We’re secretly winning the war on cancer | Hacker News Reader

We’re secretly winning the war on cancer

vox.com

459 pointslr0218 comments

I was lucky enough to be seen by MD Anderson doctors for my rare type of cancer. Within hours of the first painless infusion, the large tumors I could feel and see from the outside were completely gone. Hours, truly.

Now, the rest of the chemo wasn't as easy as the first. But the miracles of modern medicine, thanks to dedicated researchers and medical teams, truly blew my mind and that was a decade ago.

I was told I was one of 42 people ever that MD Anderson had seen with this cancer, yet they were able to tailor a treatment. I think Vox is right about the progress being amazing, and I hope it continues.

The common cancer treatment modalities: surgery, radiotherapy, chemotherapy, targeted drugs and their combinations are very effective first line treatments. I agree the statistics are much better.

In the field of cancer research it has been focusing more on drug / treatment resistance, heterogeneous response to the same treatment and development of less invasive methods both in treatment and assessment (imaging and monitoring). We have made huge progress in terms of deeper understanding of cancer biology and human disease mechanism in general.

However we have a very long way to understand when things progress outside of our control how to respond. E.g the key cancer drivers have been identified long ago but how biology and evolution modulate its response to external treatment has so much unknowns. That requires large effort to push the whole foundation of science to elucidate the details of these processes in my opinion.

I take four pills a day and the primary side effect is weight gain. The earlier 1950s era treatment made me exhausted 24/7. There's a new trial that has a new target, and looks to solve the remaining symptoms of the disease, with effectively no side effects

The big problem is that it's a chronic blood cancer, so the pills have a list price of $180k/yr. Who knows if my insurance will cough up for a second big-money prescription/

My father is 15y out from a trial (at MD Anderson) that put his CLL into remission. You may already know about The Leukemia and Lymphoma Society[1] but they can help with the cost of prescriptions (including negotiating the prices down with the pharmaceutical companies!)

1: https://www.lls.org/

At that cost it's worth looking into moving to a country that actually has reasonable medical costs instead of laws protecting those milking the system. a Plan B?

Some countries with publicly funded healthcare make immigration much more difficult if you have an expensive health condition. This is the case for Canada for example [1].

[1] https://www.canada.ca/en/immigration-refugees-citizenship/se...

This is why people need to think about these things when they are in full health.

My actual co-pay is $10/mo for the good stuff, plus warfarin (eliquiis/xeralto were too weak for me :/) which is ~$12 for a 90 day supply from the mail order PBM pharmacy. I average about $1500/yr in out-of-pocket medical expenses. My company self insures, and has an extremely generous insurance plan.

Plan B is wait until 2028, when it goes off patent. I think I can keep my job til then. I've learned from the HR folks that they just signed another 3 yr contract with the insurance company, so I'm not forseeing any major changes to coverage. This drug is super pricey, as it was originally targeted towards people with acute cancers, but now the largest market is the chronic disease patients, but they never lowered the price.

I suspect the insurer/PBM are making a small fortune off of my care. They are also being sued by the pharmaceutical industry for using a "co-pay maximizer" which caps (patients) out-of-pocket co-pays, and goes after the pharmaceutical companies' "charities" which help patients purchase their products, which the insurer then takes a cut from.

And the weight gain isn't fluid, it's definitely body fat. I think the weight gain is from the "baseline" treatment being a mutagenic chemotherapy, and the likely fact that my (previously) enlarged spleen was impinging on my stomach limiting my appetite, and the lived fact that it massively slows your metabolism, as I'm always a bit cold.

I'm not sure how that would work, do countries accept this kind of behaviour?

It's like you've been paying your (lower) taxes in country X and now come over to enjoy the saner system. I guess you should have chosen your priorities earlier?

Out of curiosity, when some medication causes weight gain, how does it work? Does it increase appetite? Or does it slow metabolic rate?

Prednisone is a pretty common drug with weight gain as a side effect, so that might be a good place to look further.

It increases water retention (obviously not permanent or unbounded), increases appetite, and redistributes fat (giving the appearance of weight gain).

My grandmother took it most of her late life for management of COPD. She had a hard time getting off it completely. She had immense self-control and managed to control the weight gain side-effects, but she had some of the moon face appearance.

Prednisone is usually not a treatment for cancer, but rather a treatment for the cancer treatment.

A potential side effect of immunotherapy is it can cause the immune system to go haywire and start attacking non-cancer cells.

Right, but it's a well researched drug with a weight gain side effect, so it's probably a reasonable entry point for them to learn about the thing they asked (unless they happened to care about that cancer drug in particular, but that's not what it sounded like to me).

I take mirtazapine for crushing depression and now I have clinical obesity and borderline diabetes. Medicare won't cover obesity treatments other than some lifestyle habits lecturing because they consider it "my fault" with zero nuance. [0]

0. https://www.medicare.gov/coverage/obesity-behavioral-therapy

Usually, aside from water retention, it’s the appetite, I would assume. Lower metabolic rate by itself would lower the appetite because the person would feel less hungry.

Metabolic rate and appetite are loosely correlated at best. Most stimulants simultaneously reduce appetite, and increase metabolic rate. (in fact, that's where a significant portion of their negative side effects come from. Habitual meth users tend to become malnourished, mostly because of the appetite suppression, which combined with teeth grinding jitters, causes the iconic "meth mouth")

its metabolic rate. im always cold.

Not OP but I'd guess fluid retention.

Usually it's just fluid.

Are you talking about acalabrutinib and zanubrutinib? If so, have you looked into the chinese version Orelabrutinib? Chinese pharma has gone from backwater to competitive with US in like 5 years

I’ve met people that have moved to Houston for cancer treatment there, were given 1-2 years to live, and they’re still here 15-20 years later. It is a really remarkable place.

MD Anderson is great.

