[HN Gopher] Proteins in blood could provide early cancer warning...
___________________________________________________________________
Proteins in blood could provide early cancer warning 'by more than
seven years'
Author : racional
Score : 267 points
Date : 2024-05-15 13:11 UTC (9 hours ago)
(HTM) web link (www.theguardian.com)
(TXT) w3m dump (www.theguardian.com)
| anonzzzies wrote:
| Hope we found a lot of these type of things. 7 years is a big
| win.
| ekanes wrote:
| Compared to most cancer-related findings, this seems clear,
| simple and easy to replicate / disprove. Hopefully quickly, as
| it'd be a huge win for humanity.
| unsupp0rted wrote:
| Oh boy, I hope one of those markers is for Pancreatic. That's
| the/a silent killer.
| adamors wrote:
| It isn't unfortunately
|
| > Little evidence for protein associations was observed in
| these data for cancers of the pancreas, thyroid, lip and oral
| cavity, or melanoma after correcting for multiple tests
|
| From the study
| https://www.nature.com/articles/s41467-024-48017-6
| anotherpaulg wrote:
| The Galleri blood test claims to pick up pancreatic cancer
| early. Which I agree, is one which would be great to find
| early.
|
| > More aggressive cancers, such as pancreatic cancer, tend to
| release more cell-free DNA into the bloodstream at early stages
| and are more likely to be detected by the Galleri test.
|
| https://www.galleri.com/hcp/galleri-test-performance
| arrosenberg wrote:
| CA 19-9 is the marker everyone is look at for Panc.
| nerdjon wrote:
| Am I crazy in thinking that we heard about this several years
| ago? Is this just a continuation of that study or am I mis-
| remembering/my timeline way off?
|
| This is really exciting though, especially when mixed with other
| cancer treatments the ability to catch and deal with this is
| fascinating. How long until a theoretical, "Oh we detected some
| cancer cells in your regular blood work, here is a shot to deal
| with it" like we treat many other things.
| jemmyw wrote:
| You're not crazy, I recall a similar story too.
| graywh wrote:
| we've been searching for blood biomarkers for cancer for
| decades -- I'm sure we've found several by now
| yieldcrv wrote:
| with the addition of an mRNA treatment approach I'm willing to
| think 8 years off from at least a dozen cancers that currently
| only get detected after they've metastasized.
| nextos wrote:
| You've been hearing about ctDNA. Which is really interesting
| and predictive.
|
| But it is hard to tune so that it is practical enough to be
| deployed in routine healthcare. Efforts so far have not been
| sensitive or specific enough.
| blindriver wrote:
| How does this differ from the GRAIL blood tests?
| epistasis wrote:
| Grail is looking at DNA methylation sites, this is looking at
| proteins.
|
| GRAIL is available today, this test will need to be validated
| and commercialized
| forinti wrote:
| And how are you going to find the source?
| _xerces_ wrote:
| You're right, these proteins could be associated with
| conditions that can later lead to mutations that cause cells to
| become cancerous, but they don't point to a specific cancer.
| Interestingly they hint at modifying the proteins to reduce the
| likelihood of getting something, but that could be risk in
| itself. A lifestyle change could be helpful in some cases.
|
| I suppose if you have enough of these markers they could
| schedule routine testing earlier than usual, say 40 instead of
| 45 for colonoscopy, mammogram, etc.
| stuff4ben wrote:
| How long before that becomes a mandatory test to get health
| insurance? Or somehow the data is bought by insurers who then use
| it to jack up the rates for those who will eventually get cancer.
| God I hate the US healthcare system!
| DennisP wrote:
| Insurance companies haven't been allowed to deny coverage for
| preexisting conditions since 2014, due to Obamacare. They can't
| even raise premiums. The only variables are age, sex, smoking,
| and where you live.
|
| This applies both to employer plans and the ACA plans on
| healthcare.gov, where you can get a quote without giving them
| any health data at all.
