3 ms·

Yup this is what needs to be tested, in other words can cancers be detected early enough so that people are more likely to be cured with treatment. Secondary be

by Gatsky 4y ago

Yup this is what needs to be tested, in other words can cancers be detected early enough so that people are more likely to be cured with treatment. Secondary benefits of detecting early are needing less extensive surgery, less intensive chemotherapy and radiation, less expensive next generation therapies in the long run. We should also remember that the assays are improving all the time. Having said all this, early detection is not prevention, and the endgame still remains prevention I think. This whole field also serves as further confirmation that everything intestesting was discovered in the life sciences in the 1970s [1]. [1] https://pubmed.ncbi.nlm.nih.gov/837366/ https://pubmed.ncbi.nlm.nih.gov/837366/

threeseed 4y ago
But the other question is whether the endgame is prevention or treatment at all. Are some types of cancer better treated like HIV/AIDS where it's simply managed.
- jmcgough 4y ago
  Seems like an odd example when HIV/AIDS can be prevented through PrEP now.
  - arcticbull 4y ago
    HIV/AIDS is a bad example but theres a bunch of cancers or tumors that you get very late in life, which grow slowly. A good example is an acoustic neuroma [1]. In many cases, you're going to die long before it takes you out. [1] https://en.wikipedia.org/wiki/Vestibular_schwannoma https://en.wikipedia.org/wiki/Vestibular_schwannoma
adamredwoods 4y ago
The endgame will never be prevention. The chance of getting any cancer is high (1 in 8 for prostate). We would have to bring some of these probabilities down, maybe by 100x? Can we even get to 10x? I hope we can get there for some cancers, for example, using the new HPV vaccine. https://www.cancer.org/healthy/cancer-causes/general-info/lifetime-probability-of-developing-or-dying-from-cancer.html https://www.cancer.org/healthy/cancer-causes/general-info/li...
bsder 4y ago
> Secondary benefits of detecting early are needing less extensive surgery, less intensive chemotherapy and radiation, less expensive next generation therapies in the long run. This is true, but you have to not have too many false positives. A friend of mine went to get her mammogram, and it saw "something". She was a mess until the biopsy came back negative. "Mess" meaning high blood pressure, palpitations, etc.--that false positive could very well have killed her with a cardiac event. A screening test like this that has even worse false positives will kill some people like her. Another one has always had negative mammograms and extensive 3D imaging. Suddenly, her breast blew up to twice its size. Everyone assumed it was a localized infection because she just had a negative mammogram set less than 30 days earlier. The only reason they bothered to order a biopsy was to try to break whatever lymph clog was causing her "edema". Oops--Stage 3 invasive lobular breast cancer throughout the entire breast. You can't see lobular breast cancers on mammograms because they never form a lump, they just inflitrate all throughout the normal cells. They're about 30% of all breast cancers and a screening test that can flag these (even with a false positive) would be a godsend. Being able to flag people for a followup MRI would be a significant improvement if it doesn't have too many false positives. A screening test like this would be quite beneficial. As always in medicine, things are complicated.

by Gatsky 4y ago

threeseed 4y ago

But the other question is whether the endgame is prevention or treatment at all. Are some types of cancer better treated like HIV/AIDS where it's simply managed.

jmcgough 4y ago
Seems like an odd example when HIV/AIDS can be prevented through PrEP now.
- arcticbull 4y ago
  HIV/AIDS is a bad example but theres a bunch of cancers or tumors that you get very late in life, which grow slowly. A good example is an acoustic neuroma [1]. In many cases, you're going to die long before it takes you out. [1] https://en.wikipedia.org/wiki/Vestibular_schwannoma https://en.wikipedia.org/wiki/Vestibular_schwannoma

adamredwoods 4y ago

The endgame will never be prevention. The chance of getting any cancer is high (1 in 8 for prostate). We would have to bring some of these probabilities down, maybe by 100x? Can we even get to 10x? I hope we can get there for some cancers, for example, using the new HPV vaccine. https://www.cancer.org/healthy/cancer-causes/general-info/lifetime-probability-of-developing-or-dying-from-cancer.html https://www.cancer.org/healthy/cancer-causes/general-info/li...

bsder 4y ago

> Secondary benefits of detecting early are needing less extensive surgery, less intensive chemotherapy and radiation, less expensive next generation therapies in the long run. This is true, but you have to not have too many false positives. A friend of mine went to get her mammogram, and it saw "something". She was a mess until the biopsy came back negative. "Mess" meaning high blood pressure, palpitations, etc.--that false positive could very well have killed her with a cardiac event. A screening test like this that has even worse false positives will kill some people like her. Another one has always had negative mammograms and extensive 3D imaging. Suddenly, her breast blew up to twice its size. Everyone assumed it was a localized infection because she just had a negative mammogram set less than 30 days earlier. The only reason they bothered to order a biopsy was to try to break whatever lymph clog was causing her "edema". Oops--Stage 3 invasive lobular breast cancer throughout the entire breast. You can't see lobular breast cancers on mammograms because they never form a lump, they just inflitrate all throughout the normal cells. They're about 30% of all breast cancers and a screening test that can flag these (even with a false positive) would be a godsend. Being able to flag people for a followup MRI would be a significant improvement if it doesn't have too many false positives. A screening test like this would be quite beneficial. As always in medicine, things are complicated.