4 ms·

Experiencing cancer in my family I can tell for sure all of that buzz is quite exciting, but in the last 5 years there haven't been breakthroughs that would sig

Experiencing cancer in my family I can tell for sure all of that buzz is quite exciting, but in the last 5 years there haven't been breakthroughs that would significantly improve outcomes for an average patient.

Retric 7mo ago
Major breakthroughs of the kind you’re talking about are extremely uncommon. Instead it’s lots of little gains that keep adding up because cancer isn’t adapting overall people still get the same mutations they got 10,000 years ago. So average person with cancer does better when any individuals cancer treatment improves and it keeps compounding over time. This doesn’t mean everyone with cancer gets a slight improvement, often it’s specific types or stages that improve without impacting others. Where general progress comes from is it’s not the same improvements year after year.
- SapporoChris 7mo ago
  https://en.wikipedia.org/wiki/Timeline_of_cancer_treatment_development https://en.wikipedia.org/wiki/Timeline_of_cancer_treatment_d... I won't debate what merits a major breakthrough. I will say, that while there hasn't been any major developments in the past five years, I can't draw any conclusions from that tidbit of information.
  - Retric 7mo ago
    That cuts out in 2015, but 5 year survival rates keep increasing with the USA just crossing 70%. Though across longer timeframes some of that is from early detection; even limited to late stage diagnosis the statistics still show significant improvement. https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.70043 https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac...
slapshot 7mo ago
There have been massive improvements in treatments in the last 5 years. Sure, cancer is far from being "cured" - but survival today is far better than 5 years ago for many forms. Among many others: - CAR T therapy going from lab to oncology suite (first launch 2017, but use rapidly growing) - Approval of Keytruda and similar for many additional forms of cancer (see the 2021-2026 milestones here: https://www.drugs.com/history/keytruda.html https://www.drugs.com/history/keytruda.html ) - Liquid biopsy going from lab to PCP's office - starting with Grail Galleri and moving from there (yes, the NIH results were weak, but the idea of a liquid biopsy at all would be laughed off 10 years ago) - Move of Atezolizumab and Tecentriq from infusion (hour) to injection (minutes) to increase availability - Lower dose CT scanning for lung cancer, including for non-smokers And a long line of immunotherapies that are making the leap from lab to chair right now. The last 5 years have probably been the most exciting in cancer research since the launch of the monoclonal antibodies in the early 2010s. There is still incredibly far to go, but the trend is in the right direction: https://employercoverage.substack.com/p/decline-in-cancer-mortality https://employercoverage.substack.com/p/decline-in-cancer-mo...
- baxtr 7mo ago
  You seem to be knowledgeable on this topic. What’s your prediction for the next five years?
  - fnord77 7mo ago
    mRNA vaccines to teach your body to destroy cancer cells
    - greygoo222 7mo ago
      I just got nerdsniped for an hour writing up a comment about how cool they are.
      - baxtr 7mo ago
        https://xkcd.com/356/ https://xkcd.com/356/
- parineum 7mo ago
  I've heard that the improvements in cancer survival are mostly a statistical trick centered around earlier detection. That people aren't actually living longer with cancer, they're living longer while we know they have cancer. Is there any truth to that?
  - dsjoerg 7mo ago
    Cool question. What form would an answer take? We need some detection benchmark data thats invariant over the period of interest. I hope the data exists but I would be surprised. Another way to come at it would be mortality data. But that has a bunch of its own problems. Everything is changing at once, it makes this kind of science so hard.
  - greygoo222 7mo ago
    Short answer, no. Long answer, it's a variable you need to consider when doing data analysis, and it depends on what exactly you're talking about, but it's absolutely not true for improvements in cancer survival general. One alternative method is to look at per-capita death rates, for example: Reduction in US and UK childhood cancer death since 2000 https://ourworldindata.org/grapher/cancer-death-rates-in-children-under-10-years-old?time=2000..latest https://ourworldindata.org/grapher/cancer-death-rates-in-chi... Reduction in several countries' age-standardized breast cancer death since 2000 (Why did it increase in South Africa? I'm not sure, maybe socioeconomic factors) https://ourworldindata.org/grapher/breast-cancer-death-rate-in-women?time=2000..latest https://ourworldindata.org/grapher/breast-cancer-death-rate-... Reduction in global age-standardized cancer death rate since 2000 (Scroll down to second graph. Since the population is getting older, age-standardization makes a fairer comparison) https://ourworldindata.org/grapher/cancer-death-rates https://ourworldindata.org/grapher/cancer-death-rates 2000 is an arbitrary year I picked for clear visual changes without needing to haggle over statistics. If you want to feel optimistic, switch the childhood cancer death graph to 1960-now. This method has different possible failure points. It could be that less people are getting cancer, or that people who would get cancer are dying of other causes, or reporting of cause of death has changed, though this is very unlikely for some figures, such as leukemia death rates for children in the US. Statistics is hard. Overall though, the evidence is very good that cancer survival has improved a lot due to better treatments since 2000. If you have a more specific claim you're dubious about, I'd be willing to look into it for you. I'm very enthusiastic about this topic.
ImageXav 7mo ago
It may feel that way due to the iterative nature of medical improvements, but over the past few decades there has been a consistent reduction in cancer mortality rates across most types of cancer [0]. Treatments really are getting better and more targeted. Immunotherapy has made huge breakthroughs. Combination treatments allow for significantly improved lifespans and better quality of life during treatments. There are a few cancers that remain hard to treat, but I have a lot of confidence that in the coming decades we will make strides in attacking them. That being said, I'm very sorry to hear about the pain you and your family must be going through. I've had a few close loved ones undergo cancer treatment and it was tough. [0] https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.70043 https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac...
greygoo222 7mo ago
Examples aside, 5 years isn't long enough for a treatment to move from early mice trials to clinical use. The average time from application to FDA approval is about 10 years. The breakthroughs happening now will benefit average patients later. It's frustrating, but it's not because we've run out of innovations.