| bonton89 wrote:
| Is there anything stopping an employer from pretesting you to
| avoid adding a potentially expensive employee to their
| roster?
| zamadatix wrote:
| Generally it runs aground with things like the ADA because
| you can't just "accidentally" find out the person has a
| covered condition, you're just never allowed to ask or
| require it be told. Exceptions for something like an
| airline pilot on matters related to the job like sight
| notwithstanding. This is why you always see things like
| "can lift up to 40 lbs" type requirements instead.
| Koala_ice wrote:
| But, you can get absolutely destroyed on life insurance and,
| just as critically, long-term care insurance. Genetic
| discrimination is perfectly legal in those domains.
| qclibre22 wrote:
| You can be denied some kinds of health insurance :
| https://www.medicarefaq.com/faqs/can-you-be-denied-a-
| medicar...
| DennisP wrote:
| Only if you miss the open enrollment period, and even then,
| you still have Medicare regardless.
|
| It seems reasonable not to let people over 65 wait until
| they have cancer before purchasing supplemental insurance.
| Tenoke wrote:
| This is such an odd take for me. If the test works and
| insurance makes the test mandatory (which seems pretty
| unlikely, what other comparable tests are mandatory?) then more
| people will get an early diagnosis, and less people will die!
| The incentives are aligned, the system works!
| tombert wrote:
| This is cool, though I do wonder if the tests will be good enough
| to differentiate between "cancers that will be lethal in the next
| seven years" and "cancers that are technically there but will
| take so long to kill you that something else will beforehand
| anyway".
| two_handfuls wrote:
| Also "cancers that your body takes care of on its own"
| Jedd wrote:
| > .. though I do wonder if the tests will be good enough ..
|
| Sure .. but ..
|
| a) knowing that cancer is there, but you may get hit by a bus
| before it kills you, can still inform some medical care
| decisions
|
| b) the 12 authors of that paper have probably put a bit of
| thought into the usefulness and efficacy of this kind of very
| early detection, and concluded it was worth reporting on their
| research
| tombert wrote:
| I don't dispute either of your points. It was a genuine mere
| curiosity on my end, not a rhetorical "gotcha!".
|
| I've just heard that for stuff like prostate cancer, a
| diagnosis can be misleading, because sometimes it can take
| 20+ years to kill you. If you get it when you're 70, it's
| probably not worth going through surgery or chemo because
| you'll likely die of heart disease or another cancer before
| that anyway.
| thfuran wrote:
| That sort of issue crops up all the time in medicine.
| Screening for conditions will always produce some false
| positives, and the ramifications can vary from scaring the
| shit out of someone for a few weeks before you determine
| they don't have cancer after all to them dying as a result
| of further testing/treatment that wouldn't have happened
| without that initial screening. That and the potential
| adverse outcomes of the screening itself (and its costs)
| always has to be weighed against the value of the true
| positives.
| snarf21 wrote:
| I think we also should be looking more at change over time, not
| just results as a distinct value. A lot of these values have
| ranges and error margins but looking at changes over time can
| be quite informative, especially for cases where your body
| takes care of any potential issues. I think there are a lot of
| diseases we could treat in cheaper ways with improved QoL if
| detected early. Too often we try to fix a crashed car instead
| of checking the brakes once a year.
| EspadaV9 wrote:
| I donated some blood a couple of years back and they came back
| saying there were proteins present. Having follow up tests at the
| moment, but none of the other markers are present that would
| normally be there if there was cancer. Still waiting to get
| further follow up tests, but no one seems to be worried enough to
| rush things along.
| dogtorwoof wrote:
| Which proteins?
| HappyJoy wrote:
| Where did you donate? The only feedback I usually get is a
| certificate every 8 trips.
| Symmetry wrote:
| I donate platelets with the Red Cross every month and I've
| got an app where they give me the blood pressure and
| hemoglobin level, and which used to tell me if I had Covid-19
| antibodies before everybody did via vaccine or infection.