The greater Houston area has too much cancer, in part caused by the many refineries and chemical factories. At least there are good treatment options nearby.

https://www.propublica.org/article/toxmap-poison-in-the-air

Any statistics on this claim?

Here in Norway there had been increasing focus on the long-term consequences of working on oil rigs.

There's been several studies[1] showing multiple different forms of cancer are over-represented among oil workers[2], and linked to benzene and crude oil exposure.

Granted Norway's oil is exclusively offshore, so exposure might be different.

But, contrary to what a former boss supposedly told his rig workers, just because oil is a natural product does imply it and its processing is harmless.

[1]: https://www.fhi.no/en/cancer/studies/cancer-among-offshorewo...

[2]: https://www.forskning.no/arbeidsvilkar-olje-og-gass/olje-pio...

'Cancer Alley' maps are generally just the same cherrypicked socioeconomic/ racial map you see everywhere- especially the refinery claims.

Adjust for those factors and the increased incidence disappears.

> Adjust for those factors and the increased incidence disappears.

'Adjusting' for those factors builds in the assumption that they're independent of the thing you're trying to measure. If living near a smokestack is undesirable, then poorer/marginalized people will live there even if it also causes cancer.

I assume they meant if you look at roughly the same socioeconomic group that lives 500 miles from refineries as opposed to 500 meters you'll find similar numbers for cancer/other stuff. I'm not on either side of the fence because I don't know, just pointing out what was meant. I'd welcome statistics from either case.

The challenge is that it’s very unlikely that race/socioeconomic factors are causal in and of themselves, the reason why you would adjust for those variables is because they are tightly correlated with other causal factors that aren’t being observed directly, e.g. poorer healthcare availability, poorer access to healthy foods, etc.

Environmental pollution very reasonably can be hypothesized to be a causal mechanism behind cancer rates. Exposure to which is going to be heavily correlated with race and socioeconomics.

I may be misinterpreting OP, but their statement came off as “cancer maps are just maps of where poor non white people live, so it’s not the pollution”, but you can’t just “control” for things that way. Given the fact that environmental pollution is a hazard, there’s a reason why that demographic lives there that makes the exposure to pollution not independent from the demographic characteristics of the population.

Isn't causality transitive though? It sounds like you're saying that low socioeconomic status causes poorer access to healthcare and healthy foods, and that those cause worse health outcomes. Yet you're claiming that low socioeconomic status doesn't cause worse health outcomes. That seems wrong to me.

If causality were transitive the phrase “correlation doesn’t equal causation” wouldn’t exist

Surely that's incorrect. The most obvious scenario is A causes B, B correlates with A, but B does not cause A. Whether causality is transitive is irrelevant.

The quote is typically brought up when there isn’t a direct causal relationship between two variables, not when the causality is reversed. e.g. ice cream sales and drownings. In both cases heat drives behavior, but neither cause each other.

I’d say reverse causality is a very common example, particularly in health and medicine (e.g. illegal drug use and psychiatric disorders).

Maybe they meant race/socioeonomics, not pollution.

Not really. It's just a widespread area that rolls up to zipcodes, etc.

My mom was in public health research -- there's a ton of cancer clusters tied to industry and other factors which don't get recognized because of the methology for defining place and jurisdictional boundaries. In rural areas you have population issues because environmental impacts can be localized due to low population density.

One example at I can't find a free article online for was a 20-30 mile long county highway that was paved with oiled gravel in the 1960s and 70s. Incidence of lung cancer in non-smokers was higher than smokers in the general population, and with smokers significantly higher. Reason? A local industry donated waste oil from industrial processes to the county highway departments. They were laden with PCBs, dioxins and other goodies, delivered to your home in the form of road dust. Another was a plant that processed depleted uranium for munitions, that elevated kidney and bladder cancers in a narrow range across a few jurisdictions. The contractor settled claims there.

Around Houston, I'd expect what I experienced as a child downwind of the former Greenpoint garbage incinerator and Newtown creek refineries in NYC ... more childhood asthma, higher incidence of cancers of lung/mouth from long tenured residents, etc. Lots of nasty stuff is emitted in refining and chemical operations.

All these things people claim in the comments section seem like not very rigorous. Also, any increase in cancer cases has to be corrected for overweight people in the US.

Houston has zillions of petrochem facilities around it that regularly blow up.

fr 90% of cancer treatment just slash, burn or poison.

You mention rapid debulking following an infusion. That must have been a surreal experience. Congratulations!

How does the treatment you received compare to the current standard of care? Would current therapies also result in rapid debulking as well?

I remember the little clear IV looked like saline and the nurse said, "Your insurance is getting billed $75,000 for this, so lay back and enjoy" - that was one of many expensive treatments, I was very lucky to have good insurance.

I was told the rapid debulking was because the first infusion I got was a targeted drug that specifically found and destroyed the cancer cells.

The follow up chemo was R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone), and my understanding this regimen is still being used.

My dad just went through lymphoma treatment using R-CHOP in 2024. It really is like a miracle. He felt like shit for a day after treatment (actually he felt like shit for one entire day, three days after treatment because he was pumped so full of steroids). Otherwise no real side effects.

Thing with any cancer treatment is that it works miraculously for someone somewhere and makes it to the news all over.

But it rarely translates to that level of success with masses of cancer patients.

That is overly reductive. Treatments are measured by metrics such as 5 year survival, 10 year survival, progression-free survival, overall survival, etc. Further, when evaluating a new treatment it will be compared against the current standard of care: does it provide better overall survival? if not, does it at least provide better progression-free survival?

right i wasn't talking about incremental improvements, Which there have been many. But there hasn't been a fundamental breakthrough to achieve what gp is describe for 99% of advanced cancers.

> Within hours of the first painless infusion, the large tumors I could feel and see from the outside were completely gone.

