[HN Gopher] Death rates are declining for many common cancers in...
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Death rates are declining for many common cancers in the U.S.,
report finds
Author : mpweiher
Score : 145 points
Date : 2021-07-08 18:46 UTC (4 hours ago)
(HTM) web link (www.statnews.com)
(TXT) w3m dump (www.statnews.com)
| GhostVII wrote:
| If you are interested in more of the history behind the different
| cancer treatments that we have today, "The Emperor of All
| Maladies: A Biography of Cancer" is a fantastic book about it.
| Probably my favourite book of all time, a lot of parallels with
| the themes in this article about prevention being a huge
| contributor, and how recently we've had some success in very
| targeted cancer drugs.
| devmor wrote:
| I just wish it were the same for pets. We've lost two cats to
| cancer in the past two years. There's so much they can do to
| extend quality of life, but not much in the way of actually
| extending their lives.
| xarope wrote:
| I have a pet-theory (see what I did there...) about pets; they
| remind us to appreciate and keep dear to us, not just pets, but
| the people around us.
| gnulinux wrote:
| This is very heart breaking. I love my cat just like a child,
| he's my everything, and I spend an important part of my day,
| playing with him, taking care of him etc. Seeing him dead would
| absolutely devastate me: but being a 20 something, it's very
| likely this will happen sometime in my lifetime (my cat is 2
| years old)!
| askonomm wrote:
| Cats can live a pretty long time however. My grandmas two
| cats (sisters) lived from when I was 7 years old, to when I
| was 27 years old, and both died just months apart from each
| other. That's pretty good I think.
| nerdponx wrote:
| Sometimes with humans we spend too much effort extending life
| without considering quality of life.
| gopalv wrote:
| There was a giant uptick in personalized treatment for cancer[1]
| that coincided with the end of the Obama era (Biden driving it
| after his son's death, in 2015).
|
| I saw bits of it in my space with large scale analysis of genomic
| testing - particularly things like analyzing old drugs with new
| genomic data (drugs which failed in the past, retesting for the
| combo of the cancer:personal-genome SNPs).
|
| My friend went through a Car-T recently for a lymphoma and
| something like that is near SciFi-tech in discussion when Steve
| Jobs had cancer, but available through the FDA today.
|
| [1] - https://www.cancer.gov/research/key-initiatives/moonshot-
| can...
| gregwebs wrote:
| Does anything in this study confirm that personalized treatment
| or any cancer treatment is moving the needle? The minor
| decrease in overall cancer rate seems to be driven by fewer
| diagnoses rather than increased survival, at least for lung
| cancer, which is the single biggest change. Skin cancer death
| rate is lower and that does coincide with the one major
| technological advancement against cancer that has happened in
| decades: immune checkpoint inhibitors. Immune checkpoint
| inhibitors are not very personalized. In general personalized
| corresponds to a focus on cancer genetics and has had an
| extremely disappointing outcome (helps a few percent of people
| a lot or helps more just a little) compared to what was hoped
| for.
| deregulateMed wrote:
| I don't hate the idea about personalized treatments, however
| this will be the excuse by physicians why they can't be
| replaced by AI and we need to continue the myth of medicine
| being Art and Science.
| f6v wrote:
| CAR-T therapy is absolutely how we imagined the "genetic age"
| would be. However, its applications to liver cancer (as well as
| other solid tumors) are far away from clinics.
|
| Some cancers haven't seen much progress in the last 30 years.
| For example, uveal melanoma is a death sentence, same as 30
| years ago. Liver metastases don't give you any chance.
| war1025 wrote:
| Similarly, glioblastoma (a brain cancer) is still a death
| sentence. My dad died of it a little over 5 years ago,
| lasting about a year and a half from initial diagnosis.
|
| Maybe a year later, John McCain came down with the same
| thing. In a weird way it was comforting to know that all the
| money and power in the world didn't make any difference in
| the outcome.
| opportune wrote:
| A close family member has stage 4 cancer.