|
| Before I donate I have to sign something that says, among
| other things "We're going to test your blood for AIDS and
| tell you if you have it, so if you don't want to know don't
| donate". I hadn't thought about the other things they test
| for but of course they don't want blood with Leukemia in it
| either.
| frontman1988 wrote:
| Why wouldn't someone not want to know they have AIDS? Given
| the disease is not a death sentence anymore and the earlier
| you know better your chances of survival. The warning
| probably deters a lot of people who could have otherwise
| been saved by timely treatment.
| vundercind wrote:
| You still need to get consent for that. Like, you can't
| just assume.
| krisoft wrote:
| > Still waiting to get further follow up tests,
|
| I hope all will turn out good for you, and wishing you the best
| of luck.
|
| > they came back saying there were proteins present.
|
| I think probably there is a bit of a Chinese whisper kind of
| misunderstanding here. Your blood will contain proteins. It
| must. Everyone's blood does. For example hemoglobin is a type
| of protein which makes your red blood cells able to carry
| oxygen.
|
| What they probably told you is that they found the wrong
| quantity or the wrong kind of proteins.
|
| Wishing you the best!
| zero-sharp wrote:
| https://youtu.be/FzFT-KuE4BQ?si=7-EXbRz1TD4a5leL&t=56
|
| The video makes the case that the early detection of cancers
| isn't always a good thing. See 6:30 and 7:00 for specific
| references to scientific studies. Some cancers (thyroid and skin)
| can be detected at a much higher rate, but the associated
| mortality remains constant (we are detecting benign cancers).
|
| To be clear: obviously this is dependent on the cancer. Really my
| point is that we need studies that show that the screening
| improves outcomes.
| brnt wrote:
| This is how Dutch public healthcare motivates its general
| aversion to medical testing, as many a foreigner finds
| surprising and incongruent to the generally OK level of
| healthcare outcomes provided by the system. You can test and
| detect, but the error margins are often large (so many false
| positives and/or false negatives), would generate way too much
| workload to follow up and thereby cost time and money for
| better leads. Plus, as you say, knowing early doesn't always or
| even often mean you can actually change the outcomes.
|
| Now, this is what they say... I have tried to find the actual
| literature they use to motivate their protocols, and apart from
| occasionally, have not been able to find that evidence. I'd
| love to have a resource that demonstrates these sorts of
| things.
| fidotron wrote:
| I am not sure that is unique to the Dutch, it is the line I
| have heard in several countries.
|
| Heavy agreement on your last part - if there is substantial
| evidence to back this up I would like to see it.
|
| As it stands I personally prefer the idea of constant mass
| testing in order that we learn as much as possible as quickly
| as possible, including improving the tests from the resulting
| feedback loop.
| brnt wrote:
| When I see the prices of some of that testing, I know that
| that cannot be the reason, and indeed, establishing
| personal baselines by regular testing can only be helpful.
| The aversion to it grounded on taking some average patient,
| I am convinced.
|
| I really wish there was more transparency, because test
| aversion is exactly the same protocol you'd invent if you
| were trying to save money. I want to be able to see which
| of the two we're dealing with.
| radicalbyte wrote:
| Given how the Dutch system seems to be designed to
| maximise paper filling and busywork instead of healthcare
| - and of course to make the insurance companies rich -
| it's no surprise that they're against it.
|
| Medical experts here have very little say in how things
| are run. It's all bankers and bureaucrats.
| brnt wrote:
| Do you have any sources for that?
|
| I've worked for a hospital and I've never been able to
| find anything approaching a complete balance sheet.
| Financing it utterly opaque, but I'd love to have
| something solid before I accuse anyone.
| 6510 wrote:
| I'm far from an expert on this topic, more on the
| contrary.
|
| The surgeons use to run the hospital. In contrast with
| mba's they knew things. I don't know what the difference
| is precisely but I hear the ziekenfonds use to have
| people to divide money over treatments (set prices)
| without their salary depending on their choices.
