The road to the clinic is long, but there have been very big improvements.
They recently found some types of rectal cancer to be PD-1 sensitive.
The other thing is that cancers are not created equal, not all treatments are evolving quickly. Your loved one may be suffering, and that’s your world.
I will say that I lost my beautiful wife a little over a year ago. She had an aggressive cancer, for which the 10-year survival rate was zero. Thanks to the miracle of immunotherapy, the five year survival rate is about 65%. At the same time, my 78 year old aunt successfully fought lung cancer that was a death sentence 20 years ago.
I think it’s important to share for a variety of reasons but most importantly to add some humanity to a topic that gets turned into technocrat babble.
We have a drug now that you can take so you won’t catch HIV, as well as another drug for HIV+ that keeps it at bay.
We haven’t found a cure-all. Rather, now we have a lot more treatment options nowadays depending on your specific cancer or illness.
If your comment was more talking about the Stone Age or something, I apologize for misinterpreting :)
E.g. from Wikipedia, female life expectancy from age 15 in Britain in the 1400-1500s century was 33 years (so reaching 48 years of age).
I don't suffer from delusions that we have accurate data on conditions like obesity and T2D going back to the middle ages, but we have seen incidence rates of these kinds of disease explode upwards over the last century.
I'd be interested in more detailed data broken down by disease over time.
That's not true. It's improving steadily: https://progressreport.cancer.gov/after/survival , and with the newer advances it's going to become even better.
Yes, it's not like an exponential Moore's law graph, but there is a steady drumbeat of incremental steps. And they keep reinforcing each other.
Edit: some of the replies below are pretty bleak “it’s just a few months that’s nothing”. The difference between a 5 year and 15 year life expectancy for a parent being diagnosed with blood cancer around 60 is huge.
60+5 => 65, maybe dying before you even retire from your job.
Seems significant.
This could be because the researchers need funding so they will hype the results as much as possible.
Then the articles need as much readership so the journalists hype the results as much as possible.
Then the people suffering from the disease want as much help as possible so they push the articles/papers to the doctors.
On the other hand, it's been my experience that GLP-1 agonsists weren't overhyped, I was completely surprised when my doctor prescribed Mounjaro for weight loss. Even after decades of articles about "NEW WEIGHT LOSS TREATMENT!" (See also phen-phen)
But for many cancers and other diseases not only has early detection gotten better but so has treatment and prognosis. Treatment isn't nearly as bad to go through and long term survival rates are higher. People can live longer with cancer while still being fully functioning.
Life is a precious and personal thing. Those years mean wishes fulfilled, graduations and weddings celebrated, life lived.
Robust biomarker discovery in toilets would let us take care of most of the other 5%.
That's the main obvious humanitarian purpose of our project www.molecularReality.com
> TIL that scientists at Stanford University have developed a smart toilet that reads your anus like a fingerprint and monitors the health of your poop and pee. The lead researcher said, "We know it seems weird, but as it turns out, your anal print is unique."
https://old.reddit.com/over18?dest=https%3A%2F%2Fold.reddit....
A good example is lipid nanoparticles, which for the first 15 years or more of their existence were horrifically lethal in every hominid, making their potential for delivering transformative genetic or immune cargo into cells impossible. Finally, PEGylation was introduced into their formulation, bypassing the toxic effect they had in precipitating out nearly all of each animal's platelets upon treatment. Within just a few years, LNPs became a very effective way to deliver MRNA vaccines to BILLIONS of human patients, effectively ending the worst of the Covid pandemic.
Medical revolutions are like evolutionary punctuated equilibrium -- barriers to advancement are overcome nonuniformly and often incompletely, requiring a lot of continued effort even after a revolution begins. So it shouldn't be surprising that more battles are won than wars. We should celebrate whatever victories we can. Cancer promises to be a war to end all wars.
We don't have a silver bullet because these diseases are so incredibly complicated. "Cancer" is a particular type of disease behavior, but is essentially a broad class of failure states across different types of cells and tissues, with different genetic, metabolic, biochemical, and molecular dysfunctions.
There is a lot of overhype in the news. When they claim that a new 80% improvement in batteries we all know it's a joke a laugh. When there is a similar exaggeration in cancer cures we get sad.
The saddest part is that the overhype shadows all the small/local improvements. They are better explained in sibling comments. Medicine is not my area so they give better examples than what I can choose.
