New Radiotracer Can Identify Nearly 30 Types of Cancer
snmmi.org
snmmi.org
At most they said they would do a blood test which checks for a couple types of cancer. I asked if I could get a CT and have a professional go over it. nope. But something like this tracer is what I'd like to do.
Pricing is usually done as multiples of what Medicare pays, so insurers will build their network and usually have a cap at 2x Medicare. If you are taken to an out-of-network hospital during an emergency, the hospital can charge their regular prices, although this usually gets negotiated down for extended in-patient stays. As an uninsured individual, however, you would be liable for the complete amount, which is a lot more than what the insurance pays.
Even the wealthiest individuals with personal doctors rarely perform full body scans for that reason.
You should ask yourself why do you want to get checked for cancer.
I spend 10000x more time and effort monitoring the health and performance indicators of my servers compared to my body, it's astoundingly ignorant that we aren't more honed in on early detection for all sorts of issues.
Can you imagine if your server monitoring runs once per minute and randomly fails 1/100 times? You'd be getting panic-inducing server is down emails many times per day. Such server monitoring would produce little to no value as you'd quickly ignore them as noise, just like you should avoid doing more tests like this on your body.
Additionally, CTs in particular produce ionizing radiation and increase your risk of cancer. If monitoring your server increased the risk of it failing, would you still want monitoring on it?
This stuff about “overtesting” and “iatrogenic risk” is silly. It’s one of the biggest misconceptions in medicine today. Every test has a sensitivity and a specificity and must be interpreted accordingly. Not doing that properly is a doctor problem not a test problem. In terms of spurious findings, it is usually possible to stack diagnostics until the answer becomes clear. There are lots of things between a CT and a biopsy.
There's a lot of accumulated knowledge out there on how much better healthcare can be for motivated patients who can afford to pay for some of it out of pocket, but it's seen as pretty contrarian, so not discussed that openly. (Just see the other comments in this thread about how "overtesting" is a dangerous waste of resources...)
I don't know of an online community or blog that collates all this info well, but Peter Attia's blog/podcast is a good place to start: https://peterattiamd.com/
[0] https://www.fda.gov/drugs/investigational-new-drug-ind-appli...
Or "who think they are"? How can you be sure?
Here's the Bayesian argument:
- Let's assume a lab test (or imaging test) has a 1% false positive rate and 100% sensitivity (that would be pretty good for many tests and imaging modalities!).
- The cancer you screening for has a 1% incidence as well (low-ish, for the sake of argument).
- Therefore the chance that a "positive" scan would be due to a false positive or a true cancer would be equivalent (i.e., the Positive Predictive Value is 50%).
If we did this at population level, we'd be massively overtreating and over-biopsy-ing... not the desired outcome.
More information is better than less, imo.
There's plenty of harmful ways to die, and you'll find they don't check for most of them until they have a decent reason.
Just sitting on our hands on this information and letting people die is the worst decision. We need to improve our technology to get better results, not throw our hands up in the air and say the problem is too hard.
Better imaging is an option but that often falls into dangerous in itself or easier said than done like say trying to do detection of cancer by scent.
Machine learning is fundamentally GIGO and tends to learn smartass shortcuts if one isn't careful. "The healthy sample data is less zoomed in while the cancer ones are zoomed in - therefore full chest x-ray is fine but a lung X-ray is cancer."
The point is that there is an opportunity for the Steve Jobs of health care to come up with a way, a new innovative novel way, for classification of tumors to be improved without needing biopsy. Once we have that, then we can take tests to our heart's content. Right now, the attitude of "we shouldn't have people take tests and detect cancer early because our current method of determining if they are cancerous would make it too hard" isn't acceptable.
Even then it's really common to see a biopsy come back as 'indeterminate'. If it's indeterminate then now what? You either punt and do nothing or go for excision.
Consider this tidbit: A lot of slow moving low grade cancers it hardly matters when you find them. Early or later matters little. Whereas aggressive cancers often are untreatable. Find them early, find them late you'll die either way. And fast growing cancers often fully develop between screenings.
If the alternative is saving a few who would otherwise die, but taking away more healthy days from many others or, possibly, even killing healthy individuals because they get overtreated, not spending money on screening _now_, but instead spending money on better understanding is the rational thing to do.
