[HN Gopher] Cancer's origin story features predictable plot line...
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       Cancer's origin story features predictable plot line, researchers
       find
        
       Author : gmays
       Score  : 69 points
       Date   : 2023-07-11 17:07 UTC (5 hours ago)
        
 (HTM) web link (med.stanford.edu)
 (TXT) w3m dump (med.stanford.edu)
        
       | chmaynard wrote:
       | Understanding the origin story is huge. This research could be
       | the way forward towards a more scientific approach to cancer
       | prevention.
        
       | nerdbert wrote:
       | This sounds really important. If we can screen for cancer earlier
       | we will save a huge number of lives (and prevent a lot of pain
       | and misery).
        
       | graypegg wrote:
       | My mother was diagnosed with endometrial cancer at the start of
       | 2020. If you haven't known someone diagnosed with cancer
       | recently, it might not be obvious how advanced cancer treatment
       | and care is now. You see so many stories about new cancer
       | treatments or prevention strategies all the time, and it's so
       | easy to discount it as just more spam, but we're getting
       | extremely good at making people better, even in comparison to as
       | recently as a decade ago. Not perfect, but the trajectory is very
       | steep.
       | 
       | (Disclaimer, I'm not an expert, I was just pretty amazed by how
       | the whole process was customized and targeted for her specific
       | case.)
       | 
       | I'm sure this isn't a catch-all, and it's bad to put hope in "one
       | thing to solve it all", but this sure is exciting.
        
         | drpgq wrote:
         | As a Canadian I wonder how available this new stuff is here.
        
           | graypegg wrote:
           | She lives in Oshawa Ontario, went to lakeridge health cancer
           | centre.
           | 
           | As for if this cancer screening process from the root post is
           | available, I'm not sure.
        
           | arcticbull wrote:
           | Cancer outcomes in Canada are approximately the same as in
           | the US. Give or take. Some are better in Canada, some better
           | in the US.
           | 
           | > Conclusions: Among younger Canadian cancer patients in the
           | lowest SES group, greater access to health care may have
           | resulted in higher cancer survival, while higher screening
           | prevalence and access to health insurance (Medicare) among
           | older Americans during the period of this study may have
           | resulted in higher survival for some screen-detected cancers.
           | Higher survival in the highest SES group for stomach and
           | liver may relate to treatment differences. [1]
           | 
           | This study breaks it down by type, and socioeconomic status
           | too, if you're curious.
           | 
           | This is just one more recent study, but there's a lot of
           | evidence to support this.
           | 
           | [edit] Note that 5-year survival rate comparisons tend to
           | benefit the US because the US does more aggressive testing.
           | Studies show that this testing often doesn't actually reduce
           | mortality, but it does start the 5-year survival clock
           | earlier. So odds are this data overstates the outcomes in the
           | US, particularly in the older demographic as the conclusion
           | calls out. But that's a conversation for another time.
           | 
           | [1] https://www.naaccr.org/wp-content/uploads/2022/07/NCRA-
           | Sprin...
        
         | johntiger1 wrote:
         | How is your mother doing now? My mom unfortunately passed away
         | from stage C liver cancer, so still a lot of advancement to be
         | made
        
           | graypegg wrote:
           | I'm deeply sorry. Cancer is a horrible disease.
           | 
           | She's doing better, only about a year off treatment
           | currently. It was originally found at stage 3 but it seems
           | that surgery + 2 radiation rounds + 2 chemo rounds has worked
           | alright.
        
         | denimnerd42 wrote:
         | Some cancer treatments have advanced a lot. Some are still
         | using the same old drugs. Mother with StageIIIc ovarian in 2019
         | resection, HIPEC, then chemo. Recurrence in 2020 and every
         | 6-9mo after that with some areas appearing, others shrinking.
         | Platinum resistant in 2022 (many many many different times
         | combined with taxol, doxil, etc). Taxol alone not working now
         | as she had a spread event. Doxil + Avastin is now being tried
         | (again but without platinum). Probably out of options sooner or
         | later even though she can physically handle more chemo. Avastin
         | is pretty much the only advance for this cancer and it's not
         | very good. She's been on it on and off several times with the
         | other chemo drugs. Of course all this depends on the mutations
         | and such. Hers aren't ones anything new if it exists works for.
         | This is a major research hospital with distinguished
         | specialists.
        
           | khuey wrote:
           | Yeah "cancer" is a variety of diseases and treatments for
           | some of those diseases have advanced very far and others
           | haven't changed much.
        
