[HN Gopher] Cancer signs could be spotted years before symptoms,...
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Cancer signs could be spotted years before symptoms, says new
research institute
Author : Brajeshwar
Score : 114 points
Date : 2024-04-01 15:03 UTC (7 hours ago)
(HTM) web link (www.theguardian.com)
(TXT) w3m dump (www.theguardian.com)
| bestouff wrote:
| Isn't a sign of a disease called ... a symptom ?
| Retric wrote:
| No, _A symptom is a manifestation of disease apparent to the
| patient himself, while a sign is a manifestation of disease
| that the physician perceives._
| https://jamanetwork.com/journals/jama/article-
| abstract/34161....
| francisofascii wrote:
| The term seems to be thrown around to mean either. High blood
| pressure is a sign of other diseases, and some call it a
| symptom, but it is a measure rather than something people can
| perceive. I feel like I can tell my blood pressure is high,
| but I think I am feeling other sensations that correlation
| with HBP.
| Retric wrote:
| People don't necessarily use terms correctly, but it's
| 'feels or experiences' so poor circulation is a symptom
| even if people are describing cold extremities. Very high
| or low blood pressure is definitely something people can
| notice unlike say latent TB which is only going to show up
| on tests.
| Spooky23 wrote:
| A symptom is what you show. A cough is a symptom, detection of
| a viral protein is evidence of infection.
|
| I lost someone close to me to melanoma that metastasized to the
| brain. It grew for at least 6 months without symptoms. And when
| symptoms presented, they weren't immediately evident of a tumor
| until it had progressed. She was being actively monitored for
| melanoma at the time - having the ability to detect it earlier
| would have made all of the difference.
| vundercind wrote:
| Doctors draw a distinction. A sign is something they can
| measure (a high body temperature, say). A symptom is something
| you report experiencing ("my joints ache")
| Solvency wrote:
| this is obvious to literally anyone who is in tune with their
| bodies, it doesn't take science to say so. Chronic inflammation
| is a great place to start. Because even if you don't have cancer,
| it's likely you're trending towards diabetes or some other major
| illness. inflammation is one of the number one markers for
| "SOMETHING IS AFOOT".
|
| most people are so divorced from being in sync with their
| physicality, and are so far removed from understanding what
| normal should feel like, and are often so blunted by prescription
| medications and other compensatory mechanisms, that it makes
| "something doesn't feel right" highly impractical sadly.
|
| even now, people here will scoff at this notion while willfully
| turning a blind eye to their own personal
| pains/afflictions/signals, even though rates of cancer and other
| diseases are skyrocketing. And this is because it's all wrapped
| up and embroiled in a scary cognitive dissonance that most people
| actively work to maintain, because it sucks and it's kind of
| scary to put a spotlight on your own mortality.
| jf22 wrote:
| This is not obvious to literally anyone.
|
| You've never met or heard about a perfectly fit person in the
| prime of their life getting a stage 4 diagnosis of something or
| other?
| Solvency wrote:
| sure have. my cousin is a personal trainer who ran a gym
| studio from his garage. Was in great external physical shape.
| And his house reeked of mold. Absolutely insanely smelly. My
| wife warned him for years because she's sensitive to the
| odor, and he just completely refused to accept that there was
| mold in the house or that it was a problem or that there was
| any smell at all.
|
| he was later found to have stage2 cancer.
|
| just because he looked good, was he ACTUALLY good?
|
| no. sleep apnea. aching joints. a random bout of shingles at
| the age of 39. the list of "things" goes on, and most people
| have lists like this that they refuse to examine or consider
| as building blocks of a potentially encroaching larger issue.
|
| again, because of fear.
| SketchySeaBeast wrote:
| The problem is you're treating these like signs of cancer
| when they aren't. People with mold in their house don't
| necessarily have cancer, people who get shingles don't
| necessarily have cancer, aching joints is less than useless
| as a measure for cancer. You're working backwards, now
| anything that's incorrect with someone is proof if they
| ever develop cancer while ignoring everyone who doesn't.
| gr8r wrote:
| Somewhat tangential question, can someone briefly say how
| mold is related to cancer?
|
| Also isn't mold somewhat common in American homes?
| bequanna wrote:
| Well, I think what the parent comment is trying to say is
| that we've made it socially acceptable to live in an
| unhealthy way and many of the "obvious" conditions that are
| precursors to serious disease like obesity, over medication,
| chronic inflammation, etc are just accepted.