Retric 7mo ago

Major breakthroughs of the kind you’re talking about are extremely uncommon. Instead it’s lots of little gains that keep adding up because cancer isn’t adapting overall people still get the same mutations they got 10,000 years ago. So average person with cancer does better when any individuals cancer treatment improves and it keeps compounding over time. This doesn’t mean everyone with cancer gets a slight improvement, often it’s specific types or stages that improve without impacting others. Where general progress comes from is it’s not the same improvements year after year.

SapporoChris 7mo ago
https://en.wikipedia.org/wiki/Timeline_of_cancer_treatment_development https://en.wikipedia.org/wiki/Timeline_of_cancer_treatment_d... I won't debate what merits a major breakthrough. I will say, that while there hasn't been any major developments in the past five years, I can't draw any conclusions from that tidbit of information.
- Retric 7mo ago
  That cuts out in 2015, but 5 year survival rates keep increasing with the USA just crossing 70%. Though across longer timeframes some of that is from early detection; even limited to late stage diagnosis the statistics still show significant improvement. https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.70043 https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac...

slapshot 7mo ago

There have been massive improvements in treatments in the last 5 years. Sure, cancer is far from being "cured" - but survival today is far better than 5 years ago for many forms. Among many others: - CAR T therapy going from lab to oncology suite (first launch 2017, but use rapidly growing) - Approval of Keytruda and similar for many additional forms of cancer (see the 2021-2026 milestones here: https://www.drugs.com/history/keytruda.html https://www.drugs.com/history/keytruda.html ) - Liquid biopsy going from lab to PCP's office - starting with Grail Galleri and moving from there (yes, the NIH results were weak, but the idea of a liquid biopsy at all would be laughed off 10 years ago) - Move of Atezolizumab and Tecentriq from infusion (hour) to injection (minutes) to increase availability - Lower dose CT scanning for lung cancer, including for non-smokers And a long line of immunotherapies that are making the leap from lab to chair right now. The last 5 years have probably been the most exciting in cancer research since the launch of the monoclonal antibodies in the early 2010s. There is still incredibly far to go, but the trend is in the right direction: https://employercoverage.substack.com/p/decline-in-cancer-mortality https://employercoverage.substack.com/p/decline-in-cancer-mo...