             | pfannkuchen wrote:
             | Is it a variety of diseases, or do the different colonies
             | of organ-specific cells just behave differently once they
             | are unleashed?
        
               | stvltvs wrote:
               | Different diseases. Not every colon cancer, for example,
               | behaves the same. And if colon cancer spreads to the
               | lungs, it's still colon cancer, not lung cancer.
        
           | adebiase44 wrote:
           | Do you know if she has been treated with the new antibody
           | drug conjugate (ADC) technology? Here is an example:
           | https://www.elahere.com/ I am not a physician but I work in
           | the space.
        
             | denimnerd42 wrote:
             | Doesn't have that folate receptor mutation on her cancer.
             | That's what I was mentioning in the last part as I had read
             | about that drug last year.
        
         | bsder wrote:
         | > You see so many stories about new cancer treatments or
         | prevention strategies all the time, and it's so easy to
         | discount it as just more spam, but we're getting extremely good
         | at making people better, even in comparison to as recently as a
         | decade ago.
         | 
         |  _IF_ we catch the cancer early, we are much better at
         | treatments.
         | 
         | What we are getting good at is treatment with early detection
         | because we can just cut it out with surgery. What we are only
         | marginally better at is treatment with late detection.
         | 
         | For cancers that we don't have early detection, the success
         | rates are far, far lower and the treatments are far more
         | limited.
         | 
         | For example, a significant fraction of women get diagnose with
         | _lobular_ breast cancer--it doesn 't form lumps. So by the time
         | you detect it, you are almost always already Stage 3 or worse.
         | 
         | Radiation, in particular, is much better thanks to computing.
         | The only advance in surgery I have seen since the 1970s is that
         | they use a radioctive marker to trace where the lymph nodes are
         | --it helps with lympedema but not the cancer. Chemotherapy is
         | only marginally better than 20 years ago--they're a little
         | better at managing side effects but chemo is still horrible.
         | 
         | Medicine does well on things that can be fixed by physical
         | means--cutting things out or sewing things together. Medicine
         | still doesn't do all that well from a chemical standpoint.
        
         | gnulinux wrote:
         | My uncle (<60, healthy) was diagnosed with pancreatic cancer.
         | Although they used extremely expensive wonder drugs,
         | personalized drugs targeting his cancer cells etc, they were
         | completely ineffective and he died less than 11 months after
         | the diagnosis. He was extremely healthy and athletic at the
         | beginning of 2022, and looked basically like a skeleton by the
         | end of it. Cancer is a terrible disease and although we made
         | incredible, awe-inspiring amount of process, we still have some
         | way to go. Of course, I understand that pancreatic cancer is a
         | particularly nasty cancer, one of the worst.
        
           | tsuujin wrote:
           | I lost my dad to prostate cancer last year with much the same
           | timeline. Healthy as could be, out surfing and building decks
           | and shit one day, dead a year later.
           | 
           | Cancer sucks.
        
             | maxioatic wrote:
             | Really sorry for your loss. My dad died of cancer about 20
             | years ago when I was pretty young. It has gotten easier
             | over the years, but still, sometimes it feels like grief
             | punches me in the sternum. Wishing you the best.
        
           | denhaus wrote:
           | Sorry to hear that. I had an uncle die from lung cancer
           | (smoker, but otherwise healthy) about a decade ago. I know
           | how horrifying the process is. Hope you have been able to
           | process your grief.
        
         | slacknatcher12 wrote:
         | Yep. Even with "old drugs" the new programs using those give
         | significantly better chances than with the old programs. Year
         | of data collecting sure have given results.
         | 
         | I had testicular cancer in 2006 in Chile. I was a teenager so I
         | went with the public system (AUGE back then). My parents
         | friends were giving the condolences for my soon to occur death.
         | The doctors had a laugh as in the last 10 years (by then) my
         | chances of dying of it became basically nil.
         | 
         | Last year we hired a new guy at $JOB that 1 week after being
         | hired was diagnosed with testicular cancer too. He really
         | thought he was gonna die. He was at stage 4 (which is a highly
         | zone specific metric). Last time I saw him he is still coding
         | and more bald. It was more difficult to sort payments than the
         | treatment as he is in the US.
        
       | deepakg wrote:
       | A little tangential, but I'd highly recommend Siddhartha
       | Mukherjee's The Emperor of All Maladies.
       | 
       | https://en.wikipedia.org/wiki/The_Emperor_of_All_Maladies
       | 
       | It really helped me appreciate how we went from treating people
       | with anything that'd kill their cells to highly specific drugs
       | that target genetic pathways.
        
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       (page generated 2023-07-11 23:02 UTC)