[HN Gopher] Almost half of cancer deaths are preventable
___________________________________________________________________
Almost half of cancer deaths are preventable
Author : LinuxBender
Score : 185 points
Date : 2022-09-04 16:12 UTC (6 hours ago)
(HTM) web link (www.nature.com)
(TXT) w3m dump (www.nature.com)
| sxg wrote:
| This article is saying a lot less than the title leads on. The
| article states half of all cancer deaths are caused by smoking,
| alcohol, and obesity. Nearly every patient in the developed world
| is aware that all three of these are bad, but the struggle is in
| changing course on these three behaviors rather than a lack of
| knowledge that they're bad.
| AdrianB1 wrote:
| It used to be true that people know these three are bad, but
| this changed a few years ago when aggressive corporate
| marketing on the "body positivity" changed the perception about
| big BMI incredibly, many people these days believe it is
| perfectly healthy to be seriously overweight. I am quite upset
| by the marketing around this matter, it is ruining lives.
| blacksmith_tb wrote:
| It seems possible that articles like this which help quantify
| the risk might do more to change behavior than the vague
| understanding that smoking, drinking, and being overweight are
| "bad for you". Many people will have had family or friends who
| developed cancer and if lucky, endured harrowing treatment and
| lived. Or did all that and didn't survive. Connecting those
| dots is a powerful motivator.
| Godel_unicode wrote:
| Is it? I think in the US that connection is quite well known,
| and yet I have seen people lose parents and grandparents that
| way and keep eating McDonald's at a prodigious rate.
| photochemsyn wrote:
| Workplace exposure to carcinogens is another major factor, as
| the article notes:
|
| > "In 2019, half of all male deaths from cancer, and more than
| one-third in women, were due to preventable risk factors
| including tobacco and alcohol use, unhealthy diets, unsafe sex
| and workplace exposure to harmful products, such as asbestos.
| From 2010 to 2019, global cancer deaths caused by these risk
| factors increased by about 20%, with excess weight accounting
| for the largest percentage of increase -- particularly in
| lower-income nations."
| loeg wrote:
| Is unsafe sex an oblique reference to cervical cancer, or is
| there some other known connection I'm not aware of?
| zaroth wrote:
| I would assume they are talking about HPV which causes
| cervical, oral, and other cancers effecting men and women.
|
| Condoms are at best ~70% effective at preventing HPV
| transmission so the "unsafe" part doesn't really strike me
| as apt. Generally everyone who is sexually active has at
| least one strain of HPV.
|
| HPV vaccination seems like the optimal strategy. It's so
| weird to me that initially it wasn't even offered to boys.
| photochemsyn wrote:
| There's quite a long list of viruses which have a knock-on
| effect of increasing cancer risk, although often by
| indirect routes. HIV of course damages the human immune
| system, and one immune function is the detection and
| elimination of cells that have escaped the normal cell
| cycle control (i.e. potentially cancerous). Hepatitis
| damages the liver and (often in conjunction with alcohol
| use) that can raise chances of cancer. HPV I think has a
| more direct effect, in that the virus actually can
| integrate into DNA and potentially (depending on the
| specific strain) disrupt cell cycle control. Here's a list:
|
| https://www.healthline.com/health/cancer-virus
| epistasis wrote:
| HPV causes a wide variety of cancers, and we are learning
| more all the time. (I'm still furious that this is not a
| population wide vaccine, and is so limited in its
| availability.)
|
| Epstein Barr spreads primarily through saliva, and also
| causes 1-2% of cancer, the last time I checked. So that
| could spread from unsafe sex, but it could also come from
| picking up slobbery toddler's toys.
|
| There's a whole world of virus and infectious disease that
| is only becoming visible because of the huge advances in
| nucleic acid sequencing and other massive biotech advances.
| We may find lots of surprises in the coming decades from
| this new technology.
| graeme wrote:
| Probably hpv. Causes a variety of cancers:
|
| https://en.wikipedia.org/wiki/Human_papillomavirus_infectio
| n...
| lkschubert8 wrote:
| There is a pretty strong relationship with HPV and a few
| different cancers.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120915/#:~:te
| x....
| icegreentea2 wrote:
| > The researchers used 'unsafe sex' as a proxy for cancer
| risks associated with human papillomavirus (HPV) and other
| sexually transmitted viruses. Cervical cancer, which is
| caused by certain strains of HPV, is the leading cause of
| cancer deaths among women in sub-Saharan Africa.
|
| HPV also plays into a variety of other cancers
| (throat/mouth, anal, penile, vaginal). Though cervical
| cancer has by far the strongest link.
|
| Throat/mouth/neck cancers are actually strongly correlated
| with smoking, alcohol consumption, and HPV
| (https://www.cancer.gov/types/head-and-neck)
| mc32 wrote:
| Was this what struck Michael Douglas?
| freeone3000 wrote:
| It's a good thing we have a vaccine for several of the
| cancer-causing HPV variants now. It's essentially a
| vaccine against some cancers -- I would get it if you
| can.
| skeeter2020 wrote:
| and yet we run into a strong religious resistance because
| if some skewed logic around HPV vaccine => wanton
| premartial sex. Once again the patriarchy strikes.
| rayiner wrote:
| Apparently the patriarchy was protecting people from
| cancer until this vaccine was invented five minutes ago.
| antegamisou wrote:
| > The article states half of all cancer deaths are caused by
| smoking, alcohol, and obesity.
|
| Add chronic sun (UVA) exposure, #1 leading cause of skin cancer
| yet still not addressed by popular media.
| Cupertino95014 wrote:
| No, don't add chronic sun.
|
| The reason it's not in there is because almost no one dies of
| basal cell, the most common skin cancer. Malignant melanoma
| is another matter, but that is much more rare, and also quite
| treatable.
|
| I've had several myself and know lots of other people who
| have, too. They're handled via outpatient surgery and there
| is no followup.
| skeeter2020 wrote:
| skin cancer is a serious medical issue, but not when we're
| talking fatalities.
| kortilla wrote:
| > Nearly every patient in the developed world is aware that all
| three of these are bad,
|
| Not so much. The whole body positive movement has swung the
| pendulum too far to where obese people are "healthy" now.
| [deleted]
| dionidium wrote:
| > _Nearly every patient in the developed world is aware that
| all three of these are bad_
|
| Smoking, yes, we seem to have broad support for that one (way
| beyond what the facts support, even, but that's probably for
| the best). But the other two? I don't think so. There's a lot
| of confusion out there about alcohol use. Most people still
| think small amounts are basically fine (maybe even good!), even
| though more recent studies [0] suggest that isn't true.
|
| And we're trending the wrong way on obesity, too. [1]
|
| [0]
| https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
|
| [1] https://www.scientificamerican.com/article/can-you-be-
| health...
| Scoundreller wrote:
| > Most people still think small amounts are basically fine
| (maybe even good!)
|
| Legalize safer alternatives now!
| [deleted]
| Izkata wrote:
| > But the other two? I don't think so.
|
| IIRC the argument about obesity is simply more cells = more
| chances for something to go wrong that turns into cancer.
| copperx wrote:
| Does cancer ever start in adipose tissue?
| pessimizer wrote:
| Yes, but fat people also have more muscle and skin.
| oaktrout wrote:
| Obesity also contributes to inflammation,fat cells release
| pro-inflammatory adipokines.
| lupire wrote:
| Also, more food => morr oxidation => more damage.
| mattmaroon wrote:
| It's practically impossible to to do a controlled study on
| any of these, so we'll likely never know for sure. If you
| were tasked with creating a study to determine, for any
| reasonable definition of "certainty", whether small amounts
| of alcohol increase or decrease one's lifespan, you'd never
| be able to come up with anything that passed any sort of
| moral or practical sniff test.
|
| So what you are left with is trying to tease causation out of
| relatively loose correlation, which is and always will be so
| problematic as to be near useless. The results will always
| just support the researchers' pre-conceived notions.
|
| Smoking is only so obvious because the rates of lung cancer
| there are an order of magnitude more. 80-90% of lung cancer
| is in smokers, while only 12% of Americans smoke. No other
| health issue is so clear, people who are moderate drinkers
| only have very slightly elevated risks of almost everything,
| so it could be confounded.
| TaupeRanger wrote:
| The article you linked (and in fact , no study exists) to
| support your claims about small amounts of alcohol. In fact
| plenty of evidence exists to the contrary.
| jnovek wrote:
| "The level of alcohol consumption that minimised harm
| across health outcomes was zero (95% UI 0*0-0*8) standard
| drinks per week." Seems pretty clear.
|
| It's likely that the risk of,(e.g.) one drink per month is
| also very low. What's not here is the inflection point
| where alcohol consumption goes from a (subjective) minimal
| risk to an elevated risk.
| dionidium wrote:
| I would just note here that the CDC is unequivocal on
| this point with respect to cigarettes, saying always that
| there is "no safe level of consumption."
|
| I think that sort of language is basically absurd, but
| the message it sends is crystal clear: this thing is bad
| for you, even in small amounts, and you're doing harm
| when you use it.
|
| I think the CDC could easily settle on the same language
| with respect to alcohol, if there weren't socio-cultural
| reasons not to.
|
| Another aspect of this is that we discourage even light
| cigarette use because of the fear that users might become
| addicted and escalate their usage. [0] It's interesting
| how rarely you hear that kind of an argument against
| drinking alcohol, and yet, unlike with smoking, increased
| usage can actually be ruinous. On the day you take your
| first sip of alcohol you're accepting a 1 in x risk that
| you'll end up a problem drinker (where x is anywhere from
| 3 or 4 to 20, depending on what definition of "problem
| drinker" you're willing to accept).
|
| [0] I remember many years ago when I was a very light
| smoker trying to find statistics online about moderate
| cigarette use and it was basically impossible, because
| every single statement about cigarettes was of the form,
| "you won't be able to only smoke a little, so don't even
| bother trying."
| lupire wrote:
| Smoking a cigarette makes you want more. Drinking a beer
| doesn't do that.
| MandieD wrote:
| You know there's a reason you don't offer even a single
| drink to a recovering alcoholic, right?
|
| A single drink is unlikely to hurt anyone, as long as it
| stays a single drink.
|
| There are a lot of people who can do a good job of not
| having that first drink, but have a really hard time
| stopping once they've had it.
|
| And beer is the beverage of choice of a surprising number
| of alcoholics.
|
| So yeah, for a lot of people, drinking a beer makes them
| want more.