|
| I don't know about the scale but longer ago we would just
| build hospital buildings and house a workforce of nuns
| nearby who had their own garden. Now we some how cant
| afford to put down a building and with realestate prices
| on the rise the salaries need to follow. We might not
| like the factory village concept but if you have to be on
| call all of the time it seems fkn convenient to me. Cut
| the salary and give the employees a house, seems a great
| perk.
|
| Employee shortage is also costing a fortune.
|
| We've created ambitious labor protection laws then we
| created a loop hole where all you have to do is pay 190%
| of the salary to a job agencies (uitzendbureu) and no
| laws apply, anything goes. If you don't like it you can
| go home. This didn't need to cost 90% of the salary.
| Unless our labor taxes are now that complicated(?) but
| that doesn't work as an excuse either.
|
| Our taxes not paying for education doesn't mean we don't
| have to pay for it eventually (+interest)
|
| I read they are also lacking the money to streamline the
| processes.
| pessimizer wrote:
| The reason this rings wrong for people is because the
| reasons early testing is dangerous are entirely social.
| People are motivated by fear to have every test
| available, doctors are motivated by fear of being accused
| of neglect by the patient, doctors are also motivated by
| the profit that they make from the tests, the
| manufacturers and patent-holders of tests are motivated
| to have them done as much as possible, the labs that do
| tests make money on the number of tests that are done,
| the nonprofits that campaign based on diseases are
| expected to message to increase testing for those
| diseases and accept money from manufacturers and patent-
| holders, there's motivation to exaggerate the danger of
| what's detected by the manufacturers and patent-holders
| of _treatments_ for the disease, and there 's motivation
| by researchers who formulate the criteria for determining
| whether a particular feature of something detected is
| potentially dangerous/deserves treatment, and a
| motivation to give them the most expensive treatment,
| regardless of whether that treatment is unpleasant; in
| fact if the treatment is dangerous, it opens up secondary
| markets.
|
| There's just an enormous number of tailwinds pushing
| overdetection and overtreatment. The sum of that is
| what's important, which is that when you test earlier,
| you often objectively end up with more death and
| suffering. Which is what a state-run national healthcare
| systems needs to look at, they can't get lost in the
| trees. You pick an optimum age for testing that shifts
| the balance to less suffering and death (and costs), and
| you look for specific exceptions (genetic, lifestyle,
| comorbidities) and test _just those people_ early.
|
| Could there be a way in which all testing would help
| instead of hurt? Yes, but it's political and
| psychological and not likely to ever happen. You'd have
| to (as a patient) trust probability in general, and
| additionally you'd have to trust the probabilities that
| they're handing you haven't been distorted by the self-
| interest of others. Not likely for the foreseeable
| future; maybe 1000 years from now.
|
| If you want to do the study, all you have to do is
| compare the number of deaths from a thing when people are
| tested early to the number of deaths when people are
| tested late. Or just look for other people who have done
| them. If early testing obviously saved lives, the people
| who sell testing would tout them everywhere. Instead,
| they're stuck trying to look for angles to argue that
| lessening death and suffering isn't the biggest
| consideration. They recently did this to push breast
| cancer screening earlier again, by arguing that if you
| specifically look at black American women, they benefit
| from early cancer screening. So overall, breast cancer
| deaths go up, _but that 's just your privilege talking._
| Woke conglomerates. Ignore that black people have a
| unique, neglected, discriminated against, and poverty-
| ridden situation in the US; in fact, it might even be
| racist to point that out (in backwards land.)
|
| Of course, you definitely don't have to do the studies,
| plenty have been done. Anybody saying that they've looked
| and haven't found them has not looked or has seen them
| and is not telling the truth. Both positive and negative,
| about every test. The studies that support earlier and
| more testing are press released and marketed, though,
| while the others can be suppressed or simply ignored,
| unless some public health system or insurance company
| champions them, and _of course they would._
| brnt wrote:
| I fully agree.
|
| However, the converse is also true: we don't actually
| know which protocols are there because they're social,
| and which are there to benefit the insurers. Both could
| motivate cost cutting.
