.H., wrote about this to tragic degree of detail in her book “The Secret History of the War on Cancer”. For background she was Director of the Center for Oncology at the University of Pittsburgh Cancer Institute and is still also a Professor of Epidemiology there. The cancer death rate has not budged that much in 40 years. Survivability has extended, absolutely, and that is worth something, but not more than a few years. Compared to AIDS, a disease also without a real cure but that has extended survivability by decades this is unacceptable. The amount of brilliant researchers driven out of the field, the failure of the Susan G Komen foundation to invest in actual research (this can be seen as more of a problem with the nonprofit industrial complex though and not per se cancer research), the null hypothesis requirement failures at NIH, and just the general climate of unethicalness and neoliberalism that began emerging in the mid 1970’s are all blamed, and there is truth in most of those arguments. There is an old joke about how many white upper middle class cancer patients does it take to screw in a light bulb? Two, one to do it, and the other to write a book about it. I go back and forth about whether that joke is inappropriate, and Mark Nepo is one such person who falls into that category but has written moving essays about the experience, but every time I read Barbara Ehrenreich’s “Cancerland” it makes me incredibly bitter. And I say that as a person who really likes Tony Robbins for the most part but who still is disgusted by the whole forced optimism cure through hope that the entire industry has turned into in lieu of actual breakthrough achievements. The fact that the latest and even somewhat exciting area of research in cancer treatment is the investigation on the role and use of viruses, a soviet innovation that has been investigated by the Russians since Stalin was alive even though they were mercilessly mocked for decades for this, is just tragic.

tanner6 7y ago
> Compared to AIDS, a disease also without a real cure but that has extended survivability by decades this is unacceptable. AIDS is a single disease, cancer is not. AIDS in fact pretty much causes certain types of cancer, so those are more survivable on account of their incidence decreasing. The same goes for certain types of cancer. There are a number of cancers that are better treated or prevented today than 40 years ago (like cervical cancer and all the HPV cancers). On the other extreme you have pancreatic cancer. But overall frankly you don’t know what you’re blabbering about and seem to be conflating political arguments (the book you mention was a thesis about health policy and prevention, it didn’t somehow disprove that we have very treatment advancements today that we did not have 40 years ago) with some very explainable trends in cancer incidence and mortality. Where’s your contribution to cancer treatment, nerd.

aSplash0fDerp 7y ago

I personally think that part of the reductions are coming from foreign healthcare screenings (off the books) and/or a combination of early term options). The cost for treatment [1] may have some considering alternate options for screenings and treatment after seeing someone elses experience/ordeal beforehand or reading about first-hand accounts online. [1] https://www.aarp.org/money/credit-loans-debt/info-2018/the-high-cost-of-cancer-treatment.html https://www.aarp.org/money/credit-loans-debt/info-2018/the-h...

robbiep 7y ago
The reductions are absolutely coming from new treatments in particular immunotherapy. When I started Med school 19 years ago the average survival of metastatic melanoma was 6 months, it is now closer to 5 years (ie basically remission). Many other cancers (including lung, which this article pinpoints as being the main driver in falls over the last 12 months) are now benefiting from the second and third generation of these drugs

DrAwdeOccarim 7y ago

If you're interested in hearing a counter point to these types of medical "press release" articles, I can't recommend enough following Vinay Prasad on Twitter. Here is his thread about this report: https://twitter.com/VPrasadMDMPH/status/1215081457854468096 https://twitter.com/VPrasadMDMPH/status/1215081457854468096

chiefalchemist 7y ago

Don't mean to be a killjoy, and perhaps this is stating the obvious for the HN crowd but this doesn't mean the broader rate of cancer is down; but that medical treatment has improved. The latter being more lucrative than prevention (at least for the med community). I'd also like to mention, that these are deaths limited to cancer. Death is attributed to something else this stat will be affected. This is, in theory, you can "survive" cancer but die from something related to that condition and it won't count as a cancer death. I'd liken it, somewhat, to war. Yes, less soldies are dying. But survival comes at a cost. No arms. No legs. Mental and emotional wounds. Etc. I'm not knocking the progress with cancer; only providing some necessary context that's often missing. <added> The point is, beating up data is easy. Be mindful of what you might be looking at, especially if the outcomes are good for an industy's well-being. </added>