Breakthrough in understanding how cancer spreads could lead to better treatments | Hacker News Reader

Breakthrough in understanding how cancer spreads could lead to better treatments

cam.ac.uk

82 pointselorant16 comments

It's difficult not to get cynical about such articles when cancer breakthroughs seem to emerge every other week. Quick Google search reveals that age-corrected cancer death rates have reduced 15% from 1990s. (https://ourworldindata.org/cancer) Given the number of supposed breakthroughs between then & now, and the general advancements in medical technology (incl. imaging), that's not a lot.

EDIT: Typo

age-corrected cancer survival rates have reduced 15% from 1990s.

Death rates have reduced, not survival rates

Correct, edited.

Yep, lots of words in these articles like: “could”, “eventually”, “if”, “possibly”. It’s honestly tiring to see these posted on social media. Show me the money or get lost.

Why is that "not a lot"? What would be "a lot"?

Let's assume there were 150 "cancer treatment breakthrough" stories in that time (about "every other month"). Then it is a reasonable guess that any "cancer treatment breakthrough" improves survival rate by 0.1 percent points, far below the effect size that could be reliably demonstrated in an academic study. Which is great, but not what the layman reader would take from such a headline.

"Breakthrough" implies "you have to update your mental model" - but no layman has to think differently about cancer treatment after reading this story.

You are quite right to be cynical about academics talking their own book and institutional press releases.

There have definitely been breakthroughs that cure people with advanced disease who would be dead otherwise. Anti-PD1 therapy in melanoma is the best example. One step down from there the median survival of seveal advanced cancers has improved dramatically (eg HER2+ breast cancer and prostate cancer).

Still a long way to go, but within the field the progress is considered quite remarkable. And the pipeline has by no means dried up, in the last few years there have still been big advances with radioligands and antibody drug conjugates.

Yes, it's very dull to hear repeatedly about breakthrough upon breakthrough, only for nothing to materialise.

Why is there this brick wall here, surely we could do something to improve understanding and health?

Well, imo, of course there is something to do, but not if you are holding to entirely the wrong paradigm(s).

First bad paradigm - that the medical industry is there to help. It's not. It makes money from disease. Lots of disease mean more profits! A protracted illness is great news, diabetes, cancer are a blessing (for profits).

If you can accept that the medical industry is not there to help, and that perhaps it even helps cause illness to ensure a good pipeline for the future, you can then consider what a better paradigm might be.

Second bad paradigm, imo, is that cancer is a disease. Instead of that, perhaps cancer is an inevitable effect of a toxic system, perhaps its your body's way of isolating dangerous elements until it is healthy enough to address them. (German new medicine would be something to look into, if this aligns.)

Anyway, if you are always treating the symptom as if it is the disease, it shouldn't be a surprise that the effectiveness of the proposed cures, aren't that great. Is it really possible to inject health, as the medical industry would have you believe? Can a tablet cure you? Or do you need to give your body the space and time to cure itself?

  >  Or do you need to give your body the space and time to cure itself?

what does that imply?

I think it means not taking additional, possibly toxic medicine, perhaps fasting and drinking juices. I think German new medicine would be a good place to look into this further.

Journalism and poor science education are the primary culprits. Medical researchers find and publish results. The journalists sensationalize those results because the headlines sell. People don't understand the path from medical research to medical regimen and the checkpoints involved. Much of the research may be shown to have marginal efficacy in practice, may have side effects that are more harmful than beneficial and so on. The path from the research lab to your oncologist's practice often takes over a decade - if it ever makes it. That's how medical science works.

As others have noted, at least the pipeline isn't drying up. Lots of researchers are investigating many different aspects of cancer treatment and all are moving the needle ever so slowly. Even so, over the past forty years we have moved the needle quite a bit.

You think there is less cancer today than in the past?

That isn't the relevant question. The relevant question is were you to get cancer today what would your prognosis be versus what it would have been forty years ago? Some cancers from forty years ago that were essentially death sentences are successfully treated today with minimal impact to quality of life. Obviously that's not the case for all cancers, but it is for many of the most common cancers - which has been our focus.

My point is year-over-year the progress has been slow and there's always reports of "breakthroughs" in cancer treatment. But if you look at the bigger picture you can see we've made serious strides in cancer treatment.

Many years ago I did IT work for a company who got the patent. They figured out you can biopsy cancer cells. Implant them in generic fish and then monitor what happens in the fish. If the cancer spreads you know it will spread in the human. If it doesn't spread in the fish it doesn't spread in the human.

The big deal, if you know this answer, you can go chemo if it does spread or surgery if it doesn't. Being able to make this informed decision basically lets you treat cancer at extremely high success rates.

They sold the rights to a big insurance company.

Great. I hope that we could cure cancers ASAP. My dad passed away because of lung cancer and i still feel pain about it.

Quote: This suggests that metastasis isn’t an abnormal process limited to cancer as previously thought, but is a normal process used by healthy cells that has been exploited by cancers to migrate to other parts of the body to generate metastases.

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