5 ms·

All these arguments are just arm chair discussions by people who have literally zero knowledge or involvement in cancer treatments. The overall 5 year survival

All these arguments are just arm chair discussions by people who have literally zero knowledge or involvement in cancer treatments. The overall 5 year survival rate has increased significantly and for some types it has increased multiple-fold thanks to new drugs. And regardless, even in types with lower success rates the side effects are generally way more manageable than traditional chemotherapy.

VHRanger 7y ago
If we diagnose earlier, it's expected that the 5Y survival rate improves even if the patient dies at the same age as she would have in the counterfactual.
- mrosett 7y ago
  Sure, that can show up in aggregated statistics. But it used to be that there was no treatment for all sorts of metastatic diseases. Now there are. That's not a function of earlier detection. This isn't made up; we have real RCTs demonstrating this stuff....
  - freethinker9 7y ago
    As long as we're talking about what 'used to be', there didn't used to be 4 year olds getting Leukemia. And there didn't used to be this idea that 40% of the entire population will be diagnosed with cancer at some point. (!) As far as I can tell, the article is full of facts, obvious stuff really, and the naysayers simply don't want to face the harsh reality that cancer 'research' is total bullshit and always has been. What's causing all of this cancer? Are we just not praying hard enough, is that it? Wait, I know--how about all of the CARCINOGENS that are everywhere, in everything, and are EPA and FDA approved also, with the revolving door always swinging as suits pass from government to big business and back again on their merry way? No...? OK then, maybe we just need to go buy more pink ribbons and 'race for the cure.' Get Usain Bolt in there. He'll turn things around. (Why hasn't anyone hired this guy yet?) And if that doesn't help, maybe try a little prayer also, perhaps.
nonbel 7y ago
The people who don't know what they are talking about (or are maliciously feigning ignorance) are those who look at 5 yr survival without considering the effect of increased surveillance/screening. https://en.m.wikipedia.org/wiki/Lead_time_bias https://en.m.wikipedia.org/wiki/Lead_time_bias
- stewbrew 7y ago
  You have to distinguish between screening detected cancer and symptomatic cancer. 5yr srvl rates say little in the former case but they are relevant for the latter. You'd really prefer having skin cancer today than ten years ago. Your short exchange of arguments is a good example of what goes wrong in the public discussion.
  - nonbel 7y ago
    I don't understand what you mean by "detected cancer" and "symptomatic cancer". Eg if a cancer is already detected then by definition it is impossible to screen for it.
    - mbreese 7y ago
      (Screening detected) Found during a routine/annual colonoscopy/mammogram/etc... vs (Symptomatic detected) Hey, what is this lump here? Why am I so tired? etc...
      - nonbel 7y ago
        I see, it should have been written "screening-detected" to be as clear as possible. Yes, the latter is more likely to be comparable over time but it will still have issues with changes in how likely someone is to report it to their doctor, etc.
- mrosett 7y ago
  Look, just because a bias exists doesn't mean that it explains every single bit of improvement. We have randomized controlled trials showing that these drugs work.

VHRanger 7y ago

If we diagnose earlier, it's expected that the 5Y survival rate improves even if the patient dies at the same age as she would have in the counterfactual.

mrosett 7y ago
Sure, that can show up in aggregated statistics. But it used to be that there was no treatment for all sorts of metastatic diseases. Now there are. That's not a function of earlier detection. This isn't made up; we have real RCTs demonstrating this stuff....
- freethinker9 7y ago
  As long as we're talking about what 'used to be', there didn't used to be 4 year olds getting Leukemia. And there didn't used to be this idea that 40% of the entire population will be diagnosed with cancer at some point. (!) As far as I can tell, the article is full of facts, obvious stuff really, and the naysayers simply don't want to face the harsh reality that cancer 'research' is total bullshit and always has been. What's causing all of this cancer? Are we just not praying hard enough, is that it? Wait, I know--how about all of the CARCINOGENS that are everywhere, in everything, and are EPA and FDA approved also, with the revolving door always swinging as suits pass from government to big business and back again on their merry way? No...? OK then, maybe we just need to go buy more pink ribbons and 'race for the cure.' Get Usain Bolt in there. He'll turn things around. (Why hasn't anyone hired this guy yet?) And if that doesn't help, maybe try a little prayer also, perhaps.

nonbel 7y ago

The people who don't know what they are talking about (or are maliciously feigning ignorance) are those who look at 5 yr survival without considering the effect of increased surveillance/screening. https://en.m.wikipedia.org/wiki/Lead_time_bias https://en.m.wikipedia.org/wiki/Lead_time_bias

stewbrew 7y ago
You have to distinguish between screening detected cancer and symptomatic cancer. 5yr srvl rates say little in the former case but they are relevant for the latter. You'd really prefer having skin cancer today than ten years ago. Your short exchange of arguments is a good example of what goes wrong in the public discussion.
- nonbel 7y ago
  I don't understand what you mean by "detected cancer" and "symptomatic cancer". Eg if a cancer is already detected then by definition it is impossible to screen for it.
  - mbreese 7y ago
    (Screening detected) Found during a routine/annual colonoscopy/mammogram/etc... vs (Symptomatic detected) Hey, what is this lump here? Why am I so tired? etc...
    - nonbel 7y ago
      I see, it should have been written "screening-detected" to be as clear as possible. Yes, the latter is more likely to be comparable over time but it will still have issues with changes in how likely someone is to report it to their doctor, etc.
mrosett 7y ago
Look, just because a bias exists doesn't mean that it explains every single bit of improvement. We have randomized controlled trials showing that these drugs work.