|
| However, we should be making it clear that unhealthy
| lifestyles result in bad outcomes.
|
| This was all very obvious before we started to muddy the
| waters with our blank check acceptance of bad choices (fat
| acceptance, etc).
| jf22 wrote:
| I don't disagree with the premise we've issued blank checks
| for unhealthy lifestyles, but I disagree that's what the
| parent comment was saying.
|
| Asking people to self diagnose inflammation is a lot
| different than understanding that being overweight is
| unhealthy.
| tcdent wrote:
| I don't know why you're getting downvoted. This is 100%
| correct.
| y-c-o-m-b wrote:
| It's an ambiguous rant, that's why it's getting down-voted.
| No specific message. No sources. No data. Just an empty
| lecture on "listen to your body!", but no substance to
| explain how, why, what to do etc.
| sdwr wrote:
| The core steps to paying attention to yourself:
|
| - notice
|
| - fill in the picture
|
| - use it to inform your decisions
|
| For example, my oral health fluctuates based on what I eat.
| Too much sugar or sweet carbs, and my gums start feeling
| itchy and sore. Having that self-awareness helps, because
| when it starts becoming a problem, I can take corrective
| action, and fix my mouth before I get a cavity or lose gum
| tissue.
|
| Now, this is exactly what a dentist would say - brush and
| avoid sugar. What self-awareness helps with is knowing how
| much is too much! I'm not flying blind, I know what "good
| mouth" and "bad mouth" feel like.
| SketchySeaBeast wrote:
| Which works fine for something simple like "if I eat too
| much sugar I get a tummy ache". It's harder to do with
| something that is hard to detect, like pancreatic cancer,
| or a symptom that could be caused by a huge number of
| things, like feeling tired. The first problem is the one
| that's trying to be solved by the solution in the
| article.
| goosejuice wrote:
| Likely because, similar the other thread about obesity, this
| article is referring to direct evidence of genetic changes
| rather than observation of ones differentials or symptoms.
|
| Just a guess, I know very little about this subject.
| bobmcnamara wrote:
| Because they didn't read the article.
| 4b11b4 wrote:
| although down voted, controversial, not generally provable, and
| possibly condescending
|
| this perspective shouldn't be discounted
| sdwr wrote:
| Yeah, very true. Obviously you can't do everything yourself,
| but a lot of people have gone the other way, and given away
| responsibility for their health to the professionals and the
| numbers.
|
| The numbers don't tell the whole story, and the professionals
| are looking out for themselves as well as taking care of you
| (at minimum!)
| glenstein wrote:
| I absolutely agree that people should try to "know their
| bodies" and develop their intuitions as far as possible. It can
| make all the difference in terms of spotting a critical illness
| in time (not always, but sometimes).
|
| However, health/medicine is a field rife with misinformation,
| rife with questionable ideas about what "intuition" can really
| tell you, and the dividing line between the true and the
| confidently incorrect can be hard to pin down.
|
| And what really sets off alarm bells, to me at least, is
| proposing that it should _substitute_ these intuitions for
| professional expertise, or should be understood as being at
| cross-purposes with it. I think the best case for valuing our
| intutions would come from a place of treating them as
| complementary to professional expertise.
| nix0n wrote:
| > it makes "something doesn't feel right" highly impractical
| sadly.
|
| What kind of doctor would a person go to for something like
| that?
| ProjectArcturis wrote:
| It would be obvious to you if your esophageal cells started
| producing TTF3? What would that feel like?
| Spooky23 wrote:
| This is really cool.
|
| Maybe as this moves on with early detection, we'll be able to
| deliver custom moderna cancer vaccines are immunotherapies to
| kill cancers before they can root.
| Dalewyn wrote:
| Having witnessed my mother fight and pass away from cancer rather
| recently, signs of cancer are definitely obvious _in hindsight_
| but they never strike anyone as such at that point in time.
|
| Basically: "Yeah, looking back on it that was cancer wasn't it?
| God damnit..."
| jseliger wrote:
| Ditto, except for myself:
| https://jakeseliger.com/2023/07/22/i-am-dying-of-squamous-ce...
|
| One problem is: how often do those signs turn out to be cancer,
| versus something else?
