Quantcast

Health "care"

The First Cell: And the Human Costs of Pursuing Cancer to the Last, Azra Raza

"...from 2002 to 2014, seventy-two new anticancer drugs gained FDA approval; they prolonged survival by 2.1 months. Of eighty-six cancer therapies for solid tumors approved between 2006 and 2017, the median gain in overall survival was 2.45 months. Of the cancer drugs approved during the past two decades, 70 percent of them were at best useless, showing no measurable survival benefit. Between 30 and 70 percent of the drugs may actually be harmful to patients. A study published in the British Medical Journal showed that thirty-nine of sixty-eight cancer drugs approved by the European regulators between 2009 and 2013 showed no improvement in survival or quality of life over existing treatment, placebo, or in combination with other agents."
 

Westy

the teste
Nov 22, 2002
54,225
20,003
Sleazattle
The First Cell: And the Human Costs of Pursuing Cancer to the Last, Azra Raza

"...from 2002 to 2014, seventy-two new anticancer drugs gained FDA approval; they prolonged survival by 2.1 months. Of eighty-six cancer therapies for solid tumors approved between 2006 and 2017, the median gain in overall survival was 2.45 months. Of the cancer drugs approved during the past two decades, 70 percent of them were at best useless, showing no measurable survival benefit. Between 30 and 70 percent of the drugs may actually be harmful to patients. A study published in the British Medical Journal showed that thirty-nine of sixty-eight cancer drugs approved by the European regulators between 2009 and 2013 showed no improvement in survival or quality of life over existing treatment, placebo, or in combination with other agents."

But those pharma stock prices.
 

Pesqueeb

bicycle in airplane hangar
Feb 2, 2007
40,137
16,532
Riding the baggage carousel.
It would of course depend on the variety, but given my family history, I'd be strongly inclined to pursue a gonzo 6-12 months of life and a comfortable exit following a cancer diagnosis.
 

jstuhlman

bagpipe wanker
Dec 3, 2009
16,622
12,911
Cackalacka du Nord
if you can surgically remove the potential odds based on genetic history like my wife did a few years back, i'd say go for it. otherwise, for the tuff stuff, i stand by my comments in some other thread about exiting myself when the writing's on the wall/what squeeb just said. eff the medical/lifestyle/geriatric industry that encourages everyone to eke out a few more months or even years of a shit lifestyle that financially devastates most families for the sake of sentiment./endannoyedrant
 

Westy

the teste
Nov 22, 2002
54,225
20,003
Sleazattle
Currently most of the way through reading Bill Bryson's The Body. He spends quite a bit of time going over cancer, it's treatments and diagnosis. With the exception of a few types, like breast and leukemia, it ain't good.

Best bets are to avoid cancer via truly un American lifestyles (no tobacco, little booze, low calorie un-processed foods). Then the chances are something else will kill you first.


Most of the increase in modern life expectancy comes from advances in childbirth, solving most communicable diseases and antibiotics. Luckily with antibiotic resistance and anti vaxxers we probably won't have to worry about cancer anymore.
 

Da Peach

Outwitted by a rodent
Jul 2, 2002
13,681
4,904
North Van
Same. My diet could be a lot better. I cover up a lot of sinning with a lot of exercise.
kinda same.

I’ve actually become a bit too conscious of the fact that I should cut down.

I’m sure the Bushmills will stamp that down.
 

Westy

the teste
Nov 22, 2002
54,225
20,003
Sleazattle
Would be better to die in the second one, so you can witness the sweet victory of watching the deniers in the first one.

First, second, whatever. What is important is that the cause is suffocation/drowning from overwhelming streams of blood squirting from the jugulars of my enemies.
 

rideit

Bob the Builder
Aug 24, 2004
23,055
11,298
In the cleavage of the Tetons
This insurance system in the US has me gaslit. (Or maybe not?)
I'm supposed to feel well taken care of because my $36,000 surgery is ‘only’ going to cost ~$6,000 out of pocket...towards a deductible that I haven’t met yet, when I have paid that insurance company ~$24,000 per year for the last four or so.
I'm truly blessed!
 

Westy

the teste
Nov 22, 2002
54,225
20,003
Sleazattle
This insurance system in the US has me gaslit. (Or maybe not?)
I'm supposed to feel well taken care of because my $36,000 surgery is ‘only’ going to cost ~$6,000 out of pocket...towards a deductible that I haven’t met yet, when I have paid that insurance company ~$24,000 per year for the last four or so.
I'm truly blessed!

Best health care in the world

If you can afford it

But not really, even then you are still more likely to die of complications, misdiagnosis and overtreatment than all the other developed countries

And spend 3 times as much for the honor

But look at those stock prices.

Best case scenario is you just end up with an opioid addiction and an antibiotic resistant infection.

And Toshi has a Peloton and a rowing machine he never uses.
 
Last edited:

Westy

the teste
Nov 22, 2002
54,225
20,003
Sleazattle
How are you two defining the quality of your diets, as it were?

Got a citation for that? I'd like to read that study.
I would rate my diet by low levels of un-processed plant matter.