| kortilla wrote:
| > Drinking a beer doesn't do that.
|
| There are a lot of binge drinkers that beg to differ.
| sarchertech wrote:
| I know plenty of people who have 1 drink a day, I know
| absolutely no one who smokes 1 cigarette per day. I'm
| sure they exist, but not in my n of several hundred, so
| I'd bet that's it's pretty rare.
|
| Smoking is also much more obnoxious and directly harms
| anyone near. This is a first order effect, not a 2nd
| order effect like increased risk of car accidents.
| robocat wrote:
| You are splitting hairs. A lot of drinking is due to
| social effects, for example drinking behaviours due to
| being around friends who are drinking.
|
| Many cancer societies are now recommending zero alcohol,
| for example in New Zealand (where I have some reasons to
| trust the organisation):
| https://www.cancer.org.nz/cancer/reducing-your-cancer-
| risk/a...
| Cupertino95014 wrote:
| Nice to meet you.
|
| In college, for a year or so, I smoked one cigarette a
| day. Eventually, I decided _any_ number was too much, and
| stopped entirely.
|
| So yeah, it's a population that probably either graduates
| to a big habit, or gives it up completely. Fortunately
| I'm in the latter group.
| dionidium wrote:
| Lots of people smoke cigarettes socially. There are in-
| jokes amongst smokers about the people who "don't smoke"
| who want to bum a cigarette in the smoking area outside
| at bars.
|
| It's extremely common.
|
| > Smoking is also much more obnoxious
|
| I'm not sure I've ever disagreed more with a claim than I
| do this one. People who have consumed alcohol are
| _practically unbearable_ to the sober. And that 's before
| we get into stuff like the fact that alcohol is
| implicated in some staggering percentage of all violent
| crime. Or drunk driving. Etc, etc.
| sarchertech wrote:
| We're talking about light use here. I very rarely drink,
| and people who consume a drink or 2 with dinner are
| totally fine to be around.
|
| On the other hand, a person smoking 1 or 2 cigarettes
| near me is actively harmful to my health. If you want to
| find a field somewhere to smoke sure, I won't find it
| obnoxious, but no one does that.
|
| >Extremely common
|
| sure I've met those people, I've never met one who does
| it anywhere near daily. Also most of the ones I've known
| drift in and out of periods of being heavy smokers.
|
| Again I have met many people who can drink a glass of
| wine every night. I have never met a single person who
| smokes a single cigarette after dinner. To me that says
| there is something different about cigarettes that makes
| them harder to moderate.
| fiddlerwoaroof wrote:
| > I have never met a single person who smokes a single
| cigarette after dinner.
|
| On the other hand, there are people who smoke one cigar
| occasionally: cigarettes, for whatever reason, seem to be
| a lot more addictive than other forms of tobacco
| consumption.
| rrrrrrrrrrrryan wrote:
| Cigarette breaks are a great -feeling way to punctuate
| your day because they force you to step outside for a
| brief moment once in a while with only your thoughts, and
| so they easily become tremendously habit-forming.
|
| The good thing about cigars is that they're terribly
| inconvenient. They're harder to acquire, harder to store
| properly, harder carry around, and they take nearly 10x
| as long to smoke. I've smoked a few cigars per year for
| almost 2 decades, and I can't imagine doing the same with
| cigarettes. Nobody really buys and smokes an entire pack
| of cigarettes in one night every few months (because it
| would be insane), but if they did, it's unlikely they'd
| become addicted.
| [deleted]
| dionidium wrote:
| > _On the other hand, a person smoking 1 or 2 cigarettes
| near me is actively harmful to my health._
|
| This would be impossible to verify and strains credulity.
| People have gotten a little too comfortable making
| outlandish claims about the effects of secondhand smoke.
| MauranKilom wrote:
| I'm not going to pull up statistics based on arbitrary
| consumption thresholds, but I would reason there are
| _way_ more consumers of alcohol around me than smokers.
| Yet the number of times I 've had to bear nuisance from
| smokers vs from drunkards is higher.
|
| Generally speaking, (here) smoking is forbidden in most
| indoor-ish spaces - which is the only reason smoking is
| anywhere close to the same level of nuisance as drunk
| people. Note that the same people that would enforce "no
| smoking" can also do something about the "practically
| unbearable" drunk person. And in outdoor-ish spaces, you
| can often avoid being affected - except in e.g.
| restaurants, where someone chain-smoking on the neighbor
| table can ruin the evening.
| TaupeRanger wrote:
| That does not support the claim that avoiding or stopping
| drinking lightly/socially will make you less likely to
| die or less likely to have disease. Drinking _at all_ is
| associated with other unhealthy behaviors, alcohol
| drinking is just easy to tease out of data, but not
| necessarily causal. If you are a healthy person with
| healthy behaviors who drinks lightly (probably almost
| everyone reading this thread), there is no evidence that
| mortality or morbidity are increased with light drinking.
| jnovek wrote:
| You really believe that light alcohol consumption carries
| no risk?
|
| For example, no one has ever, in the history of humans,
| had a single beer which has impaired them enough to get
| into a fatal crash? Even a single such accident would
| raise the impact of alcohol above the baseline by some
| tiny amount.
|
| Perhaps the impact is minimal but it certainly exists.
| lupire wrote:
| _Someone_ in history has also teetotaled, failed to make
| friendships, and died choking on a piece of food while
| sitting at home alone.
| rowanG077 wrote:
| I'm not sure what your point is. Yes if humans wouldn't
| need to eat to survive it would obviously be better to
| never eat anything.
| pjerem wrote:
| The point is about the "social lubricant" role of
| alcohol.
|
| We may like it or not, but since prehistory, alcohol
| helped groups, friendships and couples to spawn from
| nothing.
|
| It is reasonable to ask if being sober and lonely at home
| is healthier than making social connections that alcohol
| helps to create and maintain.
| rowanG077 wrote:
| That's a pretty strong claim there. Yes you are right
| that alcohol has a role a social lubricant. But to claim
| not having leads to being lonely at home is extreme.
| lazyasciiart wrote:
| You have no idea of the actual baseline though. Perhaps
| the effects of one glass of alcohol on blood pressure and
| some random internal protein already give light drinkers
| an average extra three days of lifespan, which would far
| outweigh your one time a beer killed someone.
| dionidium wrote:
| There's reason to believe those earlier studies used flawed
| methodologies:
|
| > _But there was a problem with many of these studies: They
| compared drinkers to non-drinkers, instead of comparing
| only lighter drinkers to heavier drinkers. And people who
| don't drink are pretty fundamentally different from
| drinkers in ways that are hard to control for in a study.
| Their lives probably look dissimilar.
|
| > Most importantly, they may be sicker at baseline (perhaps
| they quit drinking because of alcoholism, or because of a
| health issue like cancer). And something in these
| differences -- not their avoidance of alcohol -- may have
| caused them to look like they were in poorer health than
| the moderate drinkers. (This became known as the "sick
| quitter" problem in the world of alcohol research.)
|
| > Lately, researchers have been trying to overcome that
| problem by comparing lighter drinkers with heavier
| drinkers. And the benefits of modest amounts of alcohol
| wash away._
|
| And that even moderate amounts of alcohol are harmful:
|
| > _Their findings were stark: Drinking more than 100 grams
| of alcohol -- about seven standard glasses of wine or beer
| -- per week was associated with an increased in risk of
| death for all causes, they concluded. In the US, the
| government suggests men can drink double that amount -- up
| to two drinks per day -- but advise women who are not
| pregnant to drink up to one drink per day.
|
| > A person's risk of death shot up as they drank more. The
| researchers used a mathematical model to estimate that
| people who consumed between seven and 14 drinks per week
| had a lower life expectancy at age 40 of about six months;
| people who drank between 14 and 24 drinks per week had one
| to two years shaved off their lives; and people who imbibed
| more than 24 drinks a week had a lower life expectancy of
| four to five years._
|
| My sort of baseline here is that nobody would think twice
| about this if they weren't motivated to justify continued
| consumption. It's fairly obvious that it's bad for you.
|
| Source: https://www.vox.com/2018/4/24/17242720/alcohol-
| health-risks-...
| TaupeRanger wrote:
| But those weren't problems at all with many such studies.
| For example, this one showed light drinking reduces risk
| of leukemia by 10%: https://pubmed.ncbi.nlm.nih.gov/24986
| 108/#:~:text=Compared%2....
| lupire wrote:
| Come on
|
| > the relative risks (RRs) for all leukemia were
|
| > 0.94 0.85-1.03 "any"
|
| > 0.90 0.80-1.01 "light"
|
| > 0.91 0.81-1.02 "moderate to heavy"
|
| There is no signal there.
| MichaelCollins wrote:
| > _between seven and 14 drinks per week_
|
| That's already heavy drinking in my book; drinking every
| day of the week, or binge drinking at least once every
| week? Somebody drinking that much already has a clear
| habit and is probably developing an alcohol tolerance, a
| major step towards alcoholism.
|
| To me, a light drinker is somebody who has a drink on
| special occasions but not otherwise. One drink a week or
| less, so they're going several days if not weeks between
| drinking. I suspect the long-term harm from that is next
| to immeasurable.
| dijonman2 wrote:
| Alcohol is enjoyable and I prioritize happiness and
| satisfaction. I'll gladly trade in some risk for a delicious
| beverage and a buzz every once in awhile.
| gambiting wrote:
| Smoking is also enjoyable and gives people happiness and
| satisfaction. That isn't the point. The point is that
| cancers caused by drinking/smoking/being obese are
| preventable by behavioural changes.
| [deleted]
| pantalaimon wrote:
| Smoking has a pretty bad risk/reward ratio.
|
| It's better with alcohol and that is already not an ideal
| drug in that regard
| pessimizer wrote:
| > And we're trending the wrong way on obesity, too.
|
| It's absolutely creepy how there's a constituency of people
| who are upset by any scientific possibility that fat people
| could be relatively healthy, or be made relatively healthy,
| without losing weight. The desire for fat people to conform
| or be punished, damn the science, is fetishistic. That's the
| only motivation I can think of for being upset by the
| exploration of the precise effects that being fat has on
| health.
|
| I'm nowhere near fat right now, but if there were an
| injection that saved fat people from insulin resistance and
| inflammation, the farthest thing from my mind would be to get
| upset about it. If you believe that gluttony is a mortal sin,
| no need to be upset if the only ways fat people are punished
| on earth are cardiovascularly, through their knees, and
| through the aggression of bullies; your deity can punish them
| after death for not eating as moderately as you would have
| preferred.