The breakthroughs have been happening right under your nose. For example, when they do a biopsy now you get incredible detail about the subtype of cancer/cells and details that help target treatment.

I'm not the only person with this kind of story of rapid debulking, that's why someone else chimed in with the medical term. The miracle isn't my one story; the modern miracle of medicine and the fight against cancer is that my story IS one of thousands every month that leave MD Anderson (just one hospital) and have their lives literally extended. In my case, a decade so far with no more trouble, knock on wood.

I think you cannot expect a blanket solution for cancer. Cancers are all extremely different. We will have thousands of breakthroughs for these myriad of cancer types.

you didn't share what exactly the miracle was in your case so let me pick the most common form of cancer.

What is the breakthrough for prostate cancer ?

LU-177? Abiraterone/*Lutamide?

> when they do a biopsy now you get incredible detail about the subtype of cancer/cells and details that help target treatment.

There is no such thing for prostate cancer. Yes you can target BRCA with olaprib but that only works for little bit. But median OS is an improvement of only 4 months ( 15 vs 19). Sure you can live extra 4 months with heavily compromised blood definciency but hardly a breakthrough.

> We will have thousands of breakthroughs for these myriad of cancer types.

Not sure what makes you say this? We've only had improvements in survival for prostate cancer for early detection. All other improvements have been marginal at best. Chemo and hormone supression therapy are still the mainstay since the 70s. Like you are literally getting the same treatment for prostate cancer that ppl were getting 50 yrs ago.

> an improvement of only 4 months ( 15 vs 19). Sure you can live extra 4 months

4 months isn't a breakthrough to you because you're not facing this reality. Wake up. You'd do anything for 4 months unless your life is hell already. Anyone who is happy would be joyous to be able to have 4 more months, it's so painful how disconnected you seem.

I agree that the skepticism is warranted. These pharmaceutical companies are making a lot of money, without giving clear results on survival rates. Where it seems like the human race may turn the corner on beating cancer, are with vaccines and gene therapies. More complete victories and recoveries versus just postponement for a little while longer.

>the progress being amazing, and I hope it continues.

and that it does not require being lucky to receive, as you were.

All things have to start somewhere. My insurance paid the extreme prices that this rare treatment required at the time, and my treatment meant they had more data (and now a decade of follow up) to verify if the treatment works.

I didn't have a job with insurance because of luck, in fact I was aware enough of medical costs I chose which job I accepted based on the medical benefits.

I was lucky to be alive at a time treatment was available and within reach of a modern working person, not lucky like the Queen's nephew being promoted.

I think saying I was single and working my first job out of college should put it in perspective here. I didn't drive a Cadillac to my chemos. Stuff costs money, especially medical R&D, production, and care delivery.

Tell us the ugly truth then paint a happy picture.

“for one in six deaths around the world, killing nearly 10 million people a year globally and over 600,000 people a year in the US.”

A lot of reduced deaths come from less smoking and early detection. We will eventually get there but we need a lot more research.

Get a colonoscopy at 45. We are seeing a big increase in younger people.

https://www.cancerresearch.org/blog/colorectal-cancer-awaren...

> Get a colonoscopy at 45. We are seeing a big increase in younger people.

N.B. this is not just an increase in detection (as could happen with more/better screening where the true rate isn't changing), but mortality:

> In people under 55, however, death rates have been increasing about 1% per year since the mid-2000s. https://www.cancer.org/cancer/types/colon-rectal-cancer/abou...

It's certainly the case that colorectal cancer is becoming more common, and among younger people. Plenty of possible reasons; diet, plastics, PFAS, all of the above, take your pick.

However, the fact that mortality has been decreasing above the age of frequent screenings, and increasing below that age, tells us that whatever the problem, the symptom (cancer) could be addressed with better screening, leading to earlier detection and treatment.

Mortality is increasing in young people because they don't get screened, so when it does happened no one catches anything until it's too late.

If the age for recommended regular colonoscopies was 40 or 45, we would see the same mortality reduction above that cutoff.

> Plenty of possible reasons; diet, plastics, PFAS, all of the above, take your pick.

I think obesity is the main confounder in all such statistics. Thats the thing that has most markedly gone up over the past decades

While it's true that obesity has risen, a percentage of the human population has always been overweight. While on the other hand, the increasing amounts of environmental pollution and contamination is newer. It can be argued as being the greater challenge to human health and straining the genetic ability to adapt to such problems.

You don't know that. Environment is much more polluted, and thus is our food. We move less. And so on.

Whose environment is much more polluted. In the developed world, pollution is decreasing. For the U.S., for example: https://gispub.epa.gov/air/trendsreport/2024/

That's showing that air pollution I would guess mostly from cars has gone down since 1990.

There are lots of other new chemicals not shown on that chart that are in our food and clothes and everything, particularly almost everything modern babies in the US come in contact with.

While PFAS and microplastics and the like are a huge problem, you can't just dismiss the major efforts done over the decades to reduce pollution and improve health; wood / coal fire bans, mandatory catalytic converters, ban on asbestos and CFCs, lead-free fuel and paint, EVs, renewable electricity generation, emission zones, trash collection & safe disposal, smoking bans and discouraging measures, etc. It's not an either/or, and not celebrating successes means there will be less inclination to also solve the newly discovered issues.

Fair points honestly. We tried a lot of awful stuff in the 1900s that has been stopped and that should be celebrated.

There's also a lot that was never stopped, and more and more coming all the time.

There is also a lot less toxic chemicals around nowadays such as flame retardants, DDT, lead (petrol), asbestos, PCB etc.

Obesity is a symptom; food poverty, financial poverty, lifestyle choices, city design, culture, etc etc etc.

This mindset drives me nuts. It's like the rhetorical opposite of victim-blaming. It takes something that is within an individual's locus of control and pretends they have zero agency in the matter.