The was a broad generalization based on some specific studies discussed in the referenced Bill Bryson book. He usually includes a rather detailed bibliography in his books but alas I got the audio version for my long drive to Utah, which does not include such things. I may swing by the bookstore around the corner to see if the print version includes one.

I often consider why the hell I live where I do, having 3 actual book stores and a library in walking distance is certainly one reason, as are the various walkable options for intoxication.
 

Toshi

Harbinger of Doom
Oct 23, 2001
38,029
7,549
I would rate my diet by low levels of un-processed plant matter.
Processed plant matter is likely bad, sure, but I am far from convinced that we need much if any unprocessed plant matter, either. There are many alternate sources for the various and sundry vitamins that one might think are only, in, say, dark green plants.
 

Westy

the teste
Nov 22, 2002
54,225
20,003
Sleazattle
Processed plant matter is likely bad, sure, but I am far from convinced that we need much if any unprocessed plant matter, either. There are many alternate sources for the various and sundry vitamins that one might think are only, in, say, dark green plants.
Not from a nutritional standpoint but it sure is the easiest way to avoid colon cancer, high blood pressure and diabetes.
 

Toshi

Harbinger of Doom
Oct 23, 2001
38,029
7,549
Not from a nutritional standpoint but it sure is the easiest way to avoid colon cancer, high blood pressure and diabetes.
Avoiding carbs in general can do that as well. Re colon cancer in particular there are rat data we should be eating more bacon...

 

stevew

resident influencer
Sep 21, 2001
40,494
9,525
when it is my time i am going to buy the finest china white i can.....go to denali.....snort it up....cover myself in honey and offer mysef to the bears.....i hope i will od before the bears get to me....if not....it might only tickle...
 
Processed plant matter is likely bad, sure, but I am far from convinced that we need much if any unprocessed plant matter, either. There are many alternate sources for the various and sundry vitamins that one might think are only, in, say, dark green plants.
With respect, given the direction you seem to be taking, you may as well just hook yourself up to IVs that deliver whatever peculiar substances you desire, thus completing your path away from what most of regard as food and drink.
 

Toshi

Harbinger of Doom
Oct 23, 2001
38,029
7,549
With respect, given the direction you seem to be taking, you may as well just hook yourself up to IVs that deliver whatever peculiar substances you desire, thus completing your path away from what most of regard as food and drink.
Steaks don't fit well through IV tubing, and those I eat regularly. We also go through whole milk and heavy cream, dark chocolate, and cheese a fair bit. All foods, those, last I checked.
 

Jm_

sled dog's bollocks
Jan 14, 2002
18,850
9,556
AK
Steaks don't fit well through IV tubing, and those I eat regularly. We also go through whole milk and heavy cream, dark chocolate, and cheese a fair bit. All foods, those, last I checked.
Don’t be ridiculous, i has a friend who’s wife had to have puréed everything for a couple months while her mouth healed from surgery. They did all kinds of stuff. No saying I would, but hey, it’s possible.
 

Westy

the teste
Nov 22, 2002
54,225
20,003
Sleazattle
Not a fan of greasy shits
Avoiding carbs in general can do that as well. Re colon cancer in particular there are rat data we should be eating more bacon...

Avoiding carbs in general can do that as well. Re colon cancer in particular there are rat data we should be eating more bacon...


Not a fan of greasy shits. One must also consider properly feeding your gut bacteria, which has implications from obesity , cancer and possibly even Parkinson's and autoimmune disorders.
 

Toshi

Harbinger of Doom
Oct 23, 2001
38,029
7,549
Re Parkinson's, omega-3 supplementation is probably in order based off of the animal work:


(Search term was omega-6 but the 3s appear to be the protective ones. Lessening omega-6 in general is also probably good, perhaps not for this particular thing. Dive down in Google Scholar for OXLAMs and HODEs if you're bored.)
 

Sandwich

Pig my fish!
Staff member
May 23, 2002
21,030
5,918
borcester rhymes
ooh, is this where we talk about things we don't fully understand? fun! let me try

car engines should be made of titanium, because it's lighter!

electric cars should be free, because they are better for the environment.

elon musk should be president, because he posts memes on the internet.


how is this going? I feel like I'm on point with the rest of this thread
 

Toshi

Harbinger of Doom
Oct 23, 2001
38,029
7,549
Sandwich is very salty, therefore he should be put into use for deers to lick?
 

Sandwich

Pig my fish!
Staff member
May 23, 2002
21,030
5,918
borcester rhymes
Sandwich is very salty, therefore he should be put into use for deers to lick?
extra salty today, considering I work in immunooncology and am designing the next wave of TCR engineered T cells, yeah I'm butthurt

Looking only through 2014 ignores all PD1, CAR-T therapies, many combination therapies, and the bulk of CTLA4....but hey yeah drug companies bad
 

Toshi

Harbinger of Doom
Oct 23, 2001
38,029
7,549
His underlying point that a lot of very expensive therapies only have minimal marginal benefit is true, though, even if that needle may be pushed a bit up in the last few years.
 