| ravenstine wrote:
| I don't necessarily disagree, because yeah, having lots of
| adipose tissue doesn't necessarily mean anything is wrong
| at the moment. In my experience, the perpetually healthy
| fat person is a rarity. The possibility of being fat and
| otherwise healthy is used as an excuse the vast majority of
| the time to not actually address one's own health. If
| someone is fat, it would really be a good idea to get a
| DEXA scan to confirm that they don't have too much visceral
| fat. As any one who's pro-fat or body positive if they know
| what their level of visceral fat is and chances are they
| couldn't tell you what visceral fat is.
|
| There should be a reasonable medium where fat people aren't
| outright shamed for being towards one end of the bell curve
| but red flags for unhealth aren't ignored for the sake of
| other's feelings. America and now many parts of the west
| are facing various health crises to such an extent that I
| don't think obesity should be brushed off as perhipheral to
| other problems. Being fat has many comorbidities, and just
| focusing on losing fat is usually the best way to address
| those issues.
|
| > I'm nowhere near fat right now, but if there were an
| injection that saved fat people from insulin resistance and
| inflammation, the farthest thing from my mind would be to
| get upset about it.
|
| I agree, and there kinda sorta are medications currently
| available that would tremendously help. Off the top of my
| head, I don't know what it's called, but I know some people
| who've been on next-generation medications for obesity that
| target the ghrelin-leptin balance, basically correcting
| one's sense of hunger and satiety. Having seen the results
| myself, it works insanely well.
|
| On the other hand, solving obesity with a pill still has
| some moral issues. If everyone could just consume anything
| they want in massive amounts and not get fat, I don't think
| that's really good for a person's psychology in a similar
| sense that giving someone a bunch of money often doesn't
| end well. It's not a scientific argument, but a
| philosophical one; I know. Such drugs may also give someone
| the idea that they can just eat whatever they want because
| they don't gain weight, but just because you don't get fat
| doesn't mean there aren't other consequences to eating lots
| of sugar, carbs, odixated oils, etc.
|
| The question should be why we are so fat now. But that
| would mean believing that experts can be compromised and
| that a century of nutrition policy has been a failure,
| which many people aren't ready for. Just my opinion.
| joe_the_user wrote:
| Smoking and alcohol consumption are behaviors. Obesity is a
| condition and what behavior can change it is subject to intense
| debate and not at all settled imo.
| v7engine wrote:
| I have been smoking for close to 15 years now and I'm 40. I
| still struggle with quitting smoking even though I tell myself
| daily today is the last day.
| Clockface12 wrote:
| The older you are when you smoke, the worse it is for you.
| Smoking in your twenties is far less harmful in terms of its
| likelihood to cause cancer than smoking in your forties,
| fifties, or sixties. The damage gets worse with every decade
| of your life.
|
| Just stop. In five years' time, you'll wonder why you didn't
| stop sooner.
| skeeter2020 wrote:
| > Just stop.
|
| Not a smoker but my initial reaction to you is probably
| pretty close to that of a smoker, and not particularly
| favourable. How can you possibly think that a deeply
| physiological addiction is going to respond to either
| logical arguments or simplistic slogans? Once you fix
| smoking, can you please stop the opioid crisis?
| oaktrout wrote:
| I would look into varenicline (chantix), talk with a doctor.
| I know some people will bring up incredibly rare side effects
| as reasons not to try, but I think those are sort of like
| plane crashes, they happen sometimes and cause a very
| visceral response, but the majority of people will do fine
| flying on a plane. Also, smoking will contribute to an early
| death, so the risk benefit calculation makes sense to me.
| amanaplanacanal wrote:
| I found getting a prescription for bupropion from my doctor
| made quitting much easier. That was 20 years ago now.
| tmountain wrote:
| You can do it.
|
| One thing I've seen work for people is making a significant
| investment into a smoking counter measure. Extreme example,
| hire a personal trainer for $75/hr and go to the sessions 3x
| per week.
|
| Now you are investing $225/week into your health, and you're
| going to want to get maximum ROI from that investment, right?
| Well, smoking is diminishing that ROI. Secondly, you have
| someone encouraging you to do the best possible work you can
| do with your body every time you go to a session. You'll
| naturally want to avoid disappointing that person. You'll
| also want to see continued progress in the results they are
| measuring. Smoking will impede that progress, and again,
| minimize your ROI.
|
| This worked for someone very close to me after everything
| else failed. Incidentally, that person stopped going to the
| trainer after a while, but only after quitting "stuck". Good
| luck in your journey and never quit quitting.
| gibolt wrote:
| Would be great if today actually is the last day! Maybe visit
| this post everytime you get an urge? Don't bring a pack with
| you. Make it a nuisance to even access one.
| Thlom wrote:
| The one thing that helped me quit smoking was snus. It's not
| healthy, but much much better than cigarettes.
| pandoro wrote:
| I can recommend to read Allen Carr's "Easyway to stop
| smoking" if you haven't already. I had been smoking for 15
| years total as well, tried to stop at least 6 times
| (sometimes for 18 months, with the help of Nicorette and
| e-cigs) and was telling myself "today is the last day" every
| single day. But I was constantly tempted and was always
| picking it up again. A lot of ex-smokers I knew kept
| recommending me this book with almost magical claims. I
| finally begrudgingly read it and stopped from one day to the
| next. The craziest thing is that it was actually easy to stop
| this time and gave me great satisfaction. I have stopped for
| 2 years now and am confident that I will never smoke again
| (contrary to all other attempts).
| nilsbunger wrote:
| Congratulations! What clicked for you from reading this
| book compared to everything else?
| rzazueta wrote:
| I'm not a smoker, but know many, many people who are
| legitimately addicted to tobacco. What is it about the
| content of this book that made such a change in you? I'd
| love to hear about your experience - it sounds like an
| extraordinary approach if it indeed works as well as you're
| saying, which makes me think it's some kind of written
| neurolinguistic programming thing, a technique that could
| be helpful in a lot of other situations.
| [deleted]
| md224 wrote:
| I don't smoke, but my understanding of that book is that
| it basically reprograms your associations re: smoking and
| quitting smoking.
|
| Before you read that book, quitting smoking is perceived
| as a loss of something that made you feel good. The
| permanence of this loss -- the anticipation of living the
| rest of your life without this source of comfort -- leads
| to cravings.
|
| What the Carr book does is install a new set of
| associations: smoking is disgusting and your life is
| going to be so much better once you free yourself from
| this completely unnecessary weight that's been dragging
| you down. Instead of viewing quitting as the loss of
| something good, you learn to view it as the act of
| freeing yourself from something bad. Now, when you think
| about a future without smoking, the anticipation is
| _positive_ : you get to live the rest of your life
| without this terrible thing intefering with it! And all
| you have to do is just stop doing it! Sure, you might
| have a little bit of physical withdrawal for a little
| while, but isn't that worth it to be permanently free of
| this awful thing that's been ruining your life?
|
| That's the basic gist, as far as I can tell. In a way,
| it's just about being optimistic about a life without
| cigarettes instead of pessimistic.
| pandoro wrote:
| That's a very good summary of the approach. It stems from
| the observation that every single smoker already know
| about all the reasons they should not smoke (health,
| financial, social,...) yet they still do it.
|
| You know it's probably going to kill you, you know it
| costs a lot of money and you know it's anti-social. The
| book wastes no time trying to convince you about those
| things. However, it dispels in a very systematic and
| repetitive way all the positive myths you believe (or
| repeat to yourself) about cigarettes ("the
| brainwashing"). It does not actually relax you or bring
| you pleasure, it just relieves a nicotine addiction and
| allow you to get back to a state you already had before
| smoking. It does not taste good. It does not help you
| focus. Nicotine withdrawal is actually extremely mild.
| Etc.
|
| As the parent comment explains it's a re-framing, a
| change of paradigm. By the end of the book I could very
| clearly see that quitting would not be a sacrifice or "a
| pleasure i would loose" but something that would make my
| life better. And to be honest, this has felt like magic.
| A few days after finishing the book I just threw my pack
| in the trash and it really has been easy and at times
| actually even pleasant to quit. Every cigarette you do
| not smoke brings you a feeling of pride, accomplishment
| and liberation.
| bmy78 wrote:
| "This Naked Mind" by Annie Grace takes a similar approach
| with alcohol.
| sosborn wrote:
| Don't say it is the last day. Start by saying today is a day
| that I won't have one. Then, maybe you can say that tomorrow
| too.
| gausswho wrote:
| You have some good news because recent longitudinal studies
| show a 90 percent reduction in cancer risk if you stop at 50.
| 80 percent if 50. If you're older than that, your body can't
| keep up the same.
| wikitopian wrote:
| Just switch to vaping.
|
| It's easier to step down with it, and if you fail to step
| down, you're still getting fewer carcinogens.
| surfsvammel wrote:
| "In 2019, half of all male deaths from cancer, and more than one-
| third in women, were due to preventable risk factors including
| tobacco and alcohol use, unhealthy diets, unsafe sex and..."
|
| How does unsafe sex cause cancer? What is unsafe sex in this
| context?
| retSava wrote:
| Probably cancer from HPV virus, which (at least in Sweden) is
| vaccinated against in 10 (11? 12?) year-olds, before their
| sexual debut. HPV is so transmissible and so common that on
| average, if you have had 2-3 partners, you can kind of count on
| having HPV.
| yieldcrv wrote:
| It's been a decade since 12-18 year olds were getting the
| vaccine
|
| You can just stick with adult Gen Z people now
|
| Finally a _good_ excuse to not hook up with older people
| geysersam wrote:
| The other direction is rather more interesting in my opinion: No
| matter _what you do_ , you can only reduce your chance of getting
| cancer by 50% compared to the average population.
| _trackno5 wrote:
| "Only" and "50%" don't make much sense together in this
| sentence.
|
| 50% is a lot.
| sgtnoodle wrote:
| 50% of a tiny number is a tiny number. If the absolute risk
| of dying from any cancer is small, decreasing that risk by
| 50% isn't that much of an improvement overall.
| beefman wrote:
| Virtually all deaths from solid cancers are preventable with
| routine scans to find tumors before they metastasize. Doctors
| have for decades refused to learn to use this
| technology.[1-4][5-9] *
|
| Meanwhile, population studies like the one this article is based
| on[10] are horseshit because they are subject to unknown degrees
| of sampling bias, rely on enormous assumptions (such as linear
| relationships which may not hold at all being applied over many
| orders of magnitude), and cannot in any case establish causality.