Last week I finished a two month diet where a big chunk of my weekly calories and nutrients came from cheap staples I prepared myself (specifically brown rice, black beans, steelcut oats, spinach, and eggs).

Aside from the food, the cost was 1. watching some ads in the free version of the calorie counter app I used to make sure I was getting the nutrients I needed and 2. ~$30 for a food scale so I could be precise about what I was eating.

Circumstances make it easier to be unhealthy but what I did is attainable by the vast majority of obese people.

It's complicated because it's both, with varying levels of influence.

Obviously, it cannot be 100% on the individual. Because then, how did we get an obesity epidemic? Did people somehow, magically, become more lazy since 1970? That doesn't sound plausible to me.

It's systemic in nature. Consider tobacco use, a problem we've largely solved in the US. We went from something like 50% of people smoking in 1960 to about 10% now. In young people, the results are even more drastic. It's sort of magic - a reverse obesity epidemic.

How did we do this? A combination of things. Of course people worked very hard to quit, but they also got PSAs and their doctor's helped them. And then we made it much, much harder to smoke.

The thing is, people are creatures of influence and habit. Much of what we do is because it's low resistance. We've allowed obesity to become a systemic problem because of our food available, our culture, and our lifestyles.

It's not that some place like, say, Paris is healthy. But it's a lot easier to be accidentally not-obese in Paris, France than in Paris, Texas.

The question of how someone who wants to lose weight should do so doesn't really have much to do with why people in general are more overweight than decades ago. People in the 80s and 90s had a lot of processed foods, didn't generally use food scales, and calorie counter apps hadn't been invented yet.

FOBT which you can do painlessly at home for a few dollars is not meaningfully less preventative than an invasive colonoscopy and carries almost no risk. https://www.nejm.org/doi/full/10.1056/NEJMoa2208375

Very true, and this is what caught my father's bowel cancer and saved his life.

That said, for someone with increased risk, nothing compares to a colonoscopy - at it does a better job of catching things early, before you start getting blood in your poo.

But if you are at a standard risk, doing a fobt every couple-few years is hugely important. Ask your doctor now!

The superior stool based test would be the FIT-DNA test, which compares favorably to a colonoscopy in sensitivity. These are covered by insurance in the US.

www.nejm.org/doi/full/10.1056/NEJMoa1311194

I had not heard of those - I'll have to look out to see if the NHS offers these.

Currently on 5 yearly review until I hit 50, as my oldest brother had the same cancer at 56, which sadly took his life, so I am not of standard risk.

Reading summary of that paper:

"The numbers of persons who would need to be screened to detect one cancer were 154 with colonoscopy, 166 with DNA testing, and 208 with FIT." So I'll still stick with a colonoscopy until something better comes along.

However, if pre-cancerous polyps are found during a colonoscopy, they can be removed right then.

Of course, the best prevention is one that people actually do.

FOBT = Fecal Occult Blood Test (A highly sensitive test for detecting blood in poop even at tiny concentrations).

How effective is it when you get one every year? The idea of a colonoscopy scares the shit out of me (pun not intended).

I have done mine at 50, you are half asleep, does not hurt, you do not remember anything. Fasting day before is the worst part.

All in all, nothing to worry about, just do it.

While earlier detection has been beneficial, there's such a thing as too much. Really, there's balance to be struck. For instance the detection procedures themselves (even things like non-invasive imaging) aren't risk free themselves, false positives can set off a chain of events that carry their own harm, and even it's not at all uncommon to develop cancers you "die with" instead of "die from" but once they're detected you have to assume the worst - and treatment itself causes its own form of harm.

Getting one annually is not recommended for most patients. After my bowel resection, I had annual colonoscopies for five years, then every three years, now every five (the normal recommendation for my age cohort).

Colonoscopies are no big deal from my perspective, but they do have some risk; bowel perforation being the primary one. The prep stuff is the worst aspect for most patients; I used to love lemon lime Gatorade before I used it once as a way of drinking the liquid laxative...

Thanks for the reminder. My containers to shit in are waiting to be picked up from the doctor's office.

Looks like colonoscopy is better from your link.

The issue with things like cologuard is they really only detect cancer. Colonoscopies can prevent cancer by having polyps removed before they turn into cancer.

Colonoscopy is a more invasive procedure obviously, but complication rates are very low. It's worth it to find a great gastroenterologist to do the procedure.

Yeah wish I had grabbed one last time I had an endoscopy.

Until things radically change, people are always going to die of something. The more people avoid death from other things, the more people live long enough to die from cancer.

I know at least a dozen people in my family and friend network that are alive now after treatment from a cancer that was fatal in most cases 20 years ago. That’s not proof by any measure but I am certainly thankful it’s not 20 years ago.

Prostate cost nothing now in your 30s too

My father died last week of cancer. I'm glad for the progress, but winning seems a bit much.

I'm sorry for your loss. I lost my wife to cancer two years ago.

Obviously it didn't work out as we wanted, but she had real hope and prospects. A decade ago, her diagnosis was a guaranteed death sentence. It a nasty business, but at some level, oncology is a field where we stand on the shoulders of those before us. The hope that these tragedies we experience will help future victims brings some comfort personally.

I'm very sorry to hear this, and I hope with time you're surrounded by many good memories of better times with your father.

I lost one parent to cancer but the other has been cancer free for over ten years now. I'm devastated by the lose of one parent but incredibly grateful for the one who beat their cancer.

Is that winning? I dont know. But the likelihood that my other parent would still be around if they got their same cancer now is already higher than it was when they passed. Nothing can bring my other parent back but we can prevent others from losing their loved ones.

I'm sad to read this, as my father too is not in the best possible situation currently, cause of cancer. Wish you feel better soon and keep fond memories of him.