When I read a new about my area or something close enough, it's fun to try to guess what was the original new before it was badly rewrote by the press and how interesting it is. But when there are lives related to the new, it's not fun to read post with unrealistic promises.
So we never seem to get a dramatic breakthrough, but what we do get is steady improvement over the course of decades. And that's why we have electric cars now with ranges over 400 miles, while back in 1996 the EV1 had 70 to 100 miles.
I think cancer treatments are pretty much the same.
F*ck. Progress does exist - life has got enormously better but people reuse to see it and focus their entire lives on living the same day over and over and wonder why they are unhappy.
The problem is that most of the 80% advance in your batteries are small 2-3% advances that never got a huge press cover. The 80% improvement press announcement are the unrealistic ones.
PS: My favorite weird quantum anecdote that nobody know and everyone uses was Giant Magnetoresistance. Have you ever read about it? Do you have a device that uses it at your home? Is it weird to have two currents instead of one? https://en.wikipedia.org/wiki/Giant_magnetoresistance But now the SSD ruined the anecdote :( .
When my brother was diagnosed with MS ~30 years later, it was a nothing burger. He gets an infusion monthly and suffers no significant impact on his quality of life.
Thank you for that comment.
There is virtually no new treatment for Alzheimer for 20 years and no progress in understanding its mechanism either.
What is your basis for this claim?
... I mean I think you are possibly not just paying attention. All sorts of things that were absolute death sentences within recent memory are now very treatable. News articles tend to overhype, of course, but cancer treatment now is a different world to a few decades ago.
So usually when people talk about new cancer drugs it meant that great scientists will make billions wasting their lives barely improving the quality of life for some terminally ill cancer patients and it's just kind of sad, honestly.
You don’t get to decide how long the road is to a complete solution. Just whether it will be worth it incrementally and in the end.
You don’t propose any constructive alternative.
Life, even just extending life of millions of people a bit, survival rates just a bit, is worth a lot.
https://www.science.org/content/article/new-alzheimer-s-drug...
There's not a shortage of debate on whether they are effective, ought to have gotten any approval, or if beta amyloid buildup is even a cause or contributor to Alzheimer's disease, so whether we've actually made progress remains debatable for the short term until results on these drugs are in.
You’re both saying two different things.
Some drug company or group of investors must think it's potentially profitable to develop into a real treatment.
Then they have to move up the trials ladder, from mice to humans and the steps in-between.
Then they have to get regulatory approval.
Finally, assuming the steps prior didn't fail horribly, they need to set up the manufacturing for the drug.
All the meanwhile handing off money to a bunch of people who, more likely than not, never worked for the company in the form of earnings-per-share.
So, yeah, a couple decades.
that has always been the case. you go for a minor surgery, you sign a waiver. you go to a doctor, they are supposed to give reasonable care. No one can guarantee success. the same with lawyers or drivers or mechanics or technicians. basically anytime you go to someone for assistance, they can't guarantee anything. the person is themselves always responsible for everything.
[1] https://www.unmc.edu/healthsecurity/transmission/2023/03/14/...
[2] https://en.wikipedia.org/wiki/List_of_unproven_and_disproven...
[3] https://www.un.org/africarenewal/magazine/february-2023/fake...
Most of that advancement stopped with the introduction of the FDA and its equivalents in other countries.
The story of efficacy trials falls apart when you consider the complex reality of the human body and pharmaceutical action. There are many medical procedures and drugs which we know work on certain patients some of the time, but we are prevented from giving to new patients because the high standards of Phase III efficacy haven’t been met.
If something has efficacy, then trials will eventually prove it, it’s just a matter of time. You just made a case that the process works. If efficacy can’t be shown, then it’s very risky for people to try the treatment, riskier than using something with known outcomes, and potentially riskier than doing nothing at all.
Either way this is all irrelevant to your bogus claim at the top that the FDA has anything to do with the perception that treatments aren’t improving. The top comment’s hypothesis is incorrect, which adds to the multiple reasons your proposed explanation is wrong.
It is true that regulating drugs and having an approval process causes new drugs to take time, causes some to be rejected, and that people who could use them don’t get them until approved. It is true that some people could die waiting for drugs to be approved that will be shown effective. I lost a friend this year to a cancer that had an experimental treatment that he wasn’t eligible for, and it’s incredibly frustrating. Yet this has been thoroughly debated for hundreds of years, and what we have is a system that is fairly effective at minimizing harm and maximizing effectiveness given the science we have at hand.