|
| [1] https://www.pocus.org/ [2] https://www.butterflynetwork.com/
| [3] https://www.exo.inc/ [4] https://vavehealth.com/
|
| [5] https://ezra.com/ [6] https://www.halodx.com/ [7]
| https://www.prenuvo.com/ [8] https://www.simonone.com/ [9]
| https://www.lifeimagingfla.com/
|
| * Compare the experience of getting an x-ray from a dentist to
| getting one from a doctor. Or getting an ultrasound from an OB to
| getting one from any other doctor.
|
| [10] https://pubmed.ncbi.nlm.nih.gov/35988567/
| mfer wrote:
| There is a fair amount of scientific study that has linked diet
| to some cancers. Those same diet attributes that can make one
| obese also lead to higher rates of cancer.
|
| In cancer prevention, lifestyle matters.
| loxias wrote:
| > Virtually all deaths from solid cancers are preventable with
| routine scans to find tumors before they metastasize.
|
| Fantastic. I take it from those links this would be detectable
| with a full body MRI? I already wanted an excuse to start
| getting those regularly.
|
| > Compare the experience of getting an x-ray from a dentist to
| getting one from a doctor. Or getting an ultrasound from an OB
| to getting one from any other doctor.
|
| Can you expand on this? It sounds like you're implying
| something (I might agree with), but am not sure.
| PragmaticPulp wrote:
| > Fantastic. I take it from those links this would be
| detectable with a full body MRI? I already wanted an excuse
| to start getting those regularly.
|
| There is a lot of research on the topic but it doesn't agree
| with the OP's thesis. Full body scans can be purchased if you
| have the funds, but you are far more likely to get false
| positives than to actually catch a cancer this way. The
| ensuing medical costs and possibly even unnecessary surgeries
| are statistically likely to cause you more detriment than any
| benefit you might receive. This is counterintuitive to many,
| but the truth is that it's not actually easy to spot nascent
| pre-symptomatic cancers from full body scans without
| incurring a massive number of false positives along the way.
| Something like 1 in 8 people will end up getting flagged for
| "warning signs of potential cancer" during these scans that
| turns out to be nothing upon further investigation. Few
| people continue to get the tests for this reason.
| lupire wrote:
| I think the difference is that ultrasound/imaging is routine
| annual from dentist and monthly or whatever from OB during
| pregnancy, but otherwise requires a specialist referral for a
| specific injury or complaint.
|
| It's also the case that a pregnancy is a hugely obvious
| invisible but major health situation, and teeth are expected
| to rot frequently.
| aaaaaaaaaaab wrote:
| >I already wanted an excuse to start getting those regularly.
|
| Psychotherapy can help with hypochondria.
| loxias wrote:
| Hahaha :) Close, but no. Regularly I mean "roughly yearly",
| and I'm a signals processing dork, not much of a health
| nut.
| sgtnoodle wrote:
| If you're looking for a hobby, it's 2022 and you can buy
| better-than-a-potato ultrasound gear on eBay for less
| than $1000. Also, cheap ECG amplifiers are quite
| available these days.
| mikotodomo wrote:
| Wait, so I've been avoiding McDonalds all this time for no
| reason? I literally lost a GF because I decided to skip eating
| one afternoon when the only place close to us was McDonalds!
| picture wrote:
| Routinely scanning people without symptom or otherwise cause
| for concern is not a good idea. The human body is very messy
| and variable, and it's hard for anyone or anything to reliably
| spot thing that are actually worth acting on. If the doctor
| spots a vague blob - how can they know what it is without any
| symptoms? The course of action is then "come back in three
| months for another scan."
|
| Subjecting a population to unnecessary routine full body scans,
| especially with radiation, will cause harm statistically. There
| are also countless examples of people undergoing unnecessary
| operation and suffering complications, like losing a perfectly
| fine healthy heart and requiring transplant.
| landryraccoon wrote:
| Wouldn't the skill of analyzing scans improve if they were
| done more frequently?
|
| It seems like you're promoting a self fulfilling prophecy.
| Doctors aren't good at reading scans, so scans will cause
| false positives.
|
| But doctors are capable of learning and improving their
| skills. They will surely rapidly learn to screen a lot of
| false positives, thereby saving lives.
| MauranKilom wrote:
| You seem to assume that radiologists currently see patient
| scans too rarely to deliver accurate diagnosis. That seems
| very unfounded to me.
|
| "More frequent scans per patient" != "More scans seen per
| clinician". You would just end up having to hire more
| clinicians.
|
| (Yes, your family doctor might end up seeing more scans in
| this scheme, but it is implausible that they would be
| better at evaluating them than a trained radiologist, which
| is who this would almost surely be deferred to anyway.)
| landryraccoon wrote:
| Is the argument then that scans are intrinsically error
| prone, as in the noise level is so high that even a team
| of highly trained radiologists can't accurately determine
| if cancer is present from a scan?
| MauranKilom wrote:
| It's not the quality of the scan (although that can
| certainly be a factor). It's that there is a lot of
| variation in human anatomy, and "these pixels are
| brighter than the rest" can mean any of many things.
|
| Relatedly, for many types of brain tumors, you simply
| don't know what exact kind of tumor it is until you
| actually do a biopsy (= you undergo surgery). This can be
| important information ("how aggressive is it?"), so in
| some hospitals it is common practice to send a tissue
| sample for identification and get back the result while
| the surgery is still going on.
| moonchrome wrote:
| This is a very naive argument, it assumes the entire
| problem is lack of skill and that early intervention on
| positive diagnosis is always a good thing.
|
| Mammography is a really good candidate for random screening
| and it's still debated because of false positives and the
| impacts of misdiagnosis.
| paulpauper wrote:
| the screening guidelines take into account those risks and
| it's still deemed worthwhile because cancer can grow and
| become lethal despite being asymptomatic. colon cancer is the
| mid-life killer...plenty of ppl in their 50s or even 40s get
| it despite no risk factors. Screening is the only option to
| catch it early.
| valenterry wrote:
| We need yearly scans or even monthly scans (MRI) for
| everyone. Privacy concerns aside, I think we would learn an
| awesome lot. We could then monitor changes over time and
| machine-learning could probably get really good at
| recognizing what changes are harmless and which are harmful
| and need a doctor to look into.
|
| It's a dream scenario, but maybe some day it will be like
| that. Or it will be like that and be dystopia. :)
| discardable_dan wrote:
| MRIs would need to take a fraction of the time for this to
| be viable.
| derefr wrote:
| Or, y'know, we could have 10x more MRI machines, thus
| incentivizing them to be cost-optimized in ways they
| absolutely aren't today.
| likeabbas wrote:
| Not necessarily, we just need cheaper ones. I interviewed
| at Hyperfine last year and they seemed to have a
| promising product
|
| https://hyperfine.io/
| throwaway09223 wrote:
| No they don't. I would happily take a few hours each year
| to get an MRI done.
|
| We would need more machines, but even now the prices
| aren't too exorbitant for something done annually (or-
| even every few years)
| lazyasciiart wrote:
| 20% of americans havent even seen a doctor in the last
| year. MRI prices for a fun test are far beyond a huge
| percentage of the country.
| https://civicscience.com/20-u-s-adults-not-seen-doctor-
| past-...
| throwaway09223 wrote:
| "20% of americans havent even seen a doctor in the last
| year"
|
| And 80% have. The needs of the 80% are not determined by
| the behavior of the bottom 20%
|
| Rich people get better everything, including better
| medical care. The upper 30% or so can afford better
| diagnostics and they should be getting those better
| diagnostics.
|
| Many of us in the software industry could afford a few
| extra thousand a year for preventative care -- but it is
| very difficult to obtain care commensurate with one's
| ability to pay. This is a real problem.
| valenterry wrote:
| Well, I wouldn't call them "fun tests" but otherwise
| that's true.
|
| However, there is also a chance to save a lot of money by
| recognizing illnesses early. Sometimes it's possible to
| prevent a life-long need to take expensive
| medicamentation or it allows to detect cancer and allow
| for easy surgery in an early stage allowing for complete
| cure instead of requiring expensive chemotherapy AND
| surgery for a long time with a worse outcome. It might
| also very well prevent people from being unable to work
| due to illnesses if they are detected early enough.
|
| And that all isn't even considering the changes in
| quality of life of course.
| cableshaft wrote:
| Yeah I think my last MRI was $800, with insurance. And
| they didn't find anything. I'm not exactly champing at
| the bit to spend the money to do that every year.
|
| If it were $50-100, maybe then.
| throwaway09223 wrote:
| Everything's relative. I've had about 8 MRIs in the last
| few years.
|
| I also wouldn't bat an eye at spending $1k on
| preventative care each year. Many Americans are paying
| that annually for premium TV shows.
| cableshaft wrote:
| I've had like 4 MRI's total. The most recent one was I
| had a scare about a possible aneurism, which is what they
| didn't find anything for, and then had a couple for
| looking at my neck and back, where they found two bulging
| disks, one in the middle of my back and one in my lower
| back. And they had to check my leg for something once,
| maybe blood clots? I haven't needed to get one for
| several years now.
|
| MRI's don't seem that great for an annual preventative
| check, since they are usually checking a pretty small
| area (or at least mine were). Like those were 4 different
| MRI's to check me from head to one of my calves. Getting
| 4+ of those a year would add up quick. And that's not
| even taking into account any of a myriad of other tests
| that could be done every year. I'm sure I could probably
| take a different test every week of the year, but I'd be
| bankrupt quick.
| throwaway09223 wrote:
| Why would you jump to an absurd scenario like one every
| week?
|
| It would be an enormous benefit to do one MRI a year,
| rotating between areas of interest, at a relatively
| negligible cost ($500-1k or so per year - about what it
| costs for an annual physical).
|
| It's extremely cheap compared to your Dr's hourly
| billable rate and would get cheaper at scale.
| dan00 wrote:
| Yes, the breast cancer screening already has quite
| questionable results.
| ssivark wrote:
| > especially with radiation, will cause harm statistically.
