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<@leakycap> The common cancer treatment modalities: surgery, radiotherapy, chemotherapy, targeted drugs and their combinations are very effective first line treatments. I agree the statistics are much better.

In the field of cancer research it has been focusing more on drug / treatment resistance, heterogeneous response to the same treatment and development of less invasive methods both in treatment and assessment (imaging and monitoring). We have made huge progress in terms of deeper understanding of cancer biology and human disease mechanism in general.

However we have a very long way to understand when things progress outside of our control how to respond. E.g the key cancer drivers have been identified long ago but how biology and evolution modulate its response to external treatment has so much unknowns. That requires large effort to push the whole foundation of science to elucidate the details of these processes in my opinion.

<@leakycap> I take four pills a day and the primary side effect is weight gain. The earlier 1950s era treatment made me exhausted 24/7. There's a new trial that has a new target, and looks to solve the remaining symptoms of the disease, with effectively no side effects

The big problem is that it's a chronic blood cancer, so the pills have a list price of $180k/yr. Who knows if my insurance will cough up for a second big-money prescription/

<@leakycap> I’ve met people that have moved to Houston for cancer treatment there, were given 1-2 years to live, and they’re still here 15-20 years later. It is a really remarkable place.

<@leakycap> You mention rapid debulking following an infusion. That must have been a surreal experience. Congratulations!

How does the treatment you received compare to the current standard of care? Would current therapies also result in rapid debulking as well?

<@leakycap> Thing with any cancer treatment is that it works miraculously for someone somewhere and makes it to the news all over.

But it rarely translates to that level of success with masses of cancer patients.

<@leakycap> >the progress being amazing, and I hope it continues.

and that it does not require being lucky to receive, as you were.

<@melling> > Get a colonoscopy at 45. We are seeing a big increase in younger people.

N.B. this is not just an increase in detection (as could happen with more/better screening where the true rate isn't changing), but mortality:

> In people under 55, however, death rates have been increasing about 1% per year since the mid-2000s. https://www.cancer.org/cancer/types/colon-rectal-cancer/abou...

<@melling> FOBT which you can do painlessly at home for a few dollars is not meaningfully less preventative than an invasive colonoscopy and carries almost no risk. https://www.nejm.org/doi/full/10.1056/NEJMoa2208375

<@melling> Thanks for the reminder. My containers to shit in are waiting to be picked up from the doctor's office.

Looks like colonoscopy is better from your link.

<@melling> Until things radically change, people are always going to die of something. The more people avoid death from other things, the more people live long enough to die from cancer.

<@melling> I know at least a dozen people in my family and friend network that are alive now after treatment from a cancer that was fatal in most cases 20 years ago. That’s not proof by any measure but I am certainly thankful it’s not 20 years ago.

<@melling> Prostate cost nothing now in your 30s too

<@fooblaster> I'm sorry for your loss. I lost my wife to cancer two years ago.

Obviously it didn't work out as we wanted, but she had real hope and prospects. A decade ago, her diagnosis was a guaranteed death sentence. It a nasty business, but at some level, oncology is a field where we stand on the shoulders of those before us. The hope that these tragedies we experience will help future victims brings some comfort personally.

<@fooblaster> I'm very sorry to hear this, and I hope with time you're surrounded by many good memories of better times with your father.

<@fooblaster> I lost one parent to cancer but the other has been cancer free for over ten years now. I'm devastated by the lose of one parent but incredibly grateful for the one who beat their cancer.

Is that winning? I dont know. But the likelihood that my other parent would still be around if they got their same cancer now is already higher than it was when they passed. Nothing can bring my other parent back but we can prevent others from losing their loved ones.

<@fooblaster> I'm sad to read this, as my father too is not in the best possible situation currently, cause of cancer. Wish you feel better soon and keep fond memories of him.

<@fooblaster> Here's to your dad, may he rest easy and be remembered well.

<@fooblaster> I’m sorry for your loss, stranger.

I lost my father to cancer last year as well - the medical system failed him, his pain treated as exaggerated and his symptoms ignored until it was far too late.

There’s no win for our dads, but I hope the progress prevents future people like them from facing what they did.

<@fooblaster> winning isn't won. i'm sorry for your loss.

<@dogman123> I had a close relative diagnosed with multiple myeloma 25+ years ago (I don't remember the exact year) who only lived for a couple more years. It was rough back then. I'm really glad to hear that there is much better treatment these days.

<@prog_1> I think perspective is important here.

I'm alive because pharma developed an expensive drug that, at the time I got it, was only administered to 42 others before me.

I was a single person working my first job out of college with Blue Cross Blue Shield and got the best I think was available.

You might be jaded after working so long in a difficult industry; the medical research/pharma work done matters to the patients who receive it and get another decade+ of good life.