|
| I want to see the difference. I want whatever the full
| story is laid out in front of me.
| leto_ii wrote:
| > would generate way too much workload to follow up and
| thereby cost time and money for better leads
|
| Having lived a decade in NL, my impression was that keeping
| costs down is the top priority. Unless you have a serious
| chronic condition or were in an accident, good luck getting
| somebody to take a look at you.
|
| (irl, after a while you learn to push, exaggerate symptoms
| etc. or just go back home to get tests and treatment).
| brnt wrote:
| Yep, the loudest people get the most help. There's no good
| solution for that other than to become a bitchy 'client'.
| It's unfortunate that despite the promises, you still have
| to 'use it correctly' if you want those good outcomes as a
| patient.
| mort96 wrote:
| It's not _just_ about keeping costs down, but also about
| increasing quality of life. If you detect a benign cancer in
| someone, and they then go on to receive chemotherapy, you 've
| massively decreased that person's quality of life for a
| significant period with no upside.
| iknowstuff wrote:
| A benign tumor doesn't spread and doesn't warrant
| chemotherapy I believe? And if it's actually cancer than I
| don't understand how you would not want it gone as soon as
| possible to avoid metastasis?
| Fire-Dragon-DoL wrote:
| Well, this is talking specifically about the case where
| the cancer is benign. Of course you want a metastatic one
| gone.
|
| For the benign ones, that's going to hurt the person's
| body quite a bit
| jvanderbot wrote:
| I think the jump from "protein blood test" to
| "Chemotherapy" is a bit of a stretch. There are almost
| surely additional screenings and diagnoses going on
| there. And I don't think anyone is going into chemo for
| benign tumors.
| Fire-Dragon-DoL wrote:
| Makes sense. Is it possible for the two types of cancer
| to be confused?
|
| Should also point out that tests will negatively affect
| your life seriously either way, especially if these
| benign cancers are common. Think of the time spent going
| to/from the doctor, the incredible stress (am I dying?),
| the tests itself: it is damaging the person's life.
| Detection is good, false positives are unacceptable
| though.
| jvanderbot wrote:
| I recently read Outlive, and he makes the claim that
| almost all of the increase in survivability for cancer
| comes from early detection. I think projects like this
| are extrapolating that out. I think a little heartache
| and worry is excusable if it means 10 years added to your
| life. Over time, we'll develop a callous there and take
| it in stride.
|
| e.g.,
|
| My two friends who got early screening had a few false
| positives, and one true positive treated early. One later
| died of heart attack and one lived long enough to get
| dementia.
|
| My two friends who didn't get early screening, one died
| of heart attack and one died of cancer that could have
| been caught. Both died earlier than two above.
|
| Sadly, at this point, you _want_ to die of cancer, but
| you want to do it when you 're 85. It beats a sudden
| heart attack and it beats dementia. You just want to
| prolong the outcome.
| robocat wrote:
| > [costs:] the incredible stress
|
| I have seen a few people get benefits from a cancer
| scare: a refocus onto what matters in their lives. Agree:
| I would guess most people just get costs. Of my middle-
| aged friends with health scares only a few addressed the
| underlying cause (and even fewer are proactively avoiding
| health issues).
| canes123456 wrote:
| It's more complex than this. There is a pretty narrow
| sweet spot where early detection actually helps.
|
| If the cancer is very fast growing, it could be too fast
| for treatment to help at all. Even if treatment helps
| there likely not a very long period of time before you
| develop symptoms that would have lead to treatment
| regardless.
|
| If it is very slow growing, you might outlive the cancer
| and it doesn't require treatment. It is effectively but
| not actually a benign tumor.
|
| You also have to deal with false negative and positives,
| that could be an order of magnitude higher than the
| Goldilocks true postives that earlier detection actually
| made a difference. It's easy to see how population
| results will not show much of a benefit.
| jajko wrote:
| Probably the most famous slow growing tumor is prostate
| cancer. As per my friend who is urology surgeon,
| basically all men eventually catch it, unless they die
| young. But it goes so slowly and symptoms are rather mild
| in most cases no invasive treatment is done.
