U.S. cancer death rate drops by largest annual margin ever, report says
statnews.com
statnews.com
Here are some of the most widely cited studies of pembro in lung cancer that illustrate its clinical benefit:
Open label pembro vs chemo in first line non small cell lung cancer: https://www.nejm.org/doi/full/10.1056/NEJMoa1606774
Development of PD-L1 biomarkers in 495 patient phase 1 study: https://www.nejm.org/doi/full/10.1056/nejmoa1501824
Pembro + chemo in lung cancer: https://www.nejm.org/doi/full/10.1056/NEJMoa1801005
Pembro + docetaxel for previously treated lung cancer: https://mdanderson.elsevierpure.com/en/publications/pembroli...
This category has been incredibly successful against a wide variety of debilitating illnesses like autoimmune, cancer etc. My doctor told me that surgery for arthritis is a dying specialisation in medicine, because the new drugs like infliximab are so effective.
The discovery of how to produce them got the Nobel Prize in Medicine in 1984, and the more recent discovery of how to tailor them via directed evolution got the Nobel Prize in Chemistry in 2018.
Source: my SO the MD.
I'd say the bigger issue is filtering out the bad-greedy actors who jump into this space, who are piggybacking on the excitement generated from of word of mouth from patients who have benefit greatly - from clinics who have protocols they follow for what they know works and what won't work.
I have been getting stem cell treatments from a clinic in the US for a few years now to treat many different areas of injury (limited number of areas they can treat due to limited amount of fluid they have to use after aspiration and post-processing) and from my own experience, and that of speaking with other patients in waiting rooms (and even hotel lobby) who have returned for additional treatments - it certainly works, heals, regenerates tissues with the right protocol and condition. The most painful injection spot I had was a ruptured, torn disk, in my low back - I am doing that area again on the 16th of this month, as part of a number of areas, because it helped permanently reduce radiating pain from that area greatly; I plan to do an MRI of area a few months after this next treatment to have post imaging.
I use strength training now to keep my shoulder in check.
I couldn’t make sense of the Wikipedia article.
So it's a blip but an encouraging blip. At the same time, the headline makes this sound much more extreme and excite.
For coal mine workers, stopping further damage to their lungs may reduce the chance of tumors developing in those damaged areas.
That might show up as an increase in the number of living people with these conditions.
https://www.npr.org/2020/01/08/794772148/alcohol-related-dea...
https://www.reuters.com/article/us-health-tobacco/who-says-e...
However that doesn't answer the question whether they're an improvement. For that you need to look at what people who use e-cigs would do otherwise. And then it gets really complicated, because you really don't know and can only make estimates. That's why this is a question difficult to answer.
On the face of it this seems unrelated to lung cancer rates, but there's concern in the public health community that some percentage of these users will graduate to smoking tobacco over time.
I don't think we really know whether those concerns will be borne out, or whether they'll counteract adults switching in time to save themselves.
I guess a cigarette is smaller and easier to use where there’s no electricity source?
I guess a small percentage might migrate, though, as always happens with anything where you _can_ migrate.
A small percentage would try regular cigarettes in the first place too. It will be interesting to see if small subgroup of bigger, new subgroup is larger than historical subgroup.
To claim this is only driven by treatment innovation and not public policy changes is wildly misleading.
This stat is effectively meaningless without accounting for the rate of the US pop that develops lung cancer in the first place. If you want to measure treatment effectiveness, then the right measurement is something like '% of US population that develops lung cancer who are effectively treated/cured' and not 'overall cancer death rate'.
The fact this headline is so broad when it's really about lung cancer and not all cancers and doesn't account for any factors outside of 'treatment innovation' leads me to believe this was pushed by some healthcare trade group.
The cost for treatment [1] may have some considering alternate options for screenings and treatment after seeing someone elses experience/ordeal beforehand or reading about first-hand accounts online.
[1] https://www.aarp.org/money/credit-loans-debt/info-2018/the-h...