|
| Ultrasound is not radiation (as in photons). To the best of
| our understanding (from a physics/engg perspective)
| ultrasound imaging capped by appropriate energy/etc limits is
| expected to be perfectly safe. Likewise with MRI. If we want
| more pointed study to be sure of this, that's fair, but let's
| be clear & specific about it and commit to figuring it out
| one way or another so we don't repeat the same discussion a
| couple of decades down the line. (We have to think of moving
| the state of the art forward, instead of festering in
| unresolved disagreements)
|
| Further, if you're concerned about under-studied possible
| side-effects of radiation from occasional diagnostic testing,
| what do you plan to do about being blanketed by mm waves once
| 5G gets deployed more ubiquitously?
|
| > There are also countless examples of people undergoing
| unnecessary operation and suffering complications
|
| This sounds far more serious (and fixable) compared to the
| physics/biology interaction of diagnostic testing. Why do we
| continue to bury our heads in the sand collectively, instead
| of trying to fix this with better decision-making tools?
| DanBC wrote:
| > Likewise with MRI
|
| MRI isn't radiation, but is sometimes used with contrast
| dye. People can be allergic to the dye. For one person this
| is a small risk. Across a population we'd be causing harm.
| We'd balance the risks of harm against the benefits, and so
| far no-one can find a benefit to routine whole body MRI
| scans. And if the benefit was there the MRI machine
| companies probably would have found it by now because it'd
| massively increase the numbers of machines they could sell.
| robocat wrote:
| MRI uses electromagnetic radiation. MRI uses a magnetic
| field with a radio-frequency pulse and then the protons
| emit a radio-frequency response - that response location
| is used to synthetically generate the image. MRI does not
| use ionising radiation. Nice overview here:
| https://www.nibib.nih.gov/science-education/science-
| topics/m...
| voldacar wrote:
| This is just silly. You are never disadvantaged by knowing
| more about what's inside your body. What you don't know can
| easily kill you, though.
|
| Hopefully in the long term future we will have extremely
| cheap & frequent MRI and blood testing so you can assemble a
| high resolution digital history of your body. Doctors are
| generally not very innovative people though and they will
| probably resist it to the end.
| bagels wrote:
| It's not silly. Look at how the mammogram guidelines are
| set. If the scans are too frequent, the harm done from
| false positives (unnecessary surgeries and risks from those
| surgeries) can become too great. The standards were relaxed
| to include fewer scans in the last few years because of
| this.
|
| Apply this to more invasive exploratory surgeries, and you
| see people dying from internal surgery complications for
| benign cysts and lumps.
| derefr wrote:
| That's because single datapoints are used to trigger
| intervention. We should be intervening based on growth
| trends from time-series data. Time-series data which can
| only be collected by... frequent scans.
| Sebb767 wrote:
| Don't discount psychological stress. "You have something
| growing in your breast which might be cancer, just wait a
| few months and we'll scan again" is not something that
| gives people a good nights sleep.
| jghn wrote:
| It can be hard to predict how aggressive a tumor will be.
| It isn't uncommon for people to obtain cancers that they
| "die with" instead of "die of". In those cases, treatment
| can be worse for the patient than the cancer. But since you
| don't know which it'll be, people get the treatment and
| sometimes wind up worse off than they otherwise would have.
|
| And as the GP post cites, the scans themselves can cause
| health problems down the road. Performing them on massive
| scale will increase the occurrences of those side effects.
| gzer0 wrote:
| Full body scans, as they currently exist, are not
| recommended for routine-usage. These scans use large
| amounts of radiation. This can increase your risk of
| cancer. If you have more tests, your risk increases.
|
| Further, they are costly, and often times insurance does
| not reimburse or cover it. They can cost anywhere from
| $500-1000.
|
| Unless you find a way to make this viable for the general
| population and lower the radiation exposure, this will
| never become viable for use.
| DanBC wrote:
| > You are never disadvantaged by knowing more about what's
| inside your body.
|
| Yes, you are. This has a name - over-testing, over-
| diagnosis, and over-treatment. It's a significant cause of
| harm in healthcare.
|
| https://www.bmj.com/content/358/bmj.j4070
|
| https://qualitysafety.bmj.com/content/31/1/54
|
| https://www.choosingwisely.org/patient-resources/whole-
| body-...
| closeparen wrote:
| Knowing that there is something weird in your body sets off
| a cascade of medical care that easily escalates to surgery,
| anesthesia, medication to manage complications, side
| effects of that medication, time in the hospital being at
| risk for infection, etc. These things absolutely can kill
| you, or at least put you through hell. When there was
| actually nothing wrong with you in the first place. That is
| why the medical establishment is so conservative about it.
| telchior wrote:
| Isn't the danger of knowing there's something weird there
| caused by the rarity of knowing anything at all?
|
| I'd imagine that if there was consistent, good
| information available, we'd figure out how and when to
| act on it. The real issue is the massive cost of
| performing any given scanning procedure to everyone
| alive.
| lazyasciiart wrote:
| No. Doctors already think about this. Why do you think
| they aren't doing prostate scans and mammograms
| constantly on everyone?
| closeparen wrote:
| The question is not even what doctors think warrants a
| follow up. The question is what a malpractice attorney
| could construe as warranting a follow up, if it turns out
| later to have been real.
|
| Once a scan exists, doctors are essentially forced to act
| on it. If an algorithm for deciding which scan results to
| pay attention to were so solid that it would hold up in
| court, that might make more scanning reasonable on the
| margin? I dunno though.
| _qua wrote:
| What is your medical background? I am a physician and do not
| agree with your thesis. Linking to ultrasound websites is not
| really evidence of anything.
|
| There simply isn't good evidence that "all solid tumors caught
| early are curable." Some cancers, like localized breast cancers
| and certain renal cancers, are highly curable when caught
| early. Some other non-solid cancers like certain pediatric
| leukemias are also extremely responsive to therapy and highly
| curable. Conversely, some solid tumors, even when caught early,
| have dismal prognosis due to micrometastasis and the underlying
| biology of the tumor. I would recommend "The Hallmarks of
| Cancer" for a high level overview of the current understanding
| of what drives cancer:
| https://doi.org/10.1016/j.cell.2011.02.013
| saiya-jin wrote:
| He has no actual clue, thats for sure. On top of all correct
| items you mention, some stuff is completely benign and should
| be left alone. Nobody will know that until operation or
| other, very invasive procedures are taken which have their
| own risks anf consequences.
|
| Especially at older age, many things killing slowly are just
| too slow and other items will surpass them in achieving that
| kill, ie prostate cancer in basically all men (according to a
| close friend who is swiss urology surgeon its only question
| of time we all males get it, but most of the time you dont
| know about it and it progresses super slowly).
|
| There are many things like this. That doesnt mean there isnt
| a room for improvement. I have some bad experiences too, but
| my wife is a doctor and medicine is HARD, every case properly
| unique. IT and stuff google et al do is trivial and
| deterministic by comparison.
|
| We all would like this idea that medicine can cure it all,
| but we are far, far from it. But some folks apparently just
| love reading "10 things THEY don't want you to know about
| XYZ" articles and actually believe them.
| paulpauper wrote:
| much of this discussion is bad, whether it's people who
| insist their healthy lifestyles will prevent cancer or
| thinking that all cancer is preventable
| bagels wrote:
| Some of those devices are not decades old either, regardless
| of the other problems with the thesis.
| echelon wrote:
| Does a physician have a globally optimal understanding?
|
| Do you actively read medical journals? Developments in
| biochemistry? Even amongst the best read physicians and
| researchers, I would bet my life that we're doing a lot of
| things suboptimally or have improper understanding of many
| diseases.
|
| I'm not trying to belittle your understanding or your
| credentials, which I understand to be far better than
| untrained laymen.
|
| The current state of medical care leaves a lot to be desired.
| We have a long way to go to detect and cure every disease
| state.
|
| If more money is spent on developing better tooling, assays,
| imaging, etc. we will undoubtedly improve patient outcomes.
| lazyasciiart wrote:
| A globally optimal understanding would involve far more
| than biochemistry and medical journals - population
| analysis, behavioral economics, regular economics, risk
| analysis, and a crystal ball would all be needed to avoid
| "doing a lot of things suboptimally". The fact that you
| haven't even mentioned those fields of study makes it clear
| you're not familiar with even the scope of the problem, let
| alone how to solve it.
|
| Hell, we could improve patient outcomes enormously by
| paying for everyone to receive basic dental care, today.
| PragmaticPulp wrote:
| > Does a physician have a globally optimal understanding?
|
| I'm far more inclined to trust a trained physician than a
| random HN commenter whose first four citations are just
| random ultrasound device manufacturer websites. The parent
| comment makes bold claims and tries to overwhelm the reader
| with non sequitur citations, but it's clear they don't
| actually understand the subject matter.
| adventured wrote:
| While I agree with your premise, how the hell do we know
| the parent is a trained physician? This is an anonymous
| forum. Without a long, elaborate history on HN or public
| credentials, to be of meaningful value in terms of trust
| (in the context we're discussing) the reply needs to
| bring a lot more to the conversation than a one line
| statement and claim of being a doctor. Maybe they are a
| doctor, great: they can add a lot more to the counter
| reply if so, information that they are in theory
| particularly equipped to discuss.
| DanBC wrote:
| > While I agree with your premise, how the hell do we
| know the parent is a trained physician?
|
| We don't know, but it doesn't matter. We can go to
| websites like the BMJ and see trained physicians and
| researchers saying the same thing across a range of
| different articles.
|
| We can go to research organisations like NICE, or
| Cochrane, or the UK National Screening Committee to see
| doctors and researchers saying the same thing. For mass
| screening, the harm often outweighs the benefits.
| spaghettiToy wrote:
| A scientist posts data, then a physician comes in and let's
| everyone know they are the authority and confidently uses
| their gut feeling to say "wrong!"
|
| What an iconic duo...
|
| I really hope we get AI to take over medicine, after being
| misdiagnosed for a decade and having 2 kids misdiagnosed I've
| lost faith in Authority based medicine.
| oaktrout wrote:
| POCUS is used commonly in my experience and there are large
| amounts of curriculum devoted to it. We haven't had affordable
| access to POCUS for decades so I don't see how doctors have
| refused to learn it for decades.
| ssivark wrote:
| Do you think that affordability is the biggest hurdle holding
| back POCUS from being used ubiquitously for diagnostic
| imaging, or is it something else?
| oaktrout wrote:
| Probably not. Costs have come down immensely, most HN users
| could afford a butterfly if they wanted to play around with
| it.