|
| Even if the absolute death rates for some cancers are relatively
| unchanged, one of the amazing things I've observed is that
| medical advances have increased the long term survival rates of
| terminal/metastaticized cancers. It's partially due to the
| development of various drugs that have been identified as
| effective against various specific mutations. Even if the cancer
| is incurable with existing technology, they can extend lives by
| years, which is nothing to sneeze at. Especially considering many
| people get diagnosed with cancer once they are elderly already,
| it can mean the difference between dying directly of cancer and
| living long enough to die of something else - ie the cancer
| becomes something more like a chronic condition than it does a
| direct threat (for a period of time).
| paulpauper wrote:
| for a 40 year old diagnosed with stage 4 cancer ,a few extra
| years ain't much
| xarope wrote:
| if you measure in terms of percentage, sure. But not
| everything is statistical... considering that this 40 year
| old has not planned to be not-around so soon, these few extra
| years might allow this 40 year old to sort out and settle
| certain affairs that would allow them and their family to
| part with more "acceptance".
| gambiting wrote:
| Are you kidding me?????
|
| My dad was diagnosed with a very rare type of stomach cancer
| called GIST at 42. The average survivability at that stage
| for GIST at that time was 6-12 months. Zero patients lived
| more than 5 years.
|
| He was given experimental(at the time) drug called Glivec as
| it was being tested specifically against GIST and it was
| literally one of these "there's nothing else, so might as
| well".
|
| He lived another 8 years after that, until cancer came back
| and the drugs stopped working.
|
| When he was first diagnosed I was a teenager, my sister was a
| child - thanks to this drug he was able to see his kids go
| into adulthood, and obviously spend 8 more years with his
| wife.
|
| How is that "ain't much"??????
| paulpauper wrote:
| Consider that a 40 year old today can live 40+ more years.
| so even 4 extra years with experimental treatments is small
| relative to potential life expectancy without cancer. 4
| years is still optimistic given that stage 4 survival for
| major cancers instill in the 3-20% range depending on the
| cancer.
|
| Speaking of the number 4, awesome my comment already at -4,
| which is the cap.
| riboflavin123 wrote:
| You can't fold every individual into some sort of
| "average" case when the individualism isn't favorable.
| The universe doesn't work that way.
| angrais wrote:
| Yes, but cancer is not a solved problem, and so people
| will get it and eventually die. Also, who cares if people
| live 40+ years? Those with cancer statistically don't,
| yet drugs can increase life expectancy. That's the point.
|
| An extra day with your loved ones is paradise. Taking a
| drug and potentially gaining years?
|
| Come on mate, it's not a surprise you're being downvoted
| as your attitude is a disgrace.
| ncallaway wrote:
| > Speaking of the number 4, awesome my comment already at
| -4, which is the cap.
|
| I cannot _believe_ how flippantly you 're responding to
| someone who told the story of their dad passing away due
| to cancer, and yet you have the gall to also whine about
| downvotes.
| adventured wrote:
| > How is that "ain't much"?
|
| Whether four or eight years, either is an enormous gift
| when facing a terminal illness. There is no question about
| it. It's even more so the case if a person is 40 years old
| than if they're 80. The 80 year old has already lived a
| full life, death is far more acceptable, tolerable, at that
| age for most people.
|
| I suspect a person would have had to have never seen a
| loved one confront a terminal illness, to believe a year of
| additional time isn't a lot given the context.
|
| My mother died relatively young from small cell lung
| cancer. At the time there were no specific therapies for
| it, it was often caught late, and typically a person would
| die within 6-12 months. Almost nobody would make it more
| than three years. She lived for around 20 months post
| diagnosis, and that was a lot of very valuable time, even
| if it wasn't enough time.
|
| I've observed across my lifetime that some people live more
| in a year than other people manage to in a decade.
|
| How quickly time passes objectively and how we experience
| time are obviously two different things. Perhaps the
| skeptical parent was failing to grasp the significance of
| the difference. When facing a terminal illness, how you
| experience time is drastically altered, even if the seconds
| tick by as they did before.