Here's to your dad, may he rest easy and be remembered well.

I’m sorry for your loss, stranger.

I lost my father to cancer last year as well - the medical system failed him, his pain treated as exaggerated and his symptoms ignored until it was far too late.

There’s no win for our dads, but I hope the progress prevents future people like them from facing what they did.

winning isn't won. i'm sorry for your loss.

My dad was diagnosed with multiple myeloma 2 years ago. His bone marrow transplant failed (frequent first line of defense) and he just finished CAR-T therapy a couple months ago. The initial side effects from the treatment were _bad_, but everything is looking good right now. CAR-T is really mindbogglingly insane cyberpunk stuff.

I had a close relative diagnosed with multiple myeloma 25+ years ago (I don't remember the exact year) who only lived for a couple more years. It was rough back then. I'm really glad to hear that there is much better treatment these days.

not "war on cancer" and not "we" winning. It's pharma finding ways how to profit from rare treatment successes of few rare disease types. Majority, and by majority i mean over 80%, of patients and cancer types are still treated with bogstandard chemo+radio+surgery. Individualized treatment plans using checkpoint inhibitor combinations, biotech therapies, etc are for few select individuals with A LOT of money.

how do i know? i work in precision oncology for a decade plus

I think perspective is important here.

I'm alive because pharma developed an expensive drug that, at the time I got it, was only administered to 42 others before me.

I was a single person working my first job out of college with Blue Cross Blue Shield and got the best I think was available.

You might be jaded after working so long in a difficult industry; the medical research/pharma work done matters to the patients who receive it and get another decade+ of good life.

im glad for you and every single patient that benefits from something i work on. From the public health angle of most eu countries investment into novel cancer treatments makes a lot less sense that improving prevention.

> Individualized treatment plans using checkpoint inhibitor combinations, biotech therapies, etc are for few select individuals with A LOT of money.

This is the first step in the commoditization of any new treatment, no? Initially expensive but that creates competition to bring the price down.

[Maybe not in the US though because the customer cannot select their supplier]

You may check Europe. I can assure you that patients getting PD-1 inhibitors etc. while if I am not mistaken at least in part recruited for clinical trials pay zilch, nada for the drugs there are taking (in Spain).

I don't know... Advancements like Keytruda are huge. And it will be off patent soon. And there are over 1500 active CAR-T clinical trials going on as we speak.

Oh don't you worry some pharmabro will change (edit: will pay someone actually smart to change) a single atom within a single molecule of the antibody, or however the fuck they do it, and they'll re-patent all of the derivatives, and nobody will make the off-patent version of pembrolizumab due to drug companies bribing benefit managers to not cover the off-patent versions, the fact that you can't charge $150k/yr for it, and gentlemen's agreements between drug manufacturers to not harsh anyone's vibe.

If we're lucky congress won't be bribed, I mean lobbied for the sake of safety, into criminalizing its importation.

Great that treatment options are improving. But there are still serious bottlenecks in medicine. It seems to be a universal truth that getting a CT/MRI comes with a long wait time. General Practitioners often wait too long to order imaging as a result, and they are often unwilling to even consider cancer in younger people.

We need better (earlier) detection and faster access to it.

Just went through the process recently...

Luckily Urgent Care was able to go from ultrasound to CT scan in 1 day. The long wait time has come from the insurance honestly.

Had to go to a different hospital because the original one I went to has to get an approval from United before getting it done (other hospital 2 blocks away doesn't have that same requirement??)

I got referred to a dedicated cancer center and then guess what, I have to call United and ask them to approve it - but I can't get an appointment to do that for 2 weeks.

Ended up doing all the legwork on my own and was able to get a consultation done within a week. Now I'm having to do biopsies, PET scan, ect. Depending on the result I might be able to get it removed next week!

But the pain has become so severe I can't eat, sleep, even lay down without extreme discomfort. I can't imagine waiting around on the insurance to walk me through it.

Funny enough, United sent us a letter in the mail asking if I really wanted to get that original CT scan! Like no, I'd rather not know I have a 7" tumor in my abdomen. Simply a joke of an industry

I had a knee injury. Called my local orthopedic clinic (seven doctors). The lady who answered the phone told me I’d need to schedule an appointment . . . to schedule the appointment. I was three weeks out from the call at which I would schedule the appointment that would likely be months after that. American medicine is totally broken.

> It seems to be a universal truth that getting a CT/MRI comes with a long wait time.

I wonder if this is regional. I was able to get an MRI scheduled within a couple weeks when I needed one for my non-urgent condition. This was in Chicago, so maybe we're just blessed with a surplus of MRI machines.

I was able to get one for my head once on the same day. One of the symptoms must have raised some major red flags, I guess. This was in Heidelberg, they have a huge medschool. For my knees I waited for weeks, if not months, though.

Just outside Washington, DC my MRIs were scheduled within 4 days.

Universal in what country? In the US I've had two MRIs in the last few years for non urgent things and both were scheduled within less than a week.

The hold up is usually almost entirely insurance related for most people. People in my family (including myself) have had non-emergency imaging done several times over the past few years. We've had experiences ranging from getting it done same day to taking over a month to get approval and scheduled. This is in DFW, where there's no shortage of MRI machines around.

Meanwhile there are imaging labs that can do walk-ins if you're willing to pay cash and they have the slack in their schedule, usually somewhat cheap compared to what they'll bill insurance (and if you have a HDHP, what you'll pay). They don't want those machines idle, a gap in the schedule is money they aren't making.

I was wondering why Americans purchased MRI gift cards.

> getting a CT/MRI comes with a long wait time.

How long? It took me 1 day to get a CT at a clinic and a few hours in the ER.

I've seen anything from weeks to months. Weeks when it's the imaging center being booked, months when insurance requires pre-approval or something and times things poorly (hitting the legal deadline but missing the procedure's date for their approval, using the prior approval to deny "getting another" procedure on the date you rescheduled the missed scan, etc).

