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Comment by dannykwells | Hacker News Reader

This article is absolute 100% bullshit.

-Metastatic melanoma: used to be lethal, now 50% cure rate.[1]

-Non small cell lung cancer: same, now around 25% [2, 4]

-Breast cancer used to have a terrible prognisis, now 75% survive. [3]

-Not to mention the myriad of blood cancers with new, strong, cell therapy treatment options with 40-50% durable cure rate.

I don't know this person, but seriously, whoever he is, fuck you dude. Millions of us work day and night trying to improve care, and 99% of us arent getting rich.

[1] https://www.nejm.org/doi/full/10.1056/NEJMoa1709684

[2] https://www.nejm.org/doi/full/10.1056/NEJMoa1801946

[3] https://www.breastcancer.org/research-news/20100930

4. https://investors.merck.com/news/press-release-details/2019/...

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He also wrote an article called the "Death of the Proof" that was widely rejected by mathematicians and was also mostly hog wash.

He seems like a guy who likes to make edgy but wrong statements.

https://blogs.scientificamerican.com/cross-check/the-horgan-...

This is far from the first time, so let me state this more explicitly: John Horgan is a provocateur with no knowledge of any field, whose only claim to fame is that he is so breathtakingly and publicly wrong that he gets people with real expertise to engage with him. Then he disingenuously frames the result as a real intellectual controversy with him at its center.

He is one of the top reasons I don’t take anything from Scientific American seriously anymore, and a great example of how the incentive structures in science popularization ruin it. I find that I can tell how savvy an online community is by how much it likes his work.

> Mathematicians named a mathematical object after me. It’s called the Horgan surface, or, alternatively, Horgan non-surface. The term was intended as an insult, but I’m honored anyway.

Neatly summarizes this guy’s motivation for writing provocative bullshit. To him, infamous == famous.

> He is one of the top reasons I don’t take anything from Scientific American seriously anymore

Some people have started calling it "Two Lies, One Title".

It's turned into the BuzzFeed of science journalism.

I knew I kinda knew that name! Good reference, thank you!

> Breast cancer used to have a terrible prognisis, now 95% survive.

5 year survival rates may just mean we're now scanning a huge population and spotting many cancers much earlier. What's happened to the all-cause mortality rate for breast cancer patients? Has that all that scanning and treatment increased length of life?

I really thought I'd read (summaries of) careful statistical analyses that say this is why the medical community thought "early detection saves lives".

100% willing to be corrected by the many more knowledgable commentators, but this is an important question, even if the parent phrased it as just speculation.

Some parts of the medical community say "early detection saves lives" because they make their money from all the scanning and treatment.

https://www.harding-center.mpg.de/en/fact-boxes/early-detect...

Icon boxes can present the information in different ways: https://www.econlib.org/archives/2015/08/is_prostate_scr.htm...

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

> We found that breast cancer mortality was an unreliable outcome that was biased in favour of screening, mainly because of differential misclassification of cause of death. The trials with adequate randomisation did not find an effect of screening on total cancer mortality, including breast cancer, after 10 years (RR 1.02, 95% CI 0.95 to 1.10) or on all‐cause mortality after 13 years (RR 0.99, 95% CI 0.95 to 1.03).

> Total numbers of lumpectomies and mastectomies were significantly larger in the screened groups (RR 1.31, 95% CI 1.22 to 1.42), as were number of mastectomies (RR 1.20, 95% CI 1.08 to 1.32). The use of radiotherapy was similarly increased whereas there was no difference in the use of chemotherapy (data available in only two trials).

Screening often doesn't affect all cause mortality, but if you're screened you're significantly more likely to have treatment with all the risks and side effects that entails.

There are some screening programmes that work though. Cervical screening is important and does save life.

Thank you for writing a more concise version of what I tried to write below.

You made some very good arguments with solid information here. So much so that I flagged this article. Doesn’t seem what HN should spend its time refuting.

I flagged it as well an hour ago, I don't know why it's still up, probably the mods are not looking at HN right now.

Thanks!

Please provide sources so we can see where these numbers are coming from.

I'm out w my newborn but will do when I get back.

Ok, mostly there. Will try to find more.

Thanks, do you have one for melanoma in mind for comparison to that study when you say "used to be lethal".

If I'm reading this right it looks like 3 yr survival was 30-50% in high risk melanoma patients in the late 1960s to early 1970s: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1344342/

That is pretty much the same as in your paper. Not sure how comparable those patients are though.

You make no direct connections with the article, open with an absolute statement "100% bullshit" which can almost never be justified, and shortly describe yourself cursing at the author.

The links you added do not amount any sort of representative sample or review of the cancer treatments concerned. Of relevance to your own small selection of improved treatments (some of them decades old) the Oncologist interviewed in the article states:

> Trials have yielded improved treatments for childhood cancers and specific cancers of the blood, bone-marrow and lymph systems, Raza notes. But these successes, which involve uncommon cancers, are exceptions among a “litany of failures.”

Your comment is an exceedingly emotional and basic attack towards the articles subject and none of its content.

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