<@prog_1> > Individualized treatment plans using checkpoint inhibitor combinations, biotech therapies, etc are for few select individuals with A LOT of money.

This is the first step in the commoditization of any new treatment, no? Initially expensive but that creates competition to bring the price down.

[Maybe not in the US though because the customer cannot select their supplier]

<@prog_1> You may check Europe. I can assure you that patients getting PD-1 inhibitors etc. while if I am not mistaken at least in part recruited for clinical trials pay zilch, nada for the drugs there are taking (in Spain).

<@prog_1> I don't know... Advancements like Keytruda are huge. And it will be off patent soon. And there are over 1500 active CAR-T clinical trials going on as we speak.

<@elric> Just went through the process recently...

Luckily Urgent Care was able to go from ultrasound to CT scan in 1 day. The long wait time has come from the insurance honestly.

Had to go to a different hospital because the original one I went to has to get an approval from United before getting it done (other hospital 2 blocks away doesn't have that same requirement??)

I got referred to a dedicated cancer center and then guess what, I have to call United and ask them to approve it - but I can't get an appointment to do that for 2 weeks.

Ended up doing all the legwork on my own and was able to get a consultation done within a week. Now I'm having to do biopsies, PET scan, ect. Depending on the result I might be able to get it removed next week!

But the pain has become so severe I can't eat, sleep, even lay down without extreme discomfort. I can't imagine waiting around on the insurance to walk me through it.

Funny enough, United sent us a letter in the mail asking if I really wanted to get that original CT scan! Like no, I'd rather not know I have a 7" tumor in my abdomen. Simply a joke of an industry

<@elric> > It seems to be a universal truth that getting a CT/MRI comes with a long wait time.

I wonder if this is regional. I was able to get an MRI scheduled within a couple weeks when I needed one for my non-urgent condition. This was in Chicago, so maybe we're just blessed with a surplus of MRI machines.

<@elric> Universal in what country? In the US I've had two MRIs in the last few years for non urgent things and both were scheduled within less than a week.

<@elric> > getting a CT/MRI comes with a long wait time.

How long? It took me 1 day to get a CT at a clinic and a few hours in the ER.

<@elric> > It seems to be a universal truth that getting a CT/MRI comes with a long wait time

It 100% depends on your situation. I've had two clinical MRIs done in my life. One was same day. One was scheduled out a few days.

<@mberning> Like this?

https://www.bbc.com/news/world-australia-69006713?utm_source...

<@fumeux_fume> The difficulty is that we only care about healthcare for everyone when we're affected, not before. Realistically, every man woman and child in the USA should demand better by organizing massive peaceful protests.

<@agumonkey> Are you french by any chance?

This article made big news in France recently, but I have not heard of it anywhere else. I'm wondering if that thing is really the revolution it's been touted and I just missed the international news talking about it, or if it's just another example of "Look, France is great!" propaganda by french media.

Edit Note: I'm french.

<@cynicalsecurity> A woman in China received a transplant of pancreatic beta cells derived from her own, induced pluripotent stem cells. She was able to go off insulin, even a year out.

A cure for T1D is coming.

https://www.cell.com/cell/fulltext/S0092-8674(24)01022-5

<@cynicalsecurity> Life expectancy for T1D diagnosis in 1980 is 15 years longer than those diagnosed in the 1960s.

Life expectancy seems to continue to trend upwards.

My wife is alive and healthy with T1D, which doesn't matter at all for your claim, but the aggregate evidence for all T1D seems far removed from humanity failing diabetics.

<@Noelia->

    it’s more like countless small battles happening all at once

I hope your friend is doing okay.

<@Noelia-> I agree. Relevant PhD Comics: https://phdcomics.com/comics/archive.php?comicid=1162

<@kla-s> I was short the stock of a company called Novocure, and my thesis was based on the science. Novocure developed a literal helmet you wear on your head. It's designed to generate alternating electric fields at specific frequencies and blast them into your brain. I was skeptical, because biotech frauds are a dime a dozen, and nothing I could read in their literature made sense to me as a mechanism of action against GBM.

The randomized, double-blind phase 3 trials came out and it turns out the helmet almost triples 5 year survival rates. For "high compliance" patients (i.e. those that followed their directions and wore the helmet in accordance with the treatment plan), 5 year survival rates jumped 6x. They're selling $600mm of these helmets a year now. Progress is uneven but it's always coming!

<@kla-s> The treatment has been improving over the years, and the survival rate is going up. It’s definitely one of the most challenging forms, if our progress rate is anything to go by.

<@dghughes> Looks like they did flip a switch, but not a medical one, according to my AI friend:

Around 1990, several key shifts occurred in U.S around cancer:

- Federal Advertising Restrictions (1980s → 1990s trend)

- Cigarette ads were already banned from TV and radio since 1971, but by the late '80s and early '90s, there was increasing pressure to further restrict tobacco marketing, especially to youth.