Sandwich

Pig my fish!
Staff member
May 23, 2002
21,030
5,918
borcester rhymes
true, but I feel that cancer "therapies" are often end of life care. Many times it's caught too late to be effective, but therapies are tried anyways. Also, standard of care for solid tumors is radiation and chemo, right?

From my research, cancer tends to be elusive and a massively challenging disease to treat. It'll trick the body into using its own defenses against it, and reprogram metabolism to help the tumor rather than the body. It's a phenomenal disease, and if you can find something that works, many times it's very effective...it's just finding the thing that works before the cancer takes over. Saying that these don't work or shouldn't be funded is missing that many of them do work when the right conditions are met. It might be that our diagnosis and understanding of the disease is what is lacking, not drug effectiveness.
 

Toshi

Harbinger of Doom
Oct 23, 2001
38,029
7,549
I totally agree that we are treating people futilely when the disease is far too advanced, after far too many checkpoints have been broached.

The most effective money spent addressing cancer incidence 30 years from now is probably solid dietary trials now... but we don't have such evidence on that end, just a bunch of wild inferences from studies using, say, two self-reported dietary questionnaires.

Here's one such take, where vegetable consumption changes weren't linked to prostate adenocarcinoma progression:


And here's another (part of the reason why I went down this fasting road myself, not that I worry about my breast tissue, per se):


In repeated-measures Cox proportional hazards regression models, fasting less than 13 hours per night (lower 2 tertiles of nightly fasting distribution) was associated with an increase in the risk of breast cancer recurrence compared with fasting 13 or more hours per night (hazard ratio, 1.36; 95% CI, 1.05-1.76). Nightly fasting less than 13 hours was not associated with a statistically significant higher risk of breast cancer mortality (hazard ratio, 1.21; 95% CI, 0.91-1.60) or a statistically significant higher risk of all-cause mortality (hazard ratio, 1.22; 95% CI, 0.95-1.56). In multivariable linear regression models, each 2-hour increase in the nightly fasting duration was associated with significantly lower hemoglobin A1c levels (β = –0.37; 95% CI, –0.72 to –0.01) and a longer duration of nighttime sleep (β = 0.20; 95% CI, 0.14-0.26).
Is it the A1C driving it? The sleep? The period of presumably low insulin and glucose? Some combination? But this is a pretty strong effect for something seemingly so trivial, even if the study wasn't powered to make the mortality trends significant.
 

6thElement

Schrodinger's Immigrant
Jul 29, 2008
15,825
13,054
extra salty today, considering I work in immunooncology and am designing the next wave of TCR engineered T cells, yeah I'm butthurt

Looking only through 2014 ignores all PD1, CAR-T therapies, many combination therapies, and the bulk of CTLA4....but hey yeah drug companies bad
So you work for Umbrella Corp and when it happens we blame you for the zombie apocalypse?
 

Toshi

Harbinger of Doom
Oct 23, 2001
38,029
7,549
Re advanced disease: I have seen some remarkable responses for widely metastatic disease... for certain patients, with certain histologies, with certain drugs. See melanoma and the *inibs, for instance.

But things like pancreatic adenocarcinoma still have a pretty grim response rate, even if several times better than historical (super grim) data.
 

Sandwich

Pig my fish!
Staff member
May 23, 2002
21,030
5,918
borcester rhymes
And not only in the field of oncology.

And yes, @Sandwich, I believe that drug corporations are, as a class bad, focusing on profit rather than doing the most good for all.
you can thank an FDA that now approves not-effective, but safe therapies for that. One of our competitors in the past got a drug approved because it offered hope to parents, not because it actually improved outcome of disease. If I recall, it offered lowered than 1% improvement in the production of a mutated protein. That was what their clinical trial and approval hinged on. It's a gene therapy, so it's going to cost all the money, and a positive outcome is not only not guaranteed, it's not likely. Still, it's available.

I know that Bernie has been shouting that for ages, so I get it. By and large though, that's simply not true. There are bad eggs out there- pharma bro tactics of buying old drugs and raising prices are ridiculous. I'd love regulations to prevent that, or to only allow it in cases where it's necessary- ie a fundamental improvement in formulation or structure that requires new clinical trials. Most companies are simply trying to turn a profit (just like every other company in existence) while navigating a very challenging field. What other companies can invest hundreds of millions of dollars in a product that is more likely than not going to fail and never be approved? Would Ford exist if 90% of the cars they designed would never be sold?

The generalization that all drug companies are bad is pretty offensive, so I apologize if I seem salty.
 

Toshi

Harbinger of Doom
Oct 23, 2001
38,029
7,549
Innovation costs money, sure.

Why should America largely pay for these drugs' development, though, when the drugs are sold worldwide? That's a tremendous distortion borne out of our insurance system's design.
 

StiHacka

Compensating for something
Jan 4, 2013
21,560
12,504
In hell. Welcome!
I have a few cancer survivors in my family, I don't think the effort is a waste of energy.

I also think we need a good conventional world war to get our species off the current track. Even if just for a few decades.