|
| Ultrasound has limited penetration for deeper tissues so
| you aren't going to see lung cancer with it (especially
| behind ribs), and overweight patients don't image as well,
| again because of limitations in imaging depth. Regardless
| of uptake it's not going to solve all our diagnostic
| challenges.
|
| It also takes skill to know what you are seeing and to know
| how to find what you're looking for. Anyone could learn,
| but it's a time investment and physicians have limited time
| as is.
|
| Still, it is becoming more popular and soon it won't be
| uncommon for your primary care doc to pull out the probe
| and see if your gallbladder is inflammed or if that abscess
| is going to be amenable to in office drainage.
| [deleted]
| PragmaticPulp wrote:
| Your first four links are just random ultrasound device
| companies. Doctors are very well-versed in ultrasound
| technology so your claim that doctors refuse to learn this is
| patently false.
|
| Full-body scans have been marketed for years by companies
| looking to drum up business for their machines, but they mostly
| lead to false positives. Notice how your fifth link clearly
| says it has helped people find "warning signs of potential
| cancer" instead of that it helps people find cancer? These
| machines are basically false positive generators in most cases.
| If someone had effectively infinite time and money to dedicate
| to routine cancer screenings from these machines, they are more
| likely to end up harmed by unnecessary procedures stemming from
| false positive results than they are to catch and remove a
| specific cancer occurring randomly in their bodies.
|
| Contrary to your claims, we _do_ actually screen for certain
| cancers in cases where a clear net positive benefit can be
| demonstrated. Mammograms for breast cancer are one common
| example.
|
| Doctors definitely aren't just burying their heads in sand.
| These are common research topics and the tradeoffs of false
| positives are constantly being investigated. Full-body
| screenings aren't necessarily a net benefit.
| sigmoid10 wrote:
| There's also a lot of politics and social psychology involved
| in these things. From the government side, it can be decades
| between arranging, deploying and evaluating large scale,
| population-wide cancer screenings. These are timescales on
| which scientific consensus can easily change. Mammograms in
| particular are a touchy subject, since newer metastudies only
| show a statistically significant reduction in mortality for
| women above the age of 50 and below the age of 74 [1].
| However, many policy makers still offer screenings starting
| at the age of 40 with no upper limit, despite evidence that
| annual mammograms will result in a false positive result over
| 10 years with up to 61% probability [2]. Below the age of 50,
| regular mammograms may even _increase_ the risk of dying from
| breast cancer [3]. Ultrasound screenings on the other hand
| would be much safer from a radiation-exposure point of view
| and metastudies suggest they can detect cancers under
| difficult conditions more reliably, but they also suffer from
| more false positives [4]. This is where the social aspect
| comes in, where many woman fear getting their breasts removed
| for no reason. This is especially concerning when more than
| 50% of positive results are found to be false positives [5].
| To summarize: It 's really hard to figure out what amounts to
| "net positive benefit" when it comes to general public
| screenings.
|
| [1] https://www.aeaweb.org/articles?id=10.1257/jep.35.2.119
|
| [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3209800/
|
| [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189562/
|
| [4] https://bmccancer.biomedcentral.com/articles/10.1186/s128
| 85-...
|
| [5] https://ebmh.bmj.com/content/16/4/115
| n8henrie wrote:
| What in the world are you talking about?
|
| I'm a physician that uses ultrasound every shift, and I'm
| pretty darn good at it. I've even used one of the specific
| devices you linked to.
|
| Virtually every physician I know is foaming at the mouth to
| learn more ultrasound and to apply it to new indications and
| with new approaches. Inappropriate use of ultrasound for
| harebrained indications (for which we have far superior
| alternatives) is on of my pet peeves.
|
| I am not a cancer doc, but I am drawing a blank as to what
| solid tumors you could possibly be referring to for which
| ultrasound is the preferred screening or diagnostic technique,
| or what kind of conspiracy you're vaguely implying that
| prevents its use. IME, virtually everyone is (over?) eager to
| use ultrasound for every condition under the sun, and I am
| sincerely perplexed as to what experiences have led you to form
| your opinion on this matter.
| Ovah wrote:
| "Doctors have for decades refused to learn to use this
| technology" In Sweden this is actually standard practice. It's
| used for patients who have syndromes that guarantee them to get
| cancer several times over in their lifetime. IIRC some get an
| MRI every 6 months. The reason it's not done to a wider
| population.. well you can't justify the cost in a state funded
| healthcare system. The health benefit just isn't justifiable
| when MRIs are so scarce and expensive to run.
| giantg2 wrote:
| Yeah, and 100% of automobile deaths are preventable too (by not
| driving, which is the same logic applied in the study).
| defterGoose wrote:
| This isn't at all borne out by the data yet, unless you're
| talking about the purely tautological case.
| pimlottc wrote:
| Or by improved road design and better transit alternatives. The
| point is, we can do something about it.
| giantg2 wrote:
| Theoretically you might be right, but feasibly/politically
| that claim is tenuous.
| irrational wrote:
| My brother in laws sister was recently diagnosed with cancer.
| Before she was diagnosed, she quit her job with benefits to stay
| home and take care of her father with advanced Parkinson's. Her
| cancer is treatable and has a high probability of being curable,
| but she doesn't have and can't get insurance and doesn't qualify
| for government help. Her choice is death or go into such
| incredible debt that she will never have hope to pay it off. She
| is 29. She has chosen death.
| synaesthesisx wrote:
| I'm not following. Can't she just take on debt and eventually
| file bankruptcy and get it discharged?
|
| Bankruptcy only has temporary repercussions, and is objectively
| preferable to death, which is permanent.
|
| Medical debt is the leading cause of bankruptcy in the United
| States. Things like cancer can easily result in 7 digit bills,
| even WITH insurance.
| deltaonenine wrote:
| neilv wrote:
| This is in the US? Has she worked with hospital staff, social
| workers, and lawyers (and maybe even federal/state
| representatives/officials) on all the possible ways to swing
| this? (Examples: maybe there's some way to get into ACA
| marketplace insurance soon, or to get onto Medicaid, or to do
| asset protection?)
|
| Stress, and being in the mode of taking care of someone with
| advanced illness, might have her feeling down, and approaching
| and thinking about this differently than she would normally.
| mmaunder wrote:
| Interesting seeing alcohol appear more often as an underlying
| cause of disease. It used to be that alcohol in moderation was
| going to save us all.
| skeeter2020 wrote:
| "Alcohol in moderation" is far less than most think. Depending
| on study, closer to 3 drinks per week or 4 oz of red wine
| daily. How many people do you know who drink, but only 1/2 a
| beer a day?
| mod wrote:
| I own a bar. I don't know any customers who drink 3 only
| drinks per week.
|
| We definitely have some that don't drink, or only a couple
| times per year. They come in and play pool, etc.
|
| But I would guess 95% of our customers drink close to 5
| drinks per DAY, averaged. (It's a local regulars bar, so we
| see the same faces every day).
| visava wrote:
| The solution to obesity is simple. People want tasty food . It is
| possible to make it with healthy ingredients. But market is
| flooded with white flour,sugar,wheat and milk products. It takes
| effort to prepare it yourself.
| colechristensen wrote:
| It's not simple. Tasty food that has a considerable amount of
| water in it which can be produced and distributed on an
| industrial scale cheaply... is not an easy problem.
|
| Really we just need to evolve so that these high energy density
| foods aren't such a problem.
| elcritch wrote:
| I agree if we can sustain these food levels that subtle
| genetic modification would likely be best long term.
|
| Why not up regulate our energy usage and boost our bodies
| self-healing mechanisms, etc?
| anonporridge wrote:
| The solution isn't simple, because the problem is that we have
| bodies that are evolutionarily designed for a world of extreme
| calorie scarcity that are living in a world of extreme calorie
| abundance.
|
| Our deep genetic firmware hasn't been programmed to deal with
| this kind of extremely unnatural corner case, and we're
| collectively breaking because of it.
| yomkippur wrote:
| We just take 3 meals a day for granted without asking where
| this movement really came out of. Hint: agriculture/produce
| won't do well if people only eat 1 meal a day.
|
| Eating one/two meals a day is something that nobody talks
| about as much as this other food conscious movements like
| gluten, carbs, now keto. All of this seems driven at pushing
| demand towards certain sector.
| loeg wrote:
| I think tasty food (regardless of composition) might be the
| problem. If food was less tasty people might moderate their
| consumption better.
| bowsamic wrote:
| I don't think so, I think it's more that we grew to live in a
| "feast famine" environment, but suddenly we are now in an
| environment with infinite food. It goes against our instincts
| to not eat food that is there. Instead we have to hope we
| have the willpower to overcome it with our rational thought
| processes. Most people, if they are not busy with other
| things, will want to eat. "Thankfully" we have capitalism and
| so people are busy and pushed to be even busier. I think
| without that, if we really had time to sit and relax without
| those mental pressures of progression, we would be much
| fatter.
|
| It is just one of the ways that human material conditions has
| quickly changed way faster than the human animal has managed
| to evolve for it, and so it is unsuited for such
| environments. I think we might eventually have a
| technological solution (everyone on appetite suppressants)
| vorpalhex wrote:
| hyper-palatable is the word that has come to be used
| pengaru wrote:
| It's a sort of arms race. Unprepared plain raw organic
| produce is delicious, if you haven't been eating prepared
| food covered in salt and other seasoning for years. Once you
| start adulterating your food with flavor crystals, you
| _require_ that stuff just to move the needle.
|
| A flavor tolerance develops, similar to drug tolerance.
| mod wrote:
| > Unprepared plain raw organic produce is delicious
|
| Yeah, although I doubt it was as delicious before modern
| farming. Or even if it was, we didn't have most of it.
|
| But an animal roasted over a fire is equally as delicious;
| just ask an Alone contestant. One woman ate the gut
| contents of a rabbit and said it was one of the best things
| she'd ever eaten.
|
| Hunger is the best condiment, as the saying goes.
| denimnerd42 wrote:
| I don't think that's simple. People want tasty food with the
| least effort involved. This is a genetic programming.
| buffalo:bear::mcdonalds:healthy_cooking
| capitainenemo wrote:
| Lustig claims there was a catastrophic shift from fats to
| sugars due to blaming fats for obesity. Supposedly fructose
| doesn't trigger the satiation signals that fats do however.
|
| https://www.youtube.com/watch?v=dBnniua6-oM
| watwut wrote:
| Satiation is more complicated then that. You can eat pure fat
| or pure sugar and neither option will make you feel full.