Your argument so far has completely ignored:
- The FDA’s Investigational Drug program.
- The Right To Try Act, and all the preceding debate and legislation.
- The fact that most new drugs developed are not effective and some have very serious consequences.
- The fact that unscrupulous actors exist, and there are widespread and serious problem with fake medicines. You have nothing to say about the data I linked to on the distribution of fake drugs currently killing children by the hundreds of thousands???
If you can’t even acknowledge the basis on which the FDA was founded (regulating drugs was made a requirement by Congress) or the fact that they are balancing competing public health benefits, then your argument will get nowhere and is not being made in good faith. If you want to demonstrate why drugs should be unregulated and why we should suffer the harm that would cause, or make the case for relaxing the regulations more than the New Investgational Drug program allows and spell out how it would lead to more benefit than harm, I’m all ears!
You might not be considering the possibility that relaxing drug testing and regulations could backfire and make it harder for effective drugs to reach the market. Maybe it’s worth researching the history of this debate a bit more?
“The Right to Try Act was ‘unnecessary in the first place’, according to Kearns. Terminally or seriously ill patients have had the ability to access investigational drugs via the FDA Expanded Access (EA) pathway for decades.”
“most people overestimate the odds researchers will determine an experimental drug is safe and effective”
“if an adverse event occurs in a patient who took the drug outside a clinical trial, it could lead to negative repercussions for eventual drug availability. […] Right to try also could divert patients away from participating in clinical trials.“
And to answer your question, your first sentence made the case. All currently approved drugs represent previously unapproved treatments. The FDA is approving 100-200 drugs per year, and processing around 2000 investigational drugs per year. No idea what you mean when you claim progress has stopped, that comment doesn’t reflect reality. https://www.fda.gov/about-fda/histories-fda-regulated-produc...
if you sign up for dental extraction and you die, didn't you do that on your own risk? or is the doctor responsible in this case? that he/she didn't do their job properly and now they must pay but if the doctor says "on your own risk", that suddenly they are redeemed?
Fake and/or investigational drugs carry an additional and independent risk of unknown efficacy and unknown potential harms. That additional risk layers on top of the first kind of risk of known complications. Drugs with no proven efficacy can carry additional financial risks too.
This is all why we have drug regulations - to hopefully understand the risks, minimize chances of severe harm and/or death, give consumers informed choice and allow them to assess the risk and weigh the risks against the known benefits. Unregulated drugs carry unknown benefits, and unknown & potentially very high levels of risk that patients have no hope of knowing or evaluating rationally, and that is what the comment you replied to is referring to.
Risk isn’t binary like your first comment implied. We don’t just have risk or no risk, we have risks that are known and risks that are unknown, and we have risks with different levels of harm vs benefit, and we have risks with varying levels of likelihood. In medicine it’s important for the risks to be known, for the harm levels to be low, and for the likelihood to be low. That doesn’t always happen, but if harm is likely or high then it’s important for the benefits to be high (to outweight the risks) and its important for anyone accepting the risk to have informed consent.
I didn’t realize the USA was the only Economy of Scale
What we call a 'health' industry is a misnomer - it is a sickness industry, like the ministry of defence is really the ministry of attack.
If you want to really get cynical, you can consider the possibility that a lot of treatments are not only unnecessary, but actively detrimental to the person receiving the "treatment". The person in future may develop diseases that will then open further revenue streams from what would otherwise be a healthy individual. This would assure a healthy pipeline of future revenue for the pharmaceutical companies.
Luckily we have government agencies to manage the pharmaceutical products we are given. Unfortunately, it is something of an open door policy as senior government staff are then given senior positions in pharmaceutical companies.
I'm sure it all works out in the end!
Of course there is. Cures make billions.
This might be a conspiracy theory stupider than flat Eartherism. It requires not only every Western pharmaceutical company’s collaboration, but also every one in every other country, and also all the public labs, and every world leader and their families to suck it up for the conspiracy’s sake.
https://m.youtube.com/watch?v=2m-u4cr3fJ0
Most people act against their conscience pretty much every day for money, more so in senior positions. That money is a great motivator is not really a conspiracy.
> Most people act against their conscience pretty much every day for money, more so in senior positions
This isn't about conscience, it's about greed. Cures are great business. Also, again, rich people get cancer. If you want to come up with healthcare conspiracies, don't pick a disease the rich and powerful get.
Which option is selected in a capitalist society?