| scottshamus wrote:
| I appreciate you taking the time to tell your story. It's
| easy to view expensive treatments that only extend
| someone's life by a year or two as too costly but those
| remaining years can be the most important for that person
| and their friends/family.
| throwaway894345 wrote:
| One of the interesting developments is precision medicine: we
| can now use genomic sequencing and AI to "search" for the
| treatment that is most likely to be effective against a
| particular individual's cancer rather than following the rough
| "standard of care" playbook (for example, depending on the type
| of cancer, the standard of care might be 6 months of chemo, and
| if that doesn't work try something else, repeat until cancer
| goes away or patient dies). The precision medicine approach at
| this point seems to be among the things that we try if the
| standard of care doesn't work, but hopefully one day it will be
| step one (chemo sucks and it is an expensive use of precious
| time). In addition to searching for treatments, we can also
| search for clinical trials for which a patient is a good fit--
| this helps both the research side (it's very hard to find
| qualified patients) and possibly patients who don't have better
| options (and of course the research itself benefits future
| cancer patients).
| hanniabu wrote:
| This sounds like something insurance will either refuse to
| cover for being expensive or make you try 5 other approaches
| first before agreeing to cover it, at which point it'll
| probably be too late.
| xwdv wrote:
| This is partly why it's important to save for retirement so
| you can be well capitalized to fund such treatments on your
| own if they should become necessary.
| sjg007 wrote:
| Unlikely. It will rule out treatments that are unlikely to
| work, saving money. What we are seeing is Simpson's
| paradox. Genomics and precision medicine allow you to
| segment populations at a higher resolution then before.
| riboflavin123 wrote:
| It may rule them out. But many standard-of-care chemo
| drugs are quite cheap.
|
| When I had leukemia, my first rounds of chemo used cheap
| drugs. (The drugs were far cheaper than the daily
| hospitalization costs, which was required due to drugs
| obliterating the immune system.) The insurance company
| didn't require any oversight into the process.
|
| But once the chemo stopped working and a much more
| expensive treatment was needed, the insurance company
| became quite a pest. I'm fortunate have saved a lot of
| money, so I didn't delay treatment until insurance
| approved it. (The 2-3 weeks between treatment starting
| and the final approval from insurance may have actually
| made a difference between life-and-death when dealing
| with aggressive leukemia.)
| sjg007 wrote:
| I'm glad you're here and a survivor of that hell. Yes,
| what you are describing is a very real problem. It's
| something we need congressional action on. Call it a
| surprise medical bill but more rather a surprise
| insurance denial. I am no stranger to insurance
| battles...
|
| I actually should have put it differently. Precision
| medicine will bring new treatments to the standard of
| care because we will be able to find the correct drug for
| you or me.
| pilotneko wrote:
| Small consolation, but I believe GINA should prevent that
| behavior. https://www.hhs.gov/hipaa/for-
| professionals/special-topics/g...
| throwaway894345 wrote:
| To the extent this is true today, I suspect it's precisely
| because the precision medicine approach is not yet the
| standard. I.e., insurance companies want you to do the
| standard of care, but if/when precision medicine _becomes_
| the standard then insurance companies will embrace it (or
| that's my hypothesis, anyway).
| gregwebs wrote:
| > repeat until cancer goes away or patient dies
|
| This sounds very similar to participating in a clinical trial
| and to me ironically seems to be the opposite of precision
| medicine.
|
| The Nagourney Cancer Institute cultures live cancer cells
| from the patient to test for what drugs may work. Doesn't
| work for everyone, but seems more in line with precision.
| Whereas genomic sequencing hasn't produced the amazing
| results that were expected.
| throwaway894345 wrote:
| > This sounds very similar to participating in a clinical
| trial and to me ironically seems to be the opposite of
| precision medicine.