| Both will also cause malnutrition in you, no matter how much
| of them you consume.
| vorpalhex wrote:
| Fats come with their own issues too, especially the shelf
| stable fats that processed food uses as opposed to a bit of
| real butter.
|
| The truth is less exciting: avoid too much sugar or fat. Some
| is fine. Your "fine" and your "too much" may be different
| from someone elses.
| capitainenemo wrote:
| Yeah, fats definitely have issues, but, they come with rate
| limiters - satiation triggers. Heart of his argument is
| that fructose triggers nothing, so you keep chugging it,
| and with almost identical stress to liver as alcohol, which
| also has a limiter for most people (you pass out :) )
| arcticbull wrote:
| Fructose also has different glycemic profile - it doesn't
| trigger the same big spike is blood sugar that glucose does.
| It has to be metabolized by the liver first, which is the
| rate-limiting step. Although, too much can lead to a
| cirrhosis-like condition called non-alcoholic fatty liver
| disease [1]. Sugar is bad, even fructose.
|
| With that in mind, there's no such thing as a minimum
| required daily intake of carbohydrates.
|
| [1] https://en.wikipedia.org/wiki/Non-
| alcoholic_fatty_liver_dise...
| nevrherd wrote:
| smarkov wrote:
| While eating healthier things would probably help to an extent,
| nothing's stopping people from just eating more of those
| healthier foods and still becoming obese. Healthy or not, food
| is calories and a surplus of those calories will lead to weight
| gain.
| brazzy wrote:
| Technically correct but practically beside the point. That's
| not how humans work.
|
| What stops people from just eating more of those healthier
| foods is that they make you feel full more quickly and longer
| with the same amount of calories.
| smarkov wrote:
| I agree that they make you feel full more quickly and for
| longer but a good amount of obese people don't overeat
| because they're hungry, they overeat because it's their way
| of dealing with problems. It's an unhealthy coping
| mechanism like alcohol and drug abuse and should be treated
| as such.
|
| Don't get me wrong, I'm all for having higher food
| standards and healthier foods, I just don't think it'll
| help with obesity as much as you'd think.
| [deleted]
| hombre_fatal wrote:
| I would be surprised if any of the large people in my
| life were overeating healthy foods like oats, chickpeas,
| bananas, lentils. Usually those were the things missing
| from their diet.
|
| Frankly, it seems like low satiating, high dense foods
| are the only foods up to the task of making someone
| obese. e.g. The ease of drinking a liter of Coke vs
| eating that same amount of calories in beans.
|
| I would be interested to see the food diary of someone
| who claims to overeat healthy food. I think it would
| illuminate our mass confusion about "healthy food". The
| healthy foods I think of are the kinds you can eat ad
| libitum without much consequence.
| anonymous344 wrote:
| It's funny how cr is still billions / year, but there has been
| this natural clinic that has cured thousands of people.. .from
| 1970. was it something like gerrison miracle etc..
|
| of course big pharma does not like "free" medicine
| [deleted]
| UIUC_06 wrote:
| The argument that "more knowledge is better, always" is just not
| viable. Not when you look at all the people driving alone in
| their car, or walking alone on the street with a mask on.
|
| There are, as any doctor will tell you, large numbers of people
| who will see their doc for _any_ questionable data and demand
| treatment. Preferably a pill they can take once a day. They are
| not willing to be reassured and will happily go to a different
| doctor who gives them what they want.
| solidist wrote:
| Everything in moderation. Those who are conscientious achieve
| longevity but trade off with less than ideal experiences of
| anxiety.
| darepublic wrote:
| Early detection important but in Canada you aren't going to get
| it unless you are very lucky
| wbc wrote:
| Anyone know of promising cancer startups? Was listening to a
| podcast that mentioned pancreatic cancer mortality rates and it's
| basically a death sentence (stage 1 85%+, later 95%+)
|
| I don't drink or smoke but would love to avoid cancers. Wife was
| working at a great one but it basically shutdown cause clinical
| trials are so expensive.
| xtracto wrote:
| We need more advanced clinical trial /organ-body simulations.
|
| That's what we as Computer Scientists can do... if we could
| have a sufficiently good virtual representation of the human
| body (at least enough parts of it)the cost and time of human
| trials would be reduced so much... it would be revolutionary.
| yomkippur wrote:
| zaptheimpaler wrote:
| Fitter, happier, more productive Comfortable (Not drinking
| too much) Regular exercise at the gym (Three days a week)
| Getting on better with your associate employee contemporaries
| At ease Eating well (No more microwave dinners and
| saturated fats) A patient, better driver A safer car
| (Baby smiling in back seat) Sleeping well (No bad dreams)
| No paranoia Careful to all animals (Never washing spiders
| down the plughole) Keep in contact with old friends (Enjoy
| a drink now and then) Will frequently check credit at
| (Moral) bank (hole in wall)
| [deleted]
| quadcore wrote:
| _Careful to all animals (Never washing spiders down the
| plughole)_
|
| Whats that?
| [deleted]
| thenerdhead wrote:
| Rinsing insects down the drain which drowns and kills them in
| the process.
| quadcore wrote:
| Dont get me wrong I hate to terminate any life, but whats
| the issue regarding health I still dont get it.
| thenerdhead wrote:
| It's a song that talks about the perfect person.
| wikitopian wrote:
| Thank you, fellow nineties emo kid.
| viktorcode wrote:
| > Data show that smoking, drinking alcohol and obesity are the
| biggest contributors to cancer worldwide.
|
| Does this mean that the predominantly muslim states have far less
| cancer cases?
| nativecoinc wrote:
| My paternal grandmother got dementia and eventually died. My
| oldest uncle got dementia and eventually died. My father (the
| middle one) has dementia now. Now my youngest uncle is afraid
| that he only has a few good years left.
|
| My fortunate paternal grandfather just had a heart-related
| incident and died quickly at a much younger ager than his wife.
|
| I follow a good lifestyle to the degree that I do only because I
| want a good quality of life in my middle years and a bit beyond
| that. I am not interested in subsisting on carrots, cauliflower
| and exercise bands so that I can become a fit 75 year old with
| dementia.
|
| Hopefully I'll be lucky and die in early old age or I'll get
| cancer. Dementia can fuck off.
| retSava wrote:
| Anyone know what the curve for alcohol looks like?
|
| I know no amount of alcohol is "safe", and a lot of alc is very
| bad, but in between, what does it look like? Is it a cliff after
| more than 2 drinks a week? 10? Does it matter if it's beer or
| whiskey?
| laurencerowe wrote:
| > Adults drinking seven to 14 drinks per week could expect, on
| average, a six-month shorter life expectancy as of age 40
|
| > Those drinking 14 to 25 drinks per week could expect a
| shorter life expectancy by one to two years
|
| > Those drinking more than 25 drinks per week could expect a
| shorter life expectancy by four to five years
|
| https://www.health.harvard.edu/blog/sorting-out-the-health-e...
| acidburnNSA wrote:
| I don't know, and that is very hard to measure definitively due
| to confounding variables. In the nuclear industry we have a
| similarly hard question for ionizing radiation dose. Since the
| 50s we just use a dumb linear no threshold curve, assuming
| every little bit hurts.
| kazinator wrote:
| When speaking about cancers attributable to lifestyle, why does
| it have to be deaths? Why not incidences of cancer? Not all
| incidences of cancer lead to death.
|
| When a death is prevented, that can be at any stage, from
| avoiding the lifestyle choice like smoking and drinking, to the
| doctors spotting the cancer early and intervening in time.
|
| So if we are talking about cancer deaths preventable through
| lifestyle changes, that is just mixing in too many variable. Some
| incidences of cancer attributed to lifestyle may have been
| prevented from becoming deaths due to medical intervention, which
| clouds the numbers.
| AnonCoward42 wrote:
| The obsession that you can live longer by doing this healthy
| trick is not really helpful. Ultimately you are going to die of
| cancer if you avoid any other cause of death (and even that is
| impossible).
|
| What's annoying me is the survivor bias. How do you know that
| people wouldn't have died earlier if they didn't do what
| supposedly caused the death over decades? Let alone that you
| cannot actually pinpoint what caused the cancer (but guess of
| course).
|
| I think you shouldn't smoke and you probably should avoid alcohol
| or only consume in considerate amounts and don't eat like it's
| your last meal over and over, but you can't just say don't drink,
| smoke and overeat (or even don't eat this, but that) and pretend
| that it is better.
| onion2k wrote:
| _The obsession that you can live longer by doing this healthy
| trick is not really helpful._
|
| It's not simply a matter of 'avoiding cancer' but more
| 'avoiding a slow, painful death due to cancer'. It's not even a
| matter of "you have to die of something!" Most forms of cancer
| are _not_ a nice way to die. If you can avoid getting it so
| that you die of something else, especially something really
| nasty like lung cancer, you _definitely_ want to give that a
| go.
|
| I'm old enough to have seen friends and relatives die of cancer
| and I _really_ don 't want to go that way. Seeing the affect on
| those people, and even more on their families who had to watch
| them fade away, was $^&%ing horrible.
| Otek wrote:
| What I really want is more approachable Euthanasia. I'm not
| afraid of dying, it will happen to all of us, but I dont want
| for me or my relatives a months of pain when everyone knows
| it will only lead to death.
| hombre_fatal wrote:
| Well, you could use your reasoning to justify drinking and
| smoking. Why did you stop there? People live to old age despite
| doing those things. And how can you actually be sure that it's
| the drinking/smoking that killed you? People get lung cancer
| and cardiac events without doing either.
|
| The truth of the matter is that all we can do is try to stack
| the deck in our favor. A major part of life is deciding which
| trade-offs matter to you.
| AnonCoward42 wrote:
| > The truth of the matter is that all we can do is try to
| stack the deck in our favor. A major part of life is deciding
| which trade-offs matter to you.
|
| Which is, what I said. And the trade-off can even be smoking
| or drinking alcohol, even if this does not seem right (to you
| or me). Paracelsus applies.
| autosharp wrote:
| > you can't just say don't drink, smoke and overeat (or even
| don't eat this, but that) and pretend that it is better.
|
| Okay then, nothing you can do I guess. You're hereby absolved
| from behaving responsibly towards your own body. Is that
| better?
| AnonCoward42 wrote:
| > Okay then, nothing you can do I guess. You're hereby
| absolved from behaving responsibly towards your own body. Is
| that better?
