3 ms·

I have followed HN for about 10 years and a few times a year there is an announcement about a major finding in cancer research. Fortunately, I had no contact w

I have followed HN for about 10 years and a few times a year there is an announcement about a major finding in cancer research. Fortunately, I had no contact with oncology, so I cannot assess if any of these findings have made it to actual treatments. Is oncology moving by continuous small steps or via leaps after these major findings are put in production, so to speak?

dumb1224 3y ago
I'm not a biomedical scientist but I do software / analysis to support drug discovery groups. >Is oncology moving by continuous small steps or via leaps after these major findings are put in production, so to speak? Regarding this question, I think it is a different type of 'breakthrough' in that it can lead to direct target discovery for drug development, which is very close to the end of approval and clinical trials. My research institute has its strenghth in small molecule drugs but there is a much bigger world for therapeutics. In that sense I think it is closer to 'production'.
cnity 3y ago
I have no experience in the field, but I have a close family member with a fairly uncommon kind of cancer (multiple myeloma). One thing that is clear through speaking with doctors and moving through the process of treatment is that a _lot_ of the treatments he is receiving are quite new. Everything from drug selection to the process of marrow transplantation enjoys the benefits of recent scientific advance. We have been told regularly something to the extent of: "the best time to get cancer is always now/in the future". If he had this cancer 1 or 2 decades ago his projected outcome would have been very different.
- copperx 3y ago
  It seems like the story is similar for many cancers. There's a lot of new immunotherapy based treatments.
underdeserver 3y ago
My mother is a doctor (not an oncologist). Over the years I've heard multiple stories of people she knew or treated, saying "if they had gotten that cancer 5 years later, they'd still be alive today".
LeonardoTolstoy 3y ago
I think a lot of breakthroughs are significant in understanding but can end up being untenable are treatment or it takes a very long time. But to answer the last question: my brother works in cancer research and it goes both ways. E.g. I would argue one of the most significant developments in cancer treatment is genome sequencing. It allows you to specifically treat the cancer a person has instead of the (mostly false) perception previously of discovering some panacea in the rainforest that cures all cancers. But the genome was sequenced 20 years ago. At the time there was a perception that that was going to be a step change in custom treatment and solving genetic disease. In reality we are just now reaching the $100 genome and if anything it only served to elucidate how much we didn't know about genetics back in 2000. But slow and steady work means we do indeed sequence people's specific cancer and customize treatment for that. So there was a leap: the Human Genome Project. But afterwards it took a lot of slow and steady progress to get to where we are at. He thinks mRNA vaccines are going to be the same. A leap forward, and now we are looking at slow and steady progress to getting custom mRNA vaccines to effectively cure cancers on a person-to-person basis.
marcosdumay 3y ago
What makes you think that the things you hear about are breakthroughs and not small steps?
- gpvos 3y ago
  Wording like "fueling 75% of cancers" makes it look like a pretty huge step.
  - marcosdumay 3y ago
    You can find the disclaimers around this comment page. This look like a minor step, but maybe one that helps with a much larger one.
tim333 3y ago
There seems to be small steps but steady progress on the treatment but questionable progress on not getting it in the first place. See eg this Guardian article: >Cancer cases in under-50s worldwide up nearly 80% in three decades, study finds >Experts are still in the early stages of understanding the reasons behind the rise in cases. The authors of the study, published in BMJ Oncology, say poor diets, alcohol and tobacco use, physical inactivity and obesity are likely to be among the factors. https://www.theguardian.com/society/2023/sep/05/cancer-cases-in-under-50s-worldwide-up-nearly-80-in-three-decades-study-finds https://www.theguardian.com/society/2023/sep/05/cancer-cases...
- lupire 3y ago
  That looks almost entirely population growth and increased testin And those "causes" are just a list of everything suspected to be bad for health. Smoking rate has been decreasing.

dumb1224 3y ago

I'm not a biomedical scientist but I do software / analysis to support drug discovery groups. >Is oncology moving by continuous small steps or via leaps after these major findings are put in production, so to speak? Regarding this question, I think it is a different type of 'breakthrough' in that it can lead to direct target discovery for drug development, which is very close to the end of approval and clinical trials. My research institute has its strenghth in small molecule drugs but there is a much bigger world for therapeutics. In that sense I think it is closer to 'production'.

cnity 3y ago

I have no experience in the field, but I have a close family member with a fairly uncommon kind of cancer (multiple myeloma). One thing that is clear through speaking with doctors and moving through the process of treatment is that a _lot_ of the treatments he is receiving are quite new. Everything from drug selection to the process of marrow transplantation enjoys the benefits of recent scientific advance. We have been told regularly something to the extent of: "the best time to get cancer is always now/in the future". If he had this cancer 1 or 2 decades ago his projected outcome would have been very different.

copperx 3y ago
It seems like the story is similar for many cancers. There's a lot of new immunotherapy based treatments.

underdeserver 3y ago

My mother is a doctor (not an oncologist). Over the years I've heard multiple stories of people she knew or treated, saying "if they had gotten that cancer 5 years later, they'd still be alive today".

LeonardoTolstoy 3y ago

I think a lot of breakthroughs are significant in understanding but can end up being untenable are treatment or it takes a very long time. But to answer the last question: my brother works in cancer research and it goes both ways. E.g. I would argue one of the most significant developments in cancer treatment is genome sequencing. It allows you to specifically treat the cancer a person has instead of the (mostly false) perception previously of discovering some panacea in the rainforest that cures all cancers. But the genome was sequenced 20 years ago. At the time there was a perception that that was going to be a step change in custom treatment and solving genetic disease. In reality we are just now reaching the $100 genome and if anything it only served to elucidate how much we didn't know about genetics back in 2000. But slow and steady work means we do indeed sequence people's specific cancer and customize treatment for that. So there was a leap: the Human Genome Project. But afterwards it took a lot of slow and steady progress to get to where we are at. He thinks mRNA vaccines are going to be the same. A leap forward, and now we are looking at slow and steady progress to getting custom mRNA vaccines to effectively cure cancers on a person-to-person basis.

marcosdumay 3y ago

What makes you think that the things you hear about are breakthroughs and not small steps?

gpvos 3y ago
Wording like "fueling 75% of cancers" makes it look like a pretty huge step.
- marcosdumay 3y ago
  You can find the disclaimers around this comment page. This look like a minor step, but maybe one that helps with a much larger one.

tim333 3y ago

There seems to be small steps but steady progress on the treatment but questionable progress on not getting it in the first place. See eg this Guardian article: >Cancer cases in under-50s worldwide up nearly 80% in three decades, study finds >Experts are still in the early stages of understanding the reasons behind the rise in cases. The authors of the study, published in BMJ Oncology, say poor diets, alcohol and tobacco use, physical inactivity and obesity are likely to be among the factors. https://www.theguardian.com/society/2023/sep/05/cancer-cases-in-under-50s-worldwide-up-nearly-80-in-three-decades-study-finds https://www.theguardian.com/society/2023/sep/05/cancer-cases...

lupire 3y ago
That looks almost entirely population growth and increased testin And those "causes" are just a list of everything suspected to be bad for health. Smoking rate has been decreasing.