baxtr 7mo ago
You seem to be knowledgeable on this topic. What’s your prediction for the next five years?
- fnord77 7mo ago
  mRNA vaccines to teach your body to destroy cancer cells
  - greygoo222 7mo ago
    I just got nerdsniped for an hour writing up a comment about how cool they are.
    - baxtr 7mo ago
      https://xkcd.com/356/ https://xkcd.com/356/
parineum 7mo ago
I've heard that the improvements in cancer survival are mostly a statistical trick centered around earlier detection. That people aren't actually living longer with cancer, they're living longer while we know they have cancer. Is there any truth to that?
- dsjoerg 7mo ago
  Cool question. What form would an answer take? We need some detection benchmark data thats invariant over the period of interest. I hope the data exists but I would be surprised. Another way to come at it would be mortality data. But that has a bunch of its own problems. Everything is changing at once, it makes this kind of science so hard.
- greygoo222 7mo ago
  Short answer, no. Long answer, it's a variable you need to consider when doing data analysis, and it depends on what exactly you're talking about, but it's absolutely not true for improvements in cancer survival general. One alternative method is to look at per-capita death rates, for example: Reduction in US and UK childhood cancer death since 2000 https://ourworldindata.org/grapher/cancer-death-rates-in-children-under-10-years-old?time=2000..latest https://ourworldindata.org/grapher/cancer-death-rates-in-chi... Reduction in several countries' age-standardized breast cancer death since 2000 (Why did it increase in South Africa? I'm not sure, maybe socioeconomic factors) https://ourworldindata.org/grapher/breast-cancer-death-rate-in-women?time=2000..latest https://ourworldindata.org/grapher/breast-cancer-death-rate-... Reduction in global age-standardized cancer death rate since 2000 (Scroll down to second graph. Since the population is getting older, age-standardization makes a fairer comparison) https://ourworldindata.org/grapher/cancer-death-rates https://ourworldindata.org/grapher/cancer-death-rates 2000 is an arbitrary year I picked for clear visual changes without needing to haggle over statistics. If you want to feel optimistic, switch the childhood cancer death graph to 1960-now. This method has different possible failure points. It could be that less people are getting cancer, or that people who would get cancer are dying of other causes, or reporting of cause of death has changed, though this is very unlikely for some figures, such as leukemia death rates for children in the US. Statistics is hard. Overall though, the evidence is very good that cancer survival has improved a lot due to better treatments since 2000. If you have a more specific claim you're dubious about, I'd be willing to look into it for you. I'm very enthusiastic about this topic.

ImageXav 7mo ago

It may feel that way due to the iterative nature of medical improvements, but over the past few decades there has been a consistent reduction in cancer mortality rates across most types of cancer [0]. Treatments really are getting better and more targeted. Immunotherapy has made huge breakthroughs. Combination treatments allow for significantly improved lifespans and better quality of life during treatments. There are a few cancers that remain hard to treat, but I have a lot of confidence that in the coming decades we will make strides in attacking them. That being said, I'm very sorry to hear about the pain you and your family must be going through. I've had a few close loved ones undergo cancer treatment and it was tough. [0] https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.70043 https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac...

greygoo222 7mo ago

Examples aside, 5 years isn't long enough for a treatment to move from early mice trials to clinical use. The average time from application to FDA approval is about 10 years. The breakthroughs happening now will benefit average patients later. It's frustrating, but it's not because we've run out of innovations.