|
| yes, to be clear this is a description of "standard of
| care" in which oncologists follow a playbook based on the
| type of cancer. Precision medicine (as I, a lay person,
| understand it) involves picking a treatment that is very
| likely to work based on an individual's genes, the genes of
| their tumor, their past medical history, and other relevant
| factors. The idea is to use all available information to
| identify the treatment that is the most likely to succeed
| for that individual.
| chiefofstuffs wrote:
| I'm in a similar situation. Partially have self-serving hope,
| but agreed that the game is starting to shift. The goal is now
| to buy enough time with the current drug you can move to the
| next version. So if you get 3 years from the drug and new ones
| come out every 2, you might get to die of something else.
|
| Also aggregated death rates will always lag if treatments are
| improving.
| t3po7re5 wrote:
| Yep, its all about staying ahead of the curve
| sharadov wrote:
| I agree, my dad was diagnosed with stage 3 colon cancer in 2020.
| One of the drugs that he was given as part of the anti-cancer
| regimen "Avastin" - starves the tumor of blood supply,
| effectively limiting growth, this differs from conventional chemo
| which attacks both healthy and cancer cells. After 22 cycles, he
| went into remission earlier this year.
| hanniabu wrote:
| Are there no downsides to Avastin? How long is a cycle?
| denimnerd42 wrote:
| still harsh side effects. just not as brutal as chemo. the
| cycle depends. my mother is on it indefinitely.
| pcorsaro wrote:
| Your wounds won't heal. It also costs a fortune. I don't
| think it clinically makes a difference in survival rates
| either. My wife had stage 4 colon cancer and they used it in
| conjunction with her standard chemo treatments for a couple
| of sessions. The incision where her port was installed never
| fully healed so they took her off of it.
|
| Edit: when they took her off the avastin, her oncologist just
| said it was no big deal. They use it because it doesn't hurt
| anything.
| tyingq wrote:
| Avastin blocks vascular endothelial growth factor (VEGF).
|
| There are also drugs that block epidermal growth factor (EGF),
| like Cuba's CIMAvax for lung cancer.
| sunshineforever wrote:
| In addition to medical developments, I think that clean living
| has become more popular than ever. In 2021, you see people who
| would never have been interested in a healthy diet eating
| properly. And obesity is an significant risk factor for cancer.
| copperx wrote:
| What does clean living mean? Living in small towns away from
| pollution? Washing produce more thoroughly?
| chrisseaton wrote:
| They mean thinking about your diet, exercise, mental welling
| and other health issues. It doesn't literally mean 'clean' as
| in 'not dirty'.
| gorwell wrote:
| I hope you're right, but over the past year we went kept
| packing on weight.
|
| A majority of adults (61%) reported experiencing undesired
| weight changes since the start of the pandemic, with more than
| 2 in 5 (42%) saying they gained more weight than they intended.
| Of this group, adults reported gaining an average of 29 pounds
| (with a typical gain of 15 pounds, which is the median).
|
| https://www.apa.org/news/press/releases/stress/2021/one-year...
| nemo44x wrote:
| Depends where you live - you may have selection bias. When I go
| back home away from the wealthy bubble I see a whole lot of
| "dirty" living around and not a whole lot of wanting to change.
| nradov wrote:
| The obesity rate has continued to increase.
| deregulateMed wrote:
| Consider the other additives like food coloring or
| preservatives.
|
| But yes diabetes isn't going down.
| SubiculumCode wrote:
| Tell that to my friend who died last month at 43. Sorry. It's
| hard not to be bitter right now. Fuck Cancer.
| some_hacker3 wrote:
| We can't, he's dead.
| andy_ppp wrote:
| I do wonder if there will be trials of doing short chemotherapy
| or senescent cell clearing drugs in your 40s in the future. It
| might be better to kill these things before they even become
| noticeable as diseases...
| mdeck_ wrote:
| Ok, but hardly shocking, given the zillions of dollars and
| person-hours spent on cancer research and related public health
| initiatives...
|
| Perhaps the most interesting tidbits here are regarding the
| _increases_ in mortality from particular cancers, which seem in
| most cases to be related to increasing numbers of diagnoses of
| the relevant cancer types.
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