|
| There are now circulating tumor cancer DNA tests (ctDNA),
| though they're presently expensive:
| https://www.natera.com/oncology/signatera-advanced-cancer-
| de.... If they get cheap enough, they'd be interesting as part
| of, say, an annual blood panel. Mine were like $5k each,
| however, so that's not going to happen in the general
| population in the short term.
|
| I was using the Signatera tests to try to determine whether I
| should start prophylactic chemotherapy after a total
| glossectomy. The answer turned out to be "yes," but three days
| before I began chemo, a CT scan ordered to ascertain whether I
| could use a jaw-stretcher device showed six to eight new
| tumors, less than two months after the surgery. So the
| direction was correct.
| Dalewyn wrote:
| ...God _damn_ , man.
|
| I'm glad you're still here with us, but I... don't know what
| to even say.
| joelfried wrote:
| Thank you for speaking and not being silent when life is
| hard.
| sam2426679 wrote:
| According to an oncologist I spoke with, there are "shedders"
| and "non-shedders," i.e. whether a tumor sheds DNA into the
| bloodstream or not. Apparently I'm a non-shedder :/
| copperx wrote:
| I thought the circulating tumor DNA tests were $1k. I know
| because I was interested in getting them.
| poulsbohemian wrote:
| What examples do you have in mind? I ask because both of my in-
| laws passed from very aggressive cancers, but there really
| isn't much I can point to as meaningful signs. In hindsight, it
| did seem like a lot of people in their neighborhood also passed
| from various cancers, but even then they were all different
| types and I'm not sure it was statistically significant.
| Bostonian wrote:
| Early treatment of cancer is not always better: "Surgery for
| early prostate cancer may not save lives. Most men just as likely
| to survive with limited or no treatment"
| https://medicine.wustl.edu/news/surgery-early-prostate-cance....
| I wonder if this is true of other types of cancer.
| eftychis wrote:
| I think this is unique to prostate cancer.
|
| As it says the average age of men getting it is 67. From
| experience and from data I had seen, a lot of times, the
| surgeons simply believe the patient is too old to have any
| surgery. And when they die -- e.g. family I had -- they note
| down the cause of death as natural causes. When you are 80-90+,
| practically everything gets written as natural causes.
|
| Finally, with prostate cancer, from what we know it is not a
| question if a man will have prostate cancer but if the man will
| die before prostate cancer becomes serious or appears. That is
| if we doubled the age of survival to 200 years I think we would
| expect virtually every male at that age to have gone through
| prostate cancer.
| tptacek wrote:
| That may be the case, but the other failure mode for early
| cancer testing is that you identify disease signals which
| will not turn out to be meaningful in the long run even
| without intervention. Iatrogenesis is a big problem with a
| lot of this stuff: the follow-on treatment for an epithelial
| precancer hit from your stomach is not harmless.
|
| This is a reason I've read evidence based medicine people use
| for arguing against routine whole-body imaging.
| eftychis wrote:
| Yes. I was touching solely the likely unique
| characteristics of prostate cancer. Maybe I need to
| clarify, but that is what I got the comment I was replying
| to indicated.
| yes_man wrote:
| There was a meta-analysis published in JAMA last year which
| concluded that screening is unlikely to prolong lifetime for
| other than colorectal cancers:
|
| https://jamanetwork.com/journals/jamainternalmedicine/articl.
| ..
|
| > The findings of this meta-analysis suggest that colorectal
| cancer screening with sigmoidoscopy may extend life by
| approximately 3 months; lifetime gain for other screening
| tests appears to be unlikely or uncertain.
|
| I am neither a physician nor qualified to comment on the
| article itself, but remember reading an MD commenting on it
| last year saying efficacy of screening was better in the
| 80s-90s, but with contemporary cancer medicine and
| improvements in surgery, we can now treat bigger cancers so
| early screening doesn't necessarily prolong life expectancy.
|
| I would not take medical advice from myself or that article
| though. But to your comment, I doubt it's only prostate
| cancer where early screening and treatment might not yield
| any returns
| inglor_cz wrote:
| Hmm, I notice that melanoma wasn't addressed in this study;
| maybe "having a good look at suspicious moles just in case"
| doesn't count as screening, but early detection of melanoma
| is considered pretty important for survival.