| dukeofdoom wrote:
| Prostate cancer. Lots of nerve endings there. The
| procedure to remove it can lead you to be incontinent.
| Let's say you treat the cancer but get damaged by the
| procedure and can't be as active. Your seditary life
| style leads to a blood clot and an early death ...in the
| end you may have lowered your life expectancy as prostate
| cancer is slow growing
| vharuck wrote:
| Prostate cancer also came to my mind first. Doctors
| generally stop screening for prostate cancer after a
| certain age (70 and older is the recommended cutoff from
| the US Preventative Services Task Force), because, if the
| cancer wasn't causing symptoms, it's unlikely to impact
| quality of life or cause death before something else.
|
| The USPSTF references a lot of meta-analyses dealing with
| screening outcomes. They make decisions by whether a
| specific screening practice decreases mortality rates.
| They explicitly don't even include the financial cost of
| a screening practice.
| whimsicalism wrote:
| the scenario you're describing would never happen, you
| don't prescribe chemo based on a blood test of protein
| markers
| dukeofdoom wrote:
| My nurse friend said she only discharged 2 people after
| chemo in about 7 years of service. People have a misguided
| notion about the odds of survinvg a deadly cancer. They
| also found the diagnostic procedures for breast cancer was
| causing the cancer.
| arcticbull wrote:
| > They also found the diagnostic procedures for breast
| cancer was causing the cancer.
|
| I assume you're referring to mammograms. You do get
| exposed to a significant amount of ionizing radiation in
| mammography, about 0.4mSv, about 40% of the EPA's annual
| radiation limit for a member of the public.
|
| That's one of the very good reasons why guidance is women
| wait until age 45 to get annual screenings and switch to
| biennial at 55.
|
| At that point the rewards outweigh the risks.
| epistasis wrote:
| This is not about early detection in general, but rather a
| specific test of dubious utility, specifically full-body MRI,
| which often leads to tons of follow-on tests and invasive
| procedures that may have zero benefit.
|
| For a test with high enough specificity and sensitivity for
| early detection, it's likely that it would be quickly adopted,
| and then studied to show that it actually improves outcomes
| without undue cost (not merely dollar cost but also health
| cost) to people in terms of treatment and its side effects.
| zero-sharp wrote:
| They specifically talk about using the fully body MRI for the
| purpose of detecting cancers. I'm not sure how you missed
| that. You literally had to watch 10 seconds of the clip.
|
| It's interesting because they explicitly talk about follow up
| testing (@2:10) which is to say that multiple methods are
| used if the MRI indicates a problem. So yes, the initial MRI
| may produce a misdiagnosis and that is a defect of the test.
| But the commentary in the video obviously suggests that
| _additional_ testing for early detection is done. That 's
| partly a problem as you pointed out, but then it clearly also
| indicates the scope of the conversation is more broad.
| ceejayoz wrote:
| They didn't miss it at all.
|
| You've misunderstood the comment's point, which is "just
| because prospective full-body MRI is bad doesn't mean all
| diagnostics are".
| zero-sharp wrote:
| It's true that some of the commentary is specific to the
| full body MRI itself (such as misdiagnosis due to an
| imaging artifact), however many of the claims in the
| video are very general. And the scientific study they
| referenced at 6:30 has nothing to do with fully body
| MRIs. The study is in regards to thyroid cancer
| overdiagnosis due to screening (using ultrasound and not
| MRI). This is clearly a statement regarding the
| effectiveness of screening. And, yes, it is specific to
| the cancer.
|
| I'm not saying anything that the studies aren't saying.
| For some kinds of cancers and for some kinds of screening
| methods, screening can result in overdiagnosis.
| ceejayoz wrote:
| OK, so you had to watch a little more than ten seconds.
|
| There's no doubt that _some_ diagnostic tests - like
| getting a full-body MRI as a precaution - may do more
| harm than good. Your apparent mistake is thinking that
| means _all_ diagnostic tests probaby do.
