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Comment by s1artibartfast | Hacker News Reader

>The reality is closer to no life extension, with the remaining lifespan is spent sicker than you'd have been without the drugs.

I dont think that is true at all. The data is pretty clear that lifespan is significantly increasing.

>Over time, the mean overall survival has improved from two months in 1973 to five months in 2015. Regarding long-term survival, a clear rise in 2yS is noted, increasing from 2.6% in 1973 to 12.9% in 2013 (latest year of which 2yS data can be calculated; Figure 1 and Tables 1 and 2), occurring mostly after the mid-1990s. A more modest increase is seen in the 5yS, from 0.7% in 1973 to 3.2% in 2010.

>https://www.researchgate.net/publication/348455938_Long-Term...

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I'm sorry, but two months to five months after 50 years and hundreds of billions of dollars. That was hardly the promise of the "war on cancer"!

To be fair, there are other cancers that are essentially cured. Lung cancer is a particularly nasty one for a number of reasons. It's hard to fight with the laws of physics or biology, so I'm curious who promised you something else.

In general though, I tend to agree that in the US we spend far too much on what essentially boils down to performative end of Life Care. If you ask someone if they would rather spend $200k for 2 months or leave it to their family, I think most people would pick the second option. When someone else is paying, they choose the first option.

"This year marks the 50th anniversary of the “War on Cancer” declared by Richard Nixon, a former President of the United States of America. By signing into law the National Cancer Act on December 23, 1971, Nixon hoped this action to be the landmark legislation taken by his administration. Nixon apparently had confidence that cancer would be conquered in 5 years."

You're right, there are a small handful of unusual cancers that we have cures for, and that's great. And some small progress has been made overall. But a lot of money has been spent, and it has been half a century or more, and we don't have much to show for our efforts.

> we don't have much to show for our efforts

This is mind-bogglingly wrong for most cancers. Several death sentences have been turned into treatable diseases.

Nixon hyped up some legislation 53 years ago, few believed the hype, and the hype was clear to the rest very shortly thereafter.

You are right that progress is slow and expensive in a lot of areas.

It seems you are frustrated or angry about it. What do you want people to do? Are we not spending enough on research? Are we spending too much?

> You're right, there are a small handful of unusual cancers that we have cures for, and that's great. And some small progress has been made overall. But a lot of money has been spent, and it has been half a century or more, and we don't have much to show for our efforts.

Yes, it would be better if we had more complete treatments but it’s far from nothing. I have a friend who was given 6 months to live a couple decades ago, right before a treatment for his not especially rare cancer was approved. He didn’t expect to see his daughter leave elementary school but is still around for her post college career – and as a scientist himself is keenly aware of how much hard work made that possible. We can simultaneously acknowledge that progress has been made but cancer is one of the hardest problems humanity has tackled.

You are, again, failing to note that it’s a right skewed distribution. The mean is not what you care about.

In fairness, I was responding to the first sentence in the quote from the article.

It seems relevant, as a patient to ask, on average, how much longer will I live if I take this drug?

To which, an average is a pretty poor way to convey non-normal data.

If you run a year long trial where you flip a coin and immediately kill or save people based on the results, your average survival will be 6 months

To be fair, the Improvement for the tail is pretty Grim too. We have 'only' seen 5 year survival improve from 0.7% in 1973 to 3.2% in 2010.

I think the skewed distribution is less relevant than the sample group. There are limits to what we can expect from medicine. We don't have improved survival after decapitation, but that doesn't mean surgery has been at a standstill.

It would be interesting to look up survival rates for earlier stages. I expect the difference would be more substantial.

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