| yes_man wrote:
| Yeah, again without really having any education in
| healthcare, I suppose that if you find a cancer before it
| spreads then you can operate it out. So makes sense to
| get suspicious moles or generally any health issues
| checked
| kouru225 wrote:
| My dad refused treatment for his prostate cancer when he found
| out there was a high probability he would end up incontinent.
| He basically just said to my mom and his doctor "I'd rather
| die." It's been 20 years since. The tumor has completely halted
| its progression. Sometimes things just work out .
| binkHN wrote:
| If you know the details, care to share them? Like Gleason
| score? Does he have yearly biopsies or MRIs?
| kouru225 wrote:
| I would tell you if I could, but as you might expect from
| the type of person who would respond this way my dad hates
| talking about or dealing with anything medical. I doubt he
| even remembers these things. He does do a yearly checkup
| and I'm not sure if that includes a biopsy these days (it
| definitely has in the past.) I basically have to catch him
| a day or two after his checkup in order to get any
| information and even then I just get the minimum amount of
| information possible.
| consf wrote:
| Medical outcomes can vary widely, and sometimes, despite
| initial concerns or decisions, things can indeed work out
| favorably over time. Good to hear that evrything's ok with
| your dad now
| binkHN wrote:
| This article is from 2017.
| fortran77 wrote:
| This is almost always because of other comorbidities. People
| tend to get prostate cancer when older and it often (but not
| always) progresses slowly.. If you have other issues like
| obesity then you are likely to die from something else first.
| However, for otherwise healthy people, especially in their 60s
| or early 70s, it's a good idea to treat it early and
| aggressively. There are about 35,000 deaths from prostate
| cancer in the US every year; the leading cancer death after
| lung cancer.
| jstummbillig wrote:
| > Early treatment of cancer is not always better
|
| Sure, nothing is always better. If an intervention is
| _statistically_ not better, then we will not be doing that kind
| of thing in the future. Better data will lead to better
| treatment, as will continued research.
|
| But _statistically_ early treatment will _always_ end up being
| better. There is no theoretical situation in which having less
| time to systematically change an outcome will beat having more
| time.
|
| Also not sure how quickly things progress in this particular
| case, but the article is from 2017 so that's quite a few years
| already.
| trekkie1024 wrote:
| Semi-related: https://www.nature.com/articles/s41591-023-02640-w
| NickM wrote:
| Cells mutate and become cancerous all the time, but the immune
| system is usually able to recognize this and shut down the errant
| cells before it becomes a problem. It's only when the cancer gets
| lucky with the right site of mutations that it's able to evade
| the immune system and grow unchecked.
|
| Early diagnosis would obviously be a good thing _if_ we can
| reliably tell which cancers will become a problem. My concern is
| that most patients may have a hard time understanding this
| distinction, and we may end up with people demanding screenings
| and treatments that they 'd be better off without.
|
| In case anyone thinks these fears are unfounded, keep in mind
| this is already a problem with thyroid cancer. Thyroid cancer is
| very common and frequently harmless, but increased screening is
| leading to more people being treated for it, and it's unclear
| whether this is a net benefit.
| noncoml wrote:
| But that's not what the article says? From what I understood
| they were able to identify only those that end up developing to
| cancerous tumors. Not the ones that you mention?
| onlyrealcuzzo wrote:
| > It's only when the cancer gets lucky with the right site of
| mutations that it's able to evade the immune system and grow
| unchecked.
|
| What happens if you happen to have some cancer mutations while
| you're young and healthy - but also super sick and your immune
| system is busy with other stuff?
| pedalpete wrote:
| Is this part of the reason cancer is more prevalent later in
| life? The longer you live, the more likely something is going
| to sneak past, along with decreased effectiveness of the immune
| system as we age?
| arrosenberg wrote:
| For what it's worth, this isn't new, just a new investment. There
| are a ton of companies in the cell-free biopsy space for early
| cancer detections, with the biggest name being Grail. We're more
| or less in the engineering/process improvement stage of early
| cancer detection, not the pure research stage.
| consf wrote:
| Early detection of cancer is crucial for successful treatment and
| improved outcomes. So happy to see those kind of news.
| j45 wrote:
| Agreed.
|
| Between all of the technical dissection and interpretation that
| is sure to ensue here, the human aspect, tempered with not
| getting hopes up, is that progress like this is invaluable for
| the many who can't access the best treatment, vs the few who
| can.
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