|
| We'll have to figure out which one this is; it's a start
| of that process. We've demonstrated we can do it; now we
| have to figure out if we can distinguish between "big bad
| scary" cancer and "whatever it won't kill you" cancer.
| epistasis wrote:
| At 6:30 it's about a specific test for thyroid cancer,
| which as discussed in my second paragraph, was not found
| to actually improve outcomes for that specific type of
| cancer, not cancer in general.
|
| However, early detection is responsible for greatly
| improving outcomes in many specific cancers. Full body
| MRI is not the test to achieve that. GRAIL's gallery test
| might be one to do it for many classes of cancer, but
| that still remains to be fully seen.
|
| The general of idea of early detection is still an
| extremely promising one for most types of cancer, and in
| particular for some of the deadliest, like ovarian and
| pancreatic cancer.
| Wowfunhappy wrote:
| I can't watch a video at work but I have seen this argument
| before.
|
| I just find it fundamentally hard to believe that having more
| data is a bad thing. What we choose to _do_ with that data is a
| different story, and the actual source of these bad outcomes.
| mort96 wrote:
| Are you prepared to make the decision, "I have cancer but
| statistically it has a relatively low likelihood of killing
| me before I would die of other causes, so I won't do anything
| about it"?
|
| Are most people?
| thimkerbell wrote:
| It might provide enough impetus for getting you to avoid
| sugar and processed meats though.
| mort96 wrote:
| Has avoiding those things been shown to stop existing
| cancer? I thought those foods just increased the chance
| of getting cancer in the first place. But I'm totally
| ignorant here, it sounds plausible that some carcinogens
| work by worsening cancer which would otherwise have been
| benign, I just haven't heard about that
| nick__m wrote:
| There is a spectrum between invasive treatment and not
| doing anything.
|
| You could have a scan 3 months later and if there is no
| progression the doctor schedule a scan 6 months later and
| then 12 months... If there is a progression he schedule an
| appointmentwith an oncologist.
| ggm wrote:
| If you're male and live to over 60, you are going to be in
| this camp regarding the PSA and intervention for Prostate
| Cancer. Two GPs, a Urologist and an Epidemiologist (none of
| whom know each other btw) have all said to me "you will die
| with this not of this" because they can trace the dynamics
| of my presentation.
|
| Enhanced imaging and blood tests alone didn't do this:
| their intuition based on progression and behaviour of the
| system as a whole did.
|
| Treat the person, have a longterm relationship with your
| health provider.
| cityofdelusion wrote:
| Data isn't necessarily good because medicine and biology are
| messy and inaccurate. I just went through a scare myself with
| elevated markers on a typical blood panel. Lots of fuss,
| anxiety, and cost for zero gain. At the end, I learned that
| human bodies vary so much that we're was just no way to know
| upfront if a finding was a concern or if my body was just on
| a tail end of a bell curve. Turns out, if you fully scan
| people, we all have lumps, bumps, and various anomalies. How
| much do you spend "treating" and investigating this stuff? I
| wasted my own time and precious time with doctors for
| nothing, increasing costs to society as a whole.
|
| That kind of data, the costs, we have tons of. That's why
| pretty much every medical association regardless of culture
| has limits on recommended screenings.
| canes123456 wrote:
| If your are choosing not to do anything based on the data,
| gathering the data is objectively a net negative. There are
| financial costs related to taking the tests as well as
| emotion costs related to false positives and even with
| deciding not to act with possibly true positives.
|
| There needs to be a net positive action on a subset of the
| cases to outweigh the costs of gathering and sharing the
| data.
| brnt wrote:
| Most data is crap, and you generally can't tell where the
| needle in the haystack is.
|
| Having more consistency between doctors would already be a
| change needed to actually use data. You will find it matters
| more than you'd like. We can't all have the best doctors, but
| we could use data to level the outcomes.
