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Comment by CuriouslyC | Hacker News Reader

True, but we're getting a lot better at treating cancer, so I suspect that it is going to end up that we try to target it semi-selectively for life extension with the knowledge that it may cause cancer, then try to treat any cancers that emerge.

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> we're getting a lot better at treating cancer,

Is this really true? I know we are getting better in diagnosing cancers, so the time from initial diagnosis to death is longer, but it's not clear that overall lifespan of people with all cancers is any longer. If anything, because treatment starts sooner, quality of life may have diminshed.

It is definitely true that treatments for some cancers have improved over the last couple of decades. I find the immunotherapies particularly exciting and seemingly promising.

But in the broader cases I am not sure I could agree with your statement.

Early detection when treatment is easier is better treatment.

They asked “are we decreasing the slope of this graph” and you replied by pointing to the graph and saying “if you choose a lower value of x, you get a lower value of y”.

That’s good news, but that’s not what they asked.

But early treatment does lead to better longterm outcomes for a whole bunch of cancers, so I take issue with your facile reply.

A mole removal with local anesthetic by your local dermatologist will almost always lead to better outcomes than two rounds of surgery, chemo, and radiation to treat stage 4 metastatic melanoma.

Yes, of course! As I said, that’s good news.

Remission rates are higher the earlier you catch it

Yes, having just gone through this i was surprised to find that cancer of almost all kinds is rapidly becoming more manageable. Prognosis is quite good for most people and most cancers when caught early enough.

It is still an artform though and procedures that lead to a long healthy life in a majority of patients still cause deaths in some others.

Progress in treatment isn't uniform across all cancers, but yes we are getting a lot better at it.

Hope you are doing well, and wishing you the very best.

Your comment answers itself. There is no such thing as "cancer, singular". It's a catch-all term for a wide range of conditions relating to uncontrolled tissue growth.

We have gotten a lot better at treating cancer, in general, literally because we've gotten a lot better at treating specific types of cancer. There are no "broader cases", only cases of specific cancers which we've either gotten really good at treating, or which we haven't gotten really good at treating yet.

It is true. Stage 3 used to be a death sentence in early 1990s. It is survivable now for most kinds of cancer.

It is a really fair question, and I do not think it is totally clear cut. There are some cancers which are significantly more treatable than previously, but the numbers are also getting juiced from other directions.

We are detecting cancers earlier than before. Which can mean that, without any change in treatment efficacy, people are "surviving longer" with the disease. Another biggie is that people are smoking significantly less than 20+ years ago (both smokers and secondary exposure). While we are continually finding new ways to slowly poison ourselves (eg PFAS), we have also reduced exposure to other environmental toxins: lead paint/gas, DDT, etc,

You'd need a particularly good (and cheap!) screening method to catch them before they become fatal.

Digestive tract cancers in particular are often confused by patients with other, benign issues and are therefore diagnosed too late.

https://grail.com/ seems like the path we're on for that sort of screening (blood borne cancer biomarker surveillance)? AP-1 tweaks + mRNA and immunotherapy protocols for detected cancer + continued cancer screening developments might be a material longevity improvement. Typically, you're trying to die before any cancer gets you long term, so the need is to continually improve cancer detection and treatment.

https://www.cancer.gov/about-cancer/treatment/types/biomarke...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9074993/

Cancer treatment is still objectively primitive, unless you catch it early it still mostly boils down to balancing keeping you barely alive and hoping the cancer dies first.

Cancer survival rate has gone up because of treatment accessibility and testing, not because of any major breakthroughs.

We're still terrible at treating cancer though. And the treatments very likely cause other health issues that can actually reduce life expectancy.

We've massively improved in cancer treatment in just the past 20 years alone. Every year we get more and more precise with our ability to both map and target tumors, which in turn means less damage to the body as a whole during treatment and better odds of tumor elimination. This goes for both chemo and radiation.

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