Two months for me. PET/CT has even longer waiting times here.

What metro or region is that?

> It seems to be a universal truth that getting a CT/MRI comes with a long wait time

It 100% depends on your situation. I've had two clinical MRIs done in my life. One was same day. One was scheduled out a few days.

My brother in law just got diagnosed with Glioblastoma yesterday. He’s only 31. Sadly I don’t think we are winning fast enough for him or people in his situation.

Like this?

https://www.bbc.com/news/world-australia-69006713?utm_source...

Sadly Richard has now had recurrence. There is still hope for this treatment for others, and it likely extended his life, but it isn't happily ever after this time.

Link to a recurrence article, 2025 March 10: https://www.abc.net.au/news/2025-03-10/richard-scolyer-poor-...

more recent update from 2025 June 11: https://www.dailymail.co.uk/news/article-14800467/Professor-...

Four years ago today, I was diagnosed with primary mediastinal B-cell lymphoma, a form of diffuse large B-cell lymphoma, a form of non-Hodgkin's lymphoma.

Three years ago on May 26, I was declared in complete remission at MD Anderson, a month after a CAR T-cell infusion. I am still in complete remission after multiple PET scans and CT scans.

The specific therapy I received (Yescarta) was approved by the FDA for refractory diffuse large B-cell lymphoma on October 2017. It was the second such therapy approved by the FDA, and the second that year, after Kymriah in August.

Feels a bit odd to be saved by a class of therapy more than three decades younger than I am.

https://en.wikipedia.org/wiki/Axicabtagene_ciloleucel

https://en.wikipedia.org/wiki/CAR_T_cell

"Secretly," but perhaps in the sense that most are not exclusive enough to have the coverage, disposable income and proximity to specialists. A close family member of mine was diagnosed with stomach cancer at a very young age. I looked into getting an endoscopy and it took more than a month to see my primary for the referral and about seven months out for the endoscopy. The hospital says there a chance insurance will cover nothing.

The difficulty is that we only care about healthcare for everyone when we're affected, not before. Realistically, every man woman and child in the USA should demand better by organizing massive peaceful protests.

https://archive.is/ibUdx just in case

also, recently ferroptosis made the news as general mechanism to kill metastases https://www.nature.com/articles/s41586-025-08974-4

seems like a new path too, the more the better :)

ps: apparently cancer drug resistance is linked with tumor adaptability which relies on iron and copper, and these researchers leverage this as a weapon against itself, very clever

Are you french by any chance?

This article made big news in France recently, but I have not heard of it anywhere else. I'm wondering if that thing is really the revolution it's been touted and I just missed the international news talking about it, or if it's just another example of "Look, France is great!" propaganda by french media.

Edit Note: I'm french.

Yeah I'm french and it seems that yeah it was promoted above average, that said, this is the first time I hear about the ferroptosis strategy (and it seems a fine tuned approach) so I guess it's not 100% self-flattering (r. rodriguez didn't seem the narcissistic kind either). And it was old news and I fell for the publicity then I apologize.

Great news. Meanwhile, diabetes type 1 remains an incurable disease. I feel like humanity failed people with diabetes type 1. You could argue it's easier to destroy cells (while curing cancer) than create them (as it would be required in curing diabetes type 1), but it nonetheless feels surreal we still don't have a cure despite all of the technological progress. While it's getting worse and the number of affected people grows every year.

A woman in China received a transplant of pancreatic beta cells derived from her own, induced pluripotent stem cells. She was able to go off insulin, even a year out.

A cure for T1D is coming.

https://www.cell.com/cell/fulltext/S0092-8674(24)01022-5

This sounds like a very meaningful first step in the field of regenerative medicine! Incredibly exciting news.

Life expectancy for T1D diagnosis in 1980 is 15 years longer than those diagnosed in the 1960s.

Life expectancy seems to continue to trend upwards.

My wife is alive and healthy with T1D, which doesn't matter at all for your claim, but the aggregate evidence for all T1D seems far removed from humanity failing diabetics.

CAR-T and closely related immunotherapies are the definitive breakthrough. It will continue to get more and more effective against more and more types of cancers. The research issues surrounding them now are about cost and about how to manage the potentially fatal complications from using it against certain situations, especially developed solid tumors.

The chart understates it. Since 1990 when the death rate started falling, median age in the US rose from 32.9 to 38.5 years and vast majority of cancers are age-correlated. So we are speaking of at least 2x age-corrected decline, if not more.

I wish my cousin (triple-negative breast) and mother-in-law (ovarian) knew we were "winning the war". I'm excited about new immunotherapy and genetic treatments, and I think the tide might be turning, but winning the war is a ways off.

if only kamala had won and we didnt just cancel a bunch of research like this

Any serious ideas for a recently removed glioblastom?

I was short the stock of a company called Novocure, and my thesis was based on the science. Novocure developed a literal helmet you wear on your head. It's designed to generate alternating electric fields at specific frequencies and blast them into your brain. I was skeptical, because biotech frauds are a dime a dozen, and nothing I could read in their literature made sense to me as a mechanism of action against GBM.

The randomized, double-blind phase 3 trials came out and it turns out the helmet almost triples 5 year survival rates. For "high compliance" patients (i.e. those that followed their directions and wore the helmet in accordance with the treatment plan), 5 year survival rates jumped 6x. They're selling $600mm of these helmets a year now. Progress is uneven but it's always coming!

What in the world is the putative mechanism behind that? That's fascinating.

Pessimist in me wants to say: people with brain cancer who can keep up with daily life and follow complex operating instructions for esoteric hardware to a tee for prolonged period of time are self-selecting for better outcomes.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9574373/

The biggest effect seems to be interfering with mitosis (cell division) and causing cells that attempt mitosis to die.