| siliconc0w wrote:
| The problem with this is that they haven't done the long term
| studies (which they admit). They also don't consider that once
| these are cheap and regular enough you get the change over time
| which should get you a lot less false in positives.
| Spooky23 wrote:
| It's a risk assessment like any other. Probability/impact.
|
| My wife ultimately lost her life to metastatic melanoma, which
| was believed to be in remission. Had there been a way to detect
| the proteins associated with the mets that developed ahead of
| symptoms, the odds are she we be alive and thriving.
|
| In other scenarios, say most prostate cancers, early knowledge
| has low or negative benefits.
| Fire-Dragon-DoL wrote:
| I don't understand how we don't consider benign cancers false
| positives? Acting against those cause serious damage to the
| body for no gain
| mensetmanusman wrote:
| The more data the better though. We need to train the models to
| understand what is worth doing over time.
| kazinator wrote:
| Say we find some proteins in the blood that hint at cancer 7
| years away. How is that actionable, and will it make a
| difference?
|
| How low is the false positive rate?
| tomoyoirl wrote:
| A key benefit is that it might be able to perform follow up
| screenings that make sense for that type of cancer, rather than
| expecting absolutely everyone to take all the tests ever at the
| same rate, at significant inconvenience and expense.
| macawfish wrote:
| So you can get seven years more of nocebo effect, anxiety, stress
| and worry?
| njarboe wrote:
| Does this mean we can get the 5 year cancer survival rate to
| 100%?
| m3kw9 wrote:
| You detect it and then what? You get depressed and there is no
| treatment for something that early. Better to test for obvious
| signs every year based on susceptiblility.
|
| Maybe the depression and stress can make you more sick, let alone
| the effect on your family should you announce it
| goda90 wrote:
| Improve your health with better diet, exercise, sleep. Find and
| reduce carcinogen exposures. Give your immune system a chance
| to nip it in the bud before you even need treatment.
| andrewmutz wrote:
| You can get these sorts of tests already. Last year I used this
| company's product and it was a smooth experience:
|
| https://www.galleri.com/
| ak217 wrote:
| Grail's test is a cfDNA test. It detects DNA fragments in blood
| that are indicative of specific methylation patterns that are
| in turn indicative of possible cancerous growth. While a good
| approach, there are continued sensitivity challenges with cfDNA
| tests.
|
| This research is a high quality longitudinal retrospective
| study of protein cancer biomarkers, not cfDNA. Protein
| biomarkers are a complementary signal that has the potential to
| boost the sensitivity and precision of these tests, especially
| when the signals are combined together.
| zjp wrote:
| It seems like every other day there's a new breakthrough. I
| watched my paternal grandmother succumb to lung cancer when I was
| 7. She was my favorite person on Earth at the time and watching
| her go was devastating. It gives me so much hope to watch the
| category "treatable and preventable cancers" expand over time.
| consf wrote:
| I have a similar experience with my grandmother. Only she had
| stomach cancer. Such research warms my heart
| consf wrote:
| Early detection is crucial in improving outcomes for cancer
| patients, as it allows for timely treatment and intervention when
| the disease is most treatable. And these kinds of research are
| promising
| kemmishtree wrote:
| i.e., Why We Need Utility-Scale Solid-State Molecular Sensing,
| Reason #53,444,001
| srigi wrote:
| Isn't the cancer the "exponential game"? If there are 20 cancer
| cells in the body on day 1, on day 30 there will be 10737418240
| (10.7B) cells if they double every day. This is how we were
| taught about cancer, so it is a very quick process when started.
| How can you get 7 years of ahead of time in this setup?
| arrosenberg wrote:
| They don't necessarily double every day. Some tumors are very
| stable, some are particularly metastatic. It often depends on
| access to blood supply and what type of cell has become
| cancerous.
| jimbobthrowawy wrote:
| Here's hoping this kind of screening becomes quick and cheap
| enough to do at home or regularly at a pharmacy.
|
| I'd like to get a rough estimate of how many moles I have at
| least once a year if it wasn't a huge effort.
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