And that’s exactly what we are doing. Technology advances, models get refined. Maybe, some day, statistics (and ethics committees) will decide population screening does make sense.
And it isn’t necessarily about major invasive surgery. Even small procedures, done unnecessarily often enough, may already swing the balance.
Also, in some cases knowing that you have cancer may not affect your life expectancy at all. https://en.wikipedia.org/wiki/Screening_(medicine)#Overdiagn...:
”Screening may identify abnormalities that would never cause a problem in a person's lifetime. An example of this is prostate cancer screening; it has been said that "more men die with prostate cancer than of it". Autopsy studies have shown that between 14 and 77% of elderly men who have died of other causes are found to have had prostate cancer.[
Aside from issues with unnecessary treatment (prostate cancer treatment is by no means without risk), overdiagnosis makes a study look good at picking up abnormalities, even though they are sometimes harmless.
Overdiagnosis occurs when all of these people with harmless abnormalities are counted as "lives saved" by the screening, rather than as "healthy people needlessly harmed by overdiagnosis". So it might lead to a endless cycle: the greater the overdiagnosis, the more people will think screening is more effective than it is, which can reinforce people to do more screening tests, leading to even more overdiagnosis.”
I'm assuming here a growing cancer is easier to detect over time.
It seems such a scan causing a cancer would be due to a very low probability event on a cellular level. From that point of view the above calculation looks reasonable. It is only after that when the additional macroscopic influences caused by a specific person's body/environment come into play that your point applies.
This was interesting so I started from that 0.05 % per 1 rem and did the inverse calculation. For 2500 rem this gives about 1-(1-0.0005)^2500 = 71 % probability of developing cancer. I also made a plot from 0 up to 10000 REM[2]. The incident rate seems to be pretty much approaching 100 % around 10k, so our results differ by about a factor of 4.
[1]https://en.m.wikipedia.org/wiki/Roentgen_equivalent_man#cite...
[2]https://www.wolframalpha.com/input/?i=1+-+(1+-+0.0005)%5Ex+f...
EDIT: The initially mentioned 2500 rem figure must be over a long enough time for the exposure not to cause more immediate issues than cancer.
I should have said linear hypothesis. I’m going off what learned in a online physics lecture on radiation effects. Right at the beginning of this:
2500 people at 1 rem each yields one cancer.
250 people at 10 rem, again 1 cancer
25 at 100 rem, again 1 cancer, but they now have ARS (acute radiation sickness). This is interesting since one would think ARS would definitely cause cancer, but it’s only 1/25, whereas 1/3 of people will develop cancer.
8.3 people at 300 rem, which is the 50% threshold for death from ARS, but still 1 cancer.
I’d think 2500 CT scans/year is a typical number for a hospital. Can they be sued for causing that single incidence of cancer?
The default answer is that the extra scanning will increase risk to you, which really isn't true if you compare that radiation to other forms of radiation you get throughout the day. 10 millisieverts is nothing. [1] You can compensate for this easily by increasing your bodies own cell autophagy.
In the mean time, you should research anti-cancer foods and foods that cause cancer and increase cell autophagy. Preventative natural medicine has many benefits beyond just preventing and treating cancer cells. Obvious foods to stay away from are anything with sugar (and all its forms, there are many) and glyphosates (good luck with that, everything is sprayed with them). Cance cells live off glycogen and oxygen.
Anti-cancer foods include aged garlic extract, bioavailable enhanced curcumin, all the cruciferous vegetables, sulforaphane extract from broccoli sprouts, fatty fish, apples, beans, to name a few. For those with metabolic syndrome which increases risk of cancer, there is Berberine which is anti-tumor (natural alternative to the prescription metformin)
I am not a doctor. This is unpopular nutritional advice for naturally reducing all cause mortality.
[1] - https://www.fda.gov/radiation-emitting-products/medical-x-ra...
Also note that image based screening has a resolution of around 5-10mm (CT and MRI closer to 5mm, nuclear medicine closer to 10mm). Once a cancer is this size, we are already talking about over 100 million cancer cells in your body. You will need surgery, and possibly chemotherapy and radiotherapy to eliminate these cells once it gets to that size.
What you actually want is prevention, not early detection.
Source: I used to work in the Heidelberg lab that published this study.