When I started Med school 19 years ago the average survival of metastatic melanoma was 6 months, it is now closer to 5 years (ie basically remission). Many other cancers (including lung, which this article pinpoints as being the main driver in falls over the last 12 months) are now benefiting from the second and third generation of these drugs
First realize that these statistics are calculated via an entire field, known as “medical statistics” not surprisingly, that has enormous controversies inside of it.
Using a variety of mathematical calculations and formulas, they arrive at something called the “average death rate” that is supposed to massage out the differences between geographic regions and populations to determine the final number.
Devra Davis, Ph.D., M.P.H., wrote about this to tragic degree of detail in her book “The Secret History of the War on Cancer”. For background she was Director of the Center for Oncology at the University of Pittsburgh Cancer Institute and is still also a Professor of Epidemiology there.
The cancer death rate has not budged that much in 40 years. Survivability has extended, absolutely, and that is worth something, but not more than a few years. Compared to AIDS, a disease also without a real cure but that has extended survivability by decades this is unacceptable.
The amount of brilliant researchers driven out of the field, the failure of the Susan G Komen foundation to invest in actual research (this can be seen as more of a problem with the nonprofit industrial complex though and not per se cancer research), the null hypothesis requirement failures at NIH, and just the general climate of unethicalness and neoliberalism that began emerging in the mid 1970’s are all blamed, and there is truth in most of those arguments.
There is an old joke about how many white upper middle class cancer patients does it take to screw in a light bulb? Two, one to do it, and the other to write a book about it.
I go back and forth about whether that joke is inappropriate, and Mark Nepo is one such person who falls into that category but has written moving essays about the experience, but every time I read Barbara Ehrenreich’s “Cancerland” it makes me incredibly bitter. And I say that as a person who really likes Tony Robbins for the most part but who still is disgusted by the whole forced optimism cure through hope that the entire industry has turned into in lieu of actual breakthrough achievements. The fact that the latest and even somewhat exciting area of research in cancer treatment is the investigation on the role and use of viruses, a soviet innovation that has been investigated by the Russians since Stalin was alive even though they were mercilessly mocked for decades for this, is just tragic.
Ignoring the fact that cancer is a much harder problem than HIV, extending survivability is how the cancer death rate changes. Everyone who doesn't die by other causes would eventually get cancer because DNA replication can only happen so many times before accumulated replication errors trigger it. In a sense, curing HIV means more people will die of cancer (other things equal).
Also, cancer is not one thing. You have a particular type (like NSCLC), but also your particular genetic mutations may be unique or nearly so, affecting different combinations of oncogenes and tumor suppressors in different ways. This makes it extremely difficult to treat. Even broadly useful approaches like cancer immunology work better for some than others.
> There is an old joke about how many white upper middle class cancer patients does it take to screw in a light bulb? Two, one to do it, and the other to write a book about it. I go back and forth about whether that joke is inappropriate,...
IDK about inappropriate, but maybe find an outlet for your anger other than cancer patients?
That's a pretty high horse you're on there. Parent wrote an honest and thoughtful comment, and you wrote a thoughtful response until that last dig.
It seems unlikely that there are an infinite number of great treatments waiting to be discovered. Most likely we are asymptotically approaching some non-zero minimum death rate. (note that the function is not linear, and we just saw one interesting step)
https://www.npr.org/2020/01/08/794772148/alcohol-related-dea...
I'd also like to mention, that these are deaths limited to cancer. Death is attributed to something else this stat will be affected. This is, in theory, you can "survive" cancer but die from something related to that condition and it won't count as a cancer death.
I'd liken it, somewhat, to war. Yes, less soldies are dying. But survival comes at a cost. No arms. No legs. Mental and emotional wounds. Etc.
I'm not knocking the progress with cancer; only providing some necessary context that's often missing.
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The point is, beating up data is easy. Be mindful of what you might be looking at, especially if the outcomes are good for an industy's well-being.
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