5 ms·

This is an absolutely absurd thing to say. “We’ve never had blood tests that detect pancreatic cancer early, therefore we should never use them because when we

This is an absolutely absurd thing to say. “We’ve never had blood tests that detect pancreatic cancer early, therefore we should never use them because when we used other means to try to detect early, it didn’t lead to better outcomes.” If you can detect colon, kidney pancreatic or liver cancer early, you might be able to do surgery or develop treatments at the stage 1 stage. Right now we don’t have anything except MRIs and CT scans that are too hard and expensive to do frequently. And if you are diagnose with pancreatic cancer it’s usually so late that you will basically die in weeks. You’re basically saying “give up. Even if we detect early you all die anyway” which is frankly stupid. You’re discounting the possibility that early detection by means of a blood test adds whole new layers of possibilities to fight those particularly dangerous cancers.

jacquesm 5y ago
But: that surgery is not without risk, and if there are no symptoms there is a fair chance that there never will be symptoms. Depending on your age and your genetic make-up you might be more or less at risk. There is such a thing as spontaneous remission and so on. So no, I'm not 'basically giving up', and no you won't die anyway (well, unless you take that in the most abstract way), in particular likely not from cancer. Even for those cancers where we do screen (such as for instance breast cancer) it is not a given that the increased frequency of detection has led to better patient outcomes. But once you know someone's genetic disposition increased frequency of testing might be advantageous.
- BallyBrain 5y ago
  I don't see why early detection means early treatment. What if after detected, the illness is monitored instead. If it then gets to a point where the treatment is no longer considered risky for the stage of the illness, then the treatment can proceed. It would also give the person the opportunity to change lifestyle to perhaps prolong the time that the illness will become a problem, or perhaps halt its progress altogether. Additionally, the person who is aware of such illness, can keep an eye out for symptoms related to it, that might otherwise be ignored as something else. At which point normal cancer treatment can progress.
  - jacquesm 5y ago
    This is a tricky bit. There is a lot of interplay here between medical professionals and the general public, and not all of that is either rational or ethical. But absent symptoms non-treatment is better than treatment. Data about unnecessary procedures is relatively plentiful, which is of course sad, whether that's driven by commercial incentives or the need for 'something to be done' is not something that I have any grip on but it certainly is problematic.
  - BallyBrain 5y ago
    Sounds to me like the issues with this early detection is more of a regulation and education problem then. That could be fixed.
- plank_time 5y ago
  Again, absolutely absurd. Many cancers have no symptoms until it’s too late. Do you even understand this? At that point the choices for treatment are extremely limited. Even breast cancer needs x-rays to detect lumps, not detect cancer. You need a subsequent biopsy to differentiate. That’s our technology right now. If we had a blood test to detect cancer, not lumps, it’s game changing. Maybe after a generation of early detection, new outcomes will emerge if we can detect the most deadly cancers early. You’re taking old studies and applying them to new technologies and saying “it won’t work.” It’s ridiculous that you are doing this.
  - jacquesm 5y ago
    Even if you detect cancer you will still need a biopsy to figure out which bits are the cancer and which bits are just 'lumps'. Yes, it is a game changer, but it is not the kind of game changer that this is being made out to be here and mass screening using this method is not going to lead to improved outcomes. As an extra tool in the toolbox of the diagnostician it is very useful.
    - plank_time 5y ago
      It’s pretty easy. If blood test says “liver cancer positive. Colon cancer negative.” you check the liver for cancer. No need to check the colon for cancer. No need to scan the entire body for lumps.
      - graeme 5y ago
        Not that easy. “Check the liver for cancer” has lots of risks: surgery and the resulting tissue injury. I’m generally inclined towards the position of more testing....but there are very real tradeoffs to any of the interventions that a blood test could prompt.
        jghn 5y ago
        Also, you might have identified liver cancer that came from the patient's kidney. Or a colorectal cancer that came from the patient's liver.
- deleted 5y ago
  [deleted]
- goodpoint 5y ago
  > surgery is not without risk, and if there are no symptoms there is a fair chance that there never will be symptoms Another incredibly irrational argument. If the risk from surgery outweighs the risk from cancer it it should not be performed.

jacquesm 5y ago

But: that surgery is not without risk, and if there are no symptoms there is a fair chance that there never will be symptoms. Depending on your age and your genetic make-up you might be more or less at risk. There is such a thing as spontaneous remission and so on. So no, I'm not 'basically giving up', and no you won't die anyway (well, unless you take that in the most abstract way), in particular likely not from cancer. Even for those cancers where we do screen (such as for instance breast cancer) it is not a given that the increased frequency of detection has led to better patient outcomes. But once you know someone's genetic disposition increased frequency of testing might be advantageous.

BallyBrain 5y ago
I don't see why early detection means early treatment. What if after detected, the illness is monitored instead. If it then gets to a point where the treatment is no longer considered risky for the stage of the illness, then the treatment can proceed. It would also give the person the opportunity to change lifestyle to perhaps prolong the time that the illness will become a problem, or perhaps halt its progress altogether. Additionally, the person who is aware of such illness, can keep an eye out for symptoms related to it, that might otherwise be ignored as something else. At which point normal cancer treatment can progress.
- jacquesm 5y ago
  This is a tricky bit. There is a lot of interplay here between medical professionals and the general public, and not all of that is either rational or ethical. But absent symptoms non-treatment is better than treatment. Data about unnecessary procedures is relatively plentiful, which is of course sad, whether that's driven by commercial incentives or the need for 'something to be done' is not something that I have any grip on but it certainly is problematic.
- BallyBrain 5y ago
  Sounds to me like the issues with this early detection is more of a regulation and education problem then. That could be fixed.
plank_time 5y ago
Again, absolutely absurd. Many cancers have no symptoms until it’s too late. Do you even understand this? At that point the choices for treatment are extremely limited. Even breast cancer needs x-rays to detect lumps, not detect cancer. You need a subsequent biopsy to differentiate. That’s our technology right now. If we had a blood test to detect cancer, not lumps, it’s game changing. Maybe after a generation of early detection, new outcomes will emerge if we can detect the most deadly cancers early. You’re taking old studies and applying them to new technologies and saying “it won’t work.” It’s ridiculous that you are doing this.
- jacquesm 5y ago
  Even if you detect cancer you will still need a biopsy to figure out which bits are the cancer and which bits are just 'lumps'. Yes, it is a game changer, but it is not the kind of game changer that this is being made out to be here and mass screening using this method is not going to lead to improved outcomes. As an extra tool in the toolbox of the diagnostician it is very useful.
  - plank_time 5y ago
    It’s pretty easy. If blood test says “liver cancer positive. Colon cancer negative.” you check the liver for cancer. No need to check the colon for cancer. No need to scan the entire body for lumps.
    - graeme 5y ago
      Not that easy. “Check the liver for cancer” has lots of risks: surgery and the resulting tissue injury. I’m generally inclined towards the position of more testing....but there are very real tradeoffs to any of the interventions that a blood test could prompt.
      - jghn 5y ago
        Also, you might have identified liver cancer that came from the patient's kidney. Or a colorectal cancer that came from the patient's liver.
deleted 5y ago
[deleted]
goodpoint 5y ago
> surgery is not without risk, and if there are no symptoms there is a fair chance that there never will be symptoms Another incredibly irrational argument. If the risk from surgery outweighs the risk from cancer it it should not be performed.