- Synar Amendment (1992)

        Required states to prohibit the sale of tobacco to individuals under 18.

        States risked losing federal funding if noncompliant.

        Late 1980s to early 1990s: many cities and states began passing clean indoor air laws restricting smoking in workplaces, restaurants, and public areas.

        Examples: San Luis Obispo, CA (1990) banned smoking in all indoor public places.

        States began exploring lawsuits against tobacco companies for Medicaid costs related to smoking-related illnesses.

        CDC established the Office on Smoking and Health as a national anti-smoking effort.

        American Nonsmokers' Rights Foundation and other groups pushed for local ordinances.

        Several states raised cigarette taxes as a deterrent and revenue tool.

    EPA expanded its Integrated Risk Information System (IRIS), classifying substances based on carcinogenic risk.

    Substances like benzene, formaldehyde, dioxins, and asbestos were formally assessed and increasingly restricted.

    Major overhaul targeting hazardous air pollutants (HAPs), including 189 known or suspected carcinogens.

    Mandated technology-based emissions standards for industries emitting these substances (Maximum Achievable Control Technology - MACT).

    Examples: emissions from chemical plants, refineries, dry cleaners.

    Occupational Safety and Health Administration tightened exposure limits for carcinogens (e.g., formaldehyde, cadmium).

    Enforcement of hazard communication (HazCom) standards requiring MSDS labeling for toxic/carcinogenic workplace chemicals.

    Expansion of EPCRA (Emergency Planning and Community Right-to-Know Act), empowering communities to track local industrial emissions via the Toxics Release Inventory (TRI).

    Helped spotlight local exposure to carcinogens.

    CERCLA (Superfund) activity peaked; sites with carcinogenic contamination (e.g., PCBs, VOCs) were targeted for cleanup.

    Public concern about cancer clusters near toxic waste sites gained visibility.

    Required businesses to label products or areas with chemicals “known to the state to cause cancer or reproductive toxicity.”

    Influential beyond CA due to market pressure on manufacturers.

One of the best wins for longevity historically has been hygiene, safety design for products/places/processes, avoiding wars, and using fossil fuel to replace slavery. Medicine helped (particularly vaccines, antibiotics, and emergency surgery), but you can't offset society-level problems with it, especially since it's more expensive to scale.

So when I see such a graph, I always look for more general reasons first.

We'll see a similar drop once we tackle sugar, weight gain, and various legal and illegal addictive substances.

<@slowhadoken> Maybe in your country.

<@Marciplan> I dunno about generative AI, but machine learning has already shown promising results in for example spotting early cancers on X-rays and scans that doctors missed.

<@dgfitz> It certainly is a shame that he’s fucked up so many things so badly. I can’t wait til he’s no longer relevant.

<@dgfitz> In the case of this specific post, it is unfortunately very appropriate to bring him up: his administration is enthusiastically setting back the US’s ability to study, treat, and cure cancer by years and possibly decades; his cuts at the FDA are setting back the availability of new therapies and his cuts to AHRQ and are undermining our ability to study whether the ones we have work; and his proposed budget would strip access to healthcare (including cancer screening and relevant preventative care) from tens of millions of Americans. Oh and his administration’s attack on higher education, and his immigration policies relating thereto, are gutting our scientific and biomedical workforces.

So while I am as sick as anybody about hearing about him, on a thread about advances in cancer treatments, it would be awfully weird to ignore the elephant in the room. Just sayin’.

<@dgfitz> Well, Trump inspired a carve-out exception to Godwin's Law from Mike Godwin himself.

<@dgfitz> I'm sorry you're tired of hearing people document the end of the American experiment.

<@erickf1> > Now, even children perish from cancer in America

Is this a recent phenomenon? I never thought that children were immune to cancer.

<@cladopa> > We should activate the natural inmune defences instead of extremely invasive chemotherapy.

Yeah, it's a shame researchers don't work on immunotherapies for cancer, I bet they could do some nifty shit with engineered t-cells.

<@cladopa> Is there a pattern to these increases? Is it because so many other diseases have been prevented or cured that it causes more people to live long enough to get some form of cancer?

<@cladopa> Yep. And for the smashed to pulp extremities I would suggest a fast regrowth of an arm or a leg, preferably in a week or so.

More seriously: cancer is no joke and so are the treatments.

<@nextn> That first tweet sounds utterly deranged.

<@nextn> Chemotherapy as I understand it works by killing rapidly-dividing cells (which is why your hair falls out).

Fenbendazole purportedly slows down cell division, allowing the immune system a chance to catch up with the cancer cells.

So they would seem to employ similar mechanisms. I hope more clinical trials are performed soon.