In adult human brains, most cells don't divide, except cancer cells.

Hmm so non-ionizing electromagnetic fields DO have a biological influence apart from thermals now? That's... concerning news?

I was highly confident there was absolutely no way in the world wearing Bluetooth Earphones would have any kind of impact on my brain, but now this would seem like a possibility?

If you review the TTField information, you can see that the fields these devices emit are much stronger and at lower frequency bands. For instance, a smartphone held 5 cm away emits roughly 0.025 V/cm, whereas the helmet we're discussing hits you with anywhere between 1.0 and 3.5 V/cm. So the lower band is about 40 times stronger than a smartphone held against your temple!

Wireless headphones emit 10-400 times less energy than smartphones do. My personal takeaway is that you're safe.

3 orders of magnitude of margin in terms of power is still way less than I expected, considering that I have these devices on my head for 3 order of magnitude more hours than people using that treatment.

Of course there are dose effects and non linearities so we should very very likely be good. But huh.

I guess bioelectricity. Michael Levin is the guy to look at afaik.

Thanks @missedthecue, i wasn't aware this was productized and tested (though hoped it was)

Michael Levin focuses on manipulation of intercellular bioelectric signaling. This research is in electric field generation. They both involve electricity, but only one is modulating bioelectric circuits. The other is essentially vibrating certain cells to death.

The treatment has been improving over the years, and the survival rate is going up. It’s definitely one of the most challenging forms, if our progress rate is anything to go by.

This is misleading. A rise or fall in one kind disease doesn't mean anything out of context. Most people die of something so a fall in one disease may just as well mean that people die from something else instead. In this case, the drop in cancer seems to be the inverse of the rise in "neuropsychiatric conditions and drug use disorders". You can't die of cancer, when you are already dead from fentanyl overdose.

I'm sorry.

https://archive.ph/nsJe5

That graph! It's like in 1991 someone flipped a switch and the line just drops.

Looks like they did flip a switch, but not a medical one, according to my AI friend:

Around 1990, several key shifts occurred in U.S around cancer:

- Federal Advertising Restrictions (1980s → 1990s trend)

- Cigarette ads were already banned from TV and radio since 1971, but by the late '80s and early '90s, there was increasing pressure to further restrict tobacco marketing, especially to youth.

- Synar Amendment (1992)

        Required states to prohibit the sale of tobacco to individuals under 18.

        States risked losing federal funding if noncompliant.

- Local and State Laws

        Late 1980s to early 1990s: many cities and states began passing clean indoor air laws restricting smoking in workplaces, restaurants, and public areas.

        Examples: San Luis Obispo, CA (1990) banned smoking in all indoor public places.

- Surge in Litigation

        States began exploring lawsuits against tobacco companies for Medicaid costs related to smoking-related illnesses.

- Rise of Public Health Advocacy

        CDC established the Office on Smoking and Health as a national anti-smoking effort.

        American Nonsmokers' Rights Foundation and other groups pushed for local ordinances.

- Increased Tobacco Taxes

        Several states raised cigarette taxes as a deterrent and revenue tool.

- EPA Classification and Risk Assessments

    EPA expanded its Integrated Risk Information System (IRIS), classifying substances based on carcinogenic risk.

    Substances like benzene, formaldehyde, dioxins, and asbestos were formally assessed and increasingly restricted.

- Clean Air Act Amendments (1990)

    Major overhaul targeting hazardous air pollutants (HAPs), including 189 known or suspected carcinogens.

    Mandated technology-based emissions standards for industries emitting these substances (Maximum Achievable Control Technology - MACT).

    Examples: emissions from chemical plants, refineries, dry cleaners.

- OSHA Activity

    Occupational Safety and Health Administration tightened exposure limits for carcinogens (e.g., formaldehyde, cadmium).

    Enforcement of hazard communication (HazCom) standards requiring MSDS labeling for toxic/carcinogenic workplace chemicals.

- Right-to-Know Laws

    Expansion of EPCRA (Emergency Planning and Community Right-to-Know Act), empowering communities to track local industrial emissions via the Toxics Release Inventory (TRI).

    Helped spotlight local exposure to carcinogens.

- Superfund and Toxic Cleanup

    CERCLA (Superfund) activity peaked; sites with carcinogenic contamination (e.g., PCBs, VOCs) were targeted for cleanup.

    Public concern about cancer clusters near toxic waste sites gained visibility.

- California Prop 65 (1986 → active in 1990s)

    Required businesses to label products or areas with chemicals “known to the state to cause cancer or reproductive toxicity.”

    Influential beyond CA due to market pressure on manufacturers.

Not to remove credit from doctors, but the best treatment for cancers is to not create them from the start.

One of the best wins for longevity historically has been hygiene, safety design for products/places/processes, avoiding wars, and using fossil fuel to replace slavery. Medicine helped (particularly vaccines, antibiotics, and emergency surgery), but you can't offset society-level problems with it, especially since it's more expensive to scale.

So when I see such a graph, I always look for more general reasons first.

We'll see a similar drop once we tackle sugar, weight gain, and various legal and illegal addictive substances.

Despite an aging population

And yet it’s still legal to smoke in your apartment.

Maybe in your country.

In the US it’s not a criminal offense, it’s a civil matter. Even if a building is smoke-free (which includes incense and cheap scented candles) property management usually won’t evict unless they have ironclad evidence but that’s nearly impossible to get. Strong circumstantial, i.e. smoke coming out of an apartment, isn’t enough for them to act.

I’ve always felt like cancer is one big war, but in reality, it’s more like countless small battles happening all at once. I have a friend who went through this — he had a very rare form of cancer and had to do multiple rounds of chemo, and each round felt like starting over again because what worked once didn’t always work again.