|
| >> I think you shouldn't smoke and you probably should avoid
| alcohol or only consume in considerate amounts and don't eat
| like it's your last meal over and over, but you can't just
| say don't drink, smoke and overeat (or even don't eat this,
| but that) and pretend that it is better.
|
| I addressed it already, but let me add this: Just be sensible
| and do what is best for you (in terms of health). There is no
| single way for everyone to do it right.
| oaktrout wrote:
| Large population based studies tell us what caused the cancer.
| If smokers are 20x more likely to get lung cancer we know that
| smoking causes cancer.
| DanBC wrote:
| The advice can be more nuanced.
|
| We know that processed red meat definitely causes cancer. We
| also know that it doesn't cause very much cancer. Our message
| isn't "stop eating processed red meat", it's "if you have a
| family history of colon cancer; if you know you have a genetic
| predisposition to colon cancer; if colon cancer is something
| you're worried about, then you may wish to reduce the amount of
| processed red meat that you eat".
| yieldcrv wrote:
| Avoid it long enough for more effective treatments of cancers
| to exist
| Cupertino95014 wrote:
| Following on the discussion yesterday about "science is political
| and that's bad" (and posters saying "no, it's not"):
|
| Nature Magazine has soiled itself irrevocably with its political
| stances. Now when you read anything like this, you have to ask,
| "was this written because of some new scientific information, or
| was it just in furtherance of their agenda?"
| freeone3000 wrote:
| Furtherance of their agenda to... Get people to stop smoking,
| drink less, and lose some weight? Is this even an agenda or
| just good advice?
| Cupertino95014 wrote:
| It's certainly good advice. However, _Nature_ is there to
| publish new science, not to provide generic advice.
| oaktrout wrote:
| Ahh yes, the evil big vegetable lobby is trying to undermine
| the good that has been done by poor old Philip Morris.
| Cupertino95014 wrote:
| It's certainly good advice. However, _Nature_ is there to
| publish new science, not to provide generic advice.
| hamiltonians wrote:
| then why do doctors do cancer screening by age and family history
| and not lifetyle? hmm. except for smoking, a lot is unkown about
| who gets cancer.
| robobro wrote:
| Read the two lines of the article:
|
| > Data show that smoking, drinking alcohol and obesity are the
| biggest contributors to cancer worldwide.
|
| > Nearly 50% of cancer deaths worldwide are caused by
| preventable risk factors, such as smoking and drinking alcohol,
| according to the largest study of the link between cancer
| burden and risk factors
|
| Interested to see what your response is to the article once you
| finish reading it :-)
| toomuchtodo wrote:
| Life causes cancer. :) The symptom is cancer, the problem
| statement is a fix is needed for the human immune system to
| be more targeted and aggressive in purging cancer from the
| body, as well as more robust cellular repair mechanisms.
|
| The human body can take enormous amounts of environmental
| abuse, but there's clearly room for improvement.
| kingkawn wrote:
| A more aggressive immune system can cause cancers, such a
| myeloma or lymphoma. Gotta watch what you wish for
| toomuchtodo wrote:
| Improvements should be designed to balance self
| preservation with self destruction. Immunotherapy, gene
| therapy, and CRISPR are still in their infancy.
| fredgrott wrote:
| ahem metabolism by animals in of itself does not cause
| cancer. Biology wise cancer is the miss fire of a nature
| aging process.
| blacksmith_tb wrote:
| "Approximately 39.5% of men and women will be diagnosed
| with cancer at some point during their lifetimes (based on
| 2015-2017 data)."[1]
|
| Many lives will experience cancer, but not the majority. So
| it seems to be more complex that immune inadequacy (unless
| 60% of immune systems are working really well, which would
| be noteworthy). It seems like a reasonable hypothesis that
| environment is playing a larger role than individual
| genetic variations. So encouraging people (or even scaring
| them) to not smoke, not drink, eat better and exercise more
| seems like a reasonable approach - it won't cure cancer,
| but it could reduce rates?
|
| 1: https://www.cancer.gov/about-
| cancer/understanding/statistics
| hamiltonians wrote:
| doesnt change my point. docs screen by age, not lifestyle
| unless u smoke
| explaingarlic wrote:
| Are the majority of these risk factors not predictable
| epigenetically or genetically?
| AdrianB1 wrote:
| I read somewhere (I don't remember the source, but it was
| some medicine journal) that 4% of smokers are genetically
| more inclined to die from lung cancer; while lung cancer is
| correlated with the number of cigarettes (intensity and
| length of time), these people will have lung cancer even with
| a very low number of cigarettes.
|
| I know a few anecdotal cases where entire families of smokers
| died from lung cancer, while their partners, also smokers,
| had no problem, but I don't put much weight on that. Also I
| heard that smoking can cause other cancers like colon cancer
| in specific genetic conditions, but I don't know more
| details.
| steve_adams_86 wrote:
| There are all kinds of carcinogenic compounds we know are
| avoidable but people are exposed to nonetheless. The article
| points out several examples.
|
| Some cancers are more likely to occur based on gender and more
| predictable gene expressions, but these aren't mutually
| exclusive. You can be more likely to get cancer without doing
| anything special while still vulnerable to an increased risk of
| cancer through exposure to carcinogens (like alcohol, smoke,
| processed meats, etc).
| dec0dedab0de wrote:
| It could be argued that smoking, alcoholism, and obesity are all
| means of coping with a high stress lifestyle. I wonder how many
| more people would die from other reasons if they were no longer
| able to use those coping mechanisms. Or maybe more importantly,
| how much total happiness would they have in their life if they
| had the extra time. I say this as a fairly recent cancer survivor
| if that matters.
|
| edit: Does anyone know if psychologists or sociologists have a
| formula for quantifying happiness? Something like mechanical
| advantage. It seems intuitive that certain behaviors can act like
| a fulcrum by increasing happiness now at the expense of sadness
| later, either born by you or those close to you. I'm sure we've
| all had smokers joke that you can keep the last 20 years of life,
| maybe they're on to something.
| oaktrout wrote:
| I think if people didn't have smoking / drinking / overeating
| as coping mechanisms they might find healthy alternatives like
| exercise / altruism / creativity. Look at seventh day
| Adventists in Loma Linda (not a member myself), they live a
| long time and are very happy. For many, the last 20 years are
| only miserable because they didn't take care of themselves.
| It's possible to be 80 and active / healthy/ happy.
| siftrics wrote:
| As a cancer survivor and former alcoholic, I am one example
| of a person who has found healthy coping mechanisms.
|
| Instead of coping with alcohol, I read math textbooks and do
| problems.
|
| This has improved my life dramatically. I feel good. I feel
| proud. And despite optimizing for happiness as opposed to
| wealth, this coping strategy has made me loads of money.
|
| I should mention my cancer occurred in my childhood, so it's
| not as though my drinking was a cause.
| [deleted]
| BeetleB wrote:
| > It could be argued that smoking, alcoholism, and obesity are
| all means of coping with a high stress lifestyle.
|
| Hate to be that guy, but two of the 3 above are easily handled
| by simply not starting at all. People who don't start do _not_
| get the urge to go to these when under stress.
|
| Addressing stress is a lot more difficult than simply not
| starting. In the US, the rate of tobacco use continues to drop,
| and it is an outcome of a fairly significant campaign. Put all
| those resources into reducing stress and you simply won't move
| the needle.
| jjallen wrote:
| I think it should be postponable. If everyone wasn't obese and
| didn't smoke or drink guess what... we would still get cancer or
| die of heart disease or dementia. At least this goes for the US
| and much of Europe.
| AdrianB1 wrote:
| It is preferable to die of "old age" (including heart disease
| or dementia) at 90 than from cancer at 35. Yes, eventually
| everyone dies, but some early deaths are preventable, it seems
| to be half of cancer deaths, some car crashes, suicides etc.
| This means we can and should do something about it.
| tester756 wrote:
| >It is preferable to die of "old age" (including heart
| disease or dementia) at 90 than from cancer at 35.
|
| Dementia shouldn't be preferable, you'll make life of your
| relatives painful
| mod wrote:
| My grandmother died at 99 with dementia. It didn't last too
| long, thankfully--it came only in the last few months.
|
| I'm so thankful even just for the last couple of years she
| got to spend with us. She was my neighbor, so we got to
| spend a lot of time together, and we had always been close.
|
| There was in fact a bit of pain seeing her at the end, but
| I don't remember her that way, and I wouldn't change any of
| it.
|
| It's definitely preferable to RISK dementia. It's not like
| it's a guarantee at some certain age.
|
| A lot of the joy in my life would have been diminished if
| she hadn't lived so long.
| telotortium wrote:
| (Virtually) no-one dies of lifestyle-related cancers at 35.
| I still wouldn't want to die of cancer or heart disease at
| 60-80 (my grandmother was very unhealthy, had her first
| heart attack before 65, and died at 72), but I think
| dementia is a scarier prospect (my great grandmother died
| at 96 but had dementia for at least a decade before that).
| AdrianB1 wrote:
| Living with one case in the extended family, we are still
| glad she is alive and able to recognize most of us and have
| a discussion, but probably this is a very subjective matter
| and your experiences may be different.
| colechristensen wrote:
| Not always, if you've been close to someone who lived into
| their 90s and were barely there for a decade due to mental
| decline you wouldn't necessarily think it was the best way to
| go. Rotting in a nursing home confused and suffering for a
| couple of decades isn't luxury.
| AdrianB1 wrote:
| You are completely right. In the few cases of dementia I
| know, people lived just a few weeks after they completely
| lost memory and awareness, not long term.
| lazyasciiart wrote:
| Thats unusual, if I'm understanding your description
| right. Severe dementia (requiring 24 hour
| care/supervision) lasts a couple of years on average.
| Even moderate dementia, the level at which people can
| live in memory care units but have trouble communicating
| and understanding their surroundings, can last ten years.
| BeetleB wrote:
| You were lucky. Some forms can last several years, and
| those are not unusual.
| nativecoinc wrote:
| What the hell? A slow decline for years is not uncommon
| at all. At first you know that you are going to forget
| yourself and be completely helpless, and then you spend
| years in that state.
| usrusr wrote:
| True. What prevents cancer death is wingsuit basejumping and
| faster motorbikes. And war I guess, but that makes cancer death
| look attractive (and when you're working too close to the radar
| or DU ammunition is part of the equation, it can very well
| _cause_ cancer death on top of all the "prevention")
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