Now, seeing that cancers once thought to be nearly hopeless have five-year survival rates going up, it’s really impressive. I just hope we’ll keep seeing more good news like this in the future.

    it’s more like countless small battles happening all at once

That's also how wars work. World wars, anyway! (May there never be another)

I hope your friend is doing okay.

>World wars, anyway! (May there never be another)

there without a doubt will be another one at some point in time imo

I agree. Relevant PhD Comics: https://phdcomics.com/comics/archive.php?comicid=1162

In case it saves a life, some papers report Fenbendazol cures some cancers.

https://vigilantnews.com/post/the-overlooked-miracle-drug-fo...

One of the few instances where I think GenAI will lead to a cure. So much research done, yet not enough people in the world to fully focus on finding the needles in the haystacks

I dunno about generative AI, but machine learning has already shown promising results in for example spotting early cancers on X-rays and scans that doctors missed.

It’s pretty amazing. I’m a survivor, so far, and it’s amazing.

As an aside, Godwins law apparently needs a corollary name for trump. Almost every thread on here anymore brings him up. I understand people are emotional about it, but it sure is getting old.

It certainly is a shame that he’s fucked up so many things so badly. I can’t wait til he’s no longer relevant.

JD Vance has entered the signal chat

The anti-science movement runs deeper than just Trump unfortunately.

In the case of this specific post, it is unfortunately very appropriate to bring him up: his administration is enthusiastically setting back the US’s ability to study, treat, and cure cancer by years and possibly decades; his cuts at the FDA are setting back the availability of new therapies and his cuts to AHRQ and are undermining our ability to study whether the ones we have work; and his proposed budget would strip access to healthcare (including cancer screening and relevant preventative care) from tens of millions of Americans. Oh and his administration’s attack on higher education, and his immigration policies relating thereto, are gutting our scientific and biomedical workforces.

So while I am as sick as anybody about hearing about him, on a thread about advances in cancer treatments, it would be awfully weird to ignore the elephant in the room. Just sayin’.

And don't forget the anti-vaccine attitude rampant in his administration. The HPV vaccine stops an infection that is known to lead to cancer.

https://pmc.ncbi.nlm.nih.gov/articles/PMC6001440/

Excellent point; the administration has a serious and well-publicized antipathy to mRNA vaccine technologies in particular, and has begun to suppress research in that direction. Given that mRNA vaccines are one of the biggest advances in vaccine technology in decades, and that mRNA-related techniques are key to many of the most promising methods for treating a whole host of rare diseases etc., it seems absurd that we would intentionally be seeking out agnotology in this space, but here we are.

Well, Trump inspired a carve-out exception to Godwin's Law from Mike Godwin himself.

I'm sorry you're tired of hearing people document the end of the American experiment.

Humans are certainly not winning the war on cancer. Not even close. Now, even children perish from cancer in America. Things are getting worse, not better. When you get cancer, you'll better understand the hopelessness.

> Now, even children perish from cancer in America

Is this a recent phenomenon? I never thought that children were immune to cancer.

No, we are not.

The death rate goes down but the number of cancers increases. Cancer is extremely painful even if you survive.

Cancer treatment should be like taking antibiotics, a week of pain and it is over. We should activate the natural inmune defences instead of extremely invasive chemotherapy.

We are far from that.

> We should activate the natural inmune defences instead of extremely invasive chemotherapy.

Yeah, it's a shame researchers don't work on immunotherapies for cancer, I bet they could do some nifty shit with engineered t-cells.

Is there a pattern to these increases? Is it because so many other diseases have been prevented or cured that it causes more people to live long enough to get some form of cancer?

Yep. And for the smashed to pulp extremities I would suggest a fast regrowth of an arm or a leg, preferably in a week or so.

More seriously: cancer is no joke and so are the treatments.

In case it saves a life, some papers report Fenbendazol cures some cancers.

https://x.com/MakisMD/status/1845353670407233817

https://x.com/skymeds_store/status/1919695848222687548

https://vigilantnews.com/post/the-overlooked-miracle-drug-fo...

That first tweet sounds utterly deranged.

largely a rant about "contaminated mrna covid-19 vaccines" that ends tagging Tucker Carlson and Joe Rogan lmao

Link three is largely a list of scientific papers that show the effectiveness of Ivermectin and Fenbendazol in curing cancer.

You laughing your ass off triggers alarms.

My mate Gary from down the pub said ivermectin cured his grandmas cancer and that the medical elite doctors are just hiding it because ivermectin is cheap and doesn't make much money.

All the proof I need. Although she died 3 weeks ago, but he swears it wasn't from the cancer but old age.

It isn't.

> Mainstream Oncology collapsed after the rollout of contaminated COVID-19 mRNA Vaccines.

> Most Oncologists abandoned their Hippocratic Oath, gave contaminated mRNA Vaccines to all their cancer patients and took the mRNA jabs themselves.

> Some Oncologists have now developed mRNA Induced Cardiac arrests, blood clots and Turbo Cancer. Others have already died suddenly.

> These Oncologists buried their heads in the sand and abandoned everything that it takes to be a good competent doctor.

No, it's pretty damn deranged. If you have a good medical treatment, you can confidently let the data do the talking for you instead of hooking into political controversies to score some points for yourself.

You're being a bit gratuitously negative, which is against HN rules, considering the magnitude of the potential impact of this work. Ivermectin won the Nobel Prize.

"First-in-the-World Ivermectin, Mebendazole and Fenbendazole Protocol in Cancer has been peer-reviewed and published on Sep.19, 2024!"

Chemotherapy as I understand it works by killing rapidly-dividing cells (which is why your hair falls out).

Fenbendazole purportedly slows down cell division, allowing the immune system a chance to catch up with the cancer cells.

So they would seem to employ similar mechanisms. I hope more clinical trials are performed soon.

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