Blood test that finds 50 types of cancer is accurate enough to be rolled out • Hacker News Board

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#91

Post by plank_time » Fri, Jun 25, 2021, 1:00 PM UTC

Gatsky wrote: post #15

reacharavindh wrote: post #3

This is one of those medical revolutions that I am waiting dearly for. Facilities that are not hospitals(to avoid the risk of occupying medical devices that sick people need) built to _regulary_ check up otherwise healthy people for preventive care. Heck, I have so many alerts defined on my monitoring setup for servers to watch for signals of failure before they get too big. But, my own body is not observed until som…

Note this test is about early detection, not prevention. If your pancreatic cancer is detected early, you will still need to have your insides rearranged to get it out.

There is no early detection for pancreatic cancer. So we don’t know what we can do yet. Right now by the time we detect it, we are dead.

An entire generation of early detection might create new methods to treat it. We don’t know what we don’t know.

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#92

Post by laputan_machine » Fri, Jun 25, 2021, 1:02 PM UTC

jacquesm wrote: post #80

iandanforth wrote: post #76

Earlier quoted context omitted.

I detest this mindset. It is incredibly counter productive. "Our tests are bad, so lets not test" is not a thought worthy of respect. This states that you know about a problem but want to continue to ignore that problem. Reprehensible. No, we should take the exact opposite approach. Test everyone constantly until such methods become both cheap and powerful. So yeah we all have some cancer load but if the diagnostic o…

The problem is not my mindset, but your understanding of the subject material. Patient outcomes have very little to do with the quality of the tests, even a 100% accurate test would not necessarily lead to improved patient outcomes because these are defined independent of the tests. You are treating this like a software problem, but it isn't, it's a medical problem, and medical problems tend to be complex because the…

For someone who has no medical background, you are certainly spouting a lot of nonsense as if it was fact.

The WHO, for example, disagree.

https://www.who.int/activities/promoting-cancer-early-diagno...

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#93

Post by dmitryminkovsky » Fri, Jun 25, 2021, 1:03 PM UTC

hans1729 wrote: post #69

dmitryminkovsky wrote: post #65

One of my great fears in life is that employers/insurers will impose this en masse on people, causing immeasurable harm to the mental health of people who can’t handle the anxiety that this type of approach to medicine would cause. I’m definitely a big proponent of evidence-based medicine and using it to help living quality life as long as possible, but this sort of thing would just wreck my day to day existence and…

One of your greatest fears in life is to be regularly checked for diseases that would end your life unless thy are detected in time? ...What? e: you mean the emotional distress caused by the process? But that's just in your head, and it's beyond irrational. Getting checked is inherently a good thing . Even if you are extremely anxious, the people who love you want you to live - this is a psychological problem that yo…

Yes that is right. I make no claims to being a rational being. I am at best pseudo rational. As much as I love computers, I make no claim to being one. I am a human.

And yes, I do also greatly appreciate evidence based medicine. There are many terminal illnesses where there is no evidence that constant screening improves outcomes. My impression is that people successfully market products like this to give people a false sense of control tire through micromanagement where given the state of the art, control is lacking.

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#94

Post by ssijak » Fri, Jun 25, 2021, 1:04 PM UTC

jacquesm wrote: post #46

reacharavindh wrote: post #3

This is one of those medical revolutions that I am waiting dearly for. Facilities that are not hospitals(to avoid the risk of occupying medical devices that sick people need) built to _regulary_ check up otherwise healthy people for preventive care. Heck, I have so many alerts defined on my monitoring setup for servers to watch for signals of failure before they get too big. But, my own body is not observed until som…

Regularly checking people that are otherwise healthy for cancer will turn up a lot of cancer through false positives or slowly growing ones, will lead to a lot of unnecessary intervention and will in fact lead to a reduction in quality of life and lifespan. This is one of the reasons why exhaustive cancer screening (which was more costly in the past but could have been done) was not promoted, it had nothing to do wit…

The test in the article actually has very few false positives. And who knows, maybe even those false positives were just extremely early cases of cancer.

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#95

Post by jacquesm » Fri, Jun 25, 2021, 1:05 PM UTC

11thEarlOfMar wrote: post #85

jacquesm wrote: post #74

Earlier quoted context omitted.

With the present invasive methods of excising cancer the answer is that on an individual basis you might be better off with early detection but on a statistical basis across a larger population you'll be worse off. The important variables are patient age, how aggressive the cancer is (growth rate), what the risks of that particular type of cancer metastasizing are, what your genetic disposition is etc.

Again, personally, I lost both parents to cancer. One thyroid (very slow progression) one pancreatic (very fast). In both cases, I believe that pre-symptomatic detection would have had a high probability of eradicating their cancers. That experience skews my view and if I get the opportunity, I'll have these tests done 3x annually. But I understand your point. How about making it elective? That way, people who prefer…

I'm really sorry for your loss, but please try to keep a healthy balance between personal tragedy versus medical policy set for a whole population, which are two entirely different things.

For any particular individual, especially those who end up dying from cancer early detection would have likely mattered. Which is exactly where the problem lies: that is a large number of people, but still (much) smaller than the number of people who will end up with positive cancer test. And policy is set by the outcome for the population as a whole, not for any particular individual.

In most places in the developed world cancer screening is already elective, but not for all types of cancer. Even so, how often are you going to do it? Once every year could easily be too slow to make a difference, and these tests aren't free so say a bi-annual test on all of the population would wreck the ability of the medical world to do much else. This is a tough problem to solve, especially because wetware tends to be finicky to work on and tiny little details will have a huge effect on outcome.

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#96

Post by TaupeRanger » Fri, Jun 25, 2021, 1:05 PM UTC

reacharavindh wrote: post #3

This is one of those medical revolutions that I am waiting dearly for. Facilities that are not hospitals(to avoid the risk of occupying medical devices that sick people need) built to _regulary_ check up otherwise healthy people for preventive care. Heck, I have so many alerts defined on my monitoring setup for servers to watch for signals of failure before they get too big. But, my own body is not observed until som…

Actually you don't want this, and you are describing a nightmare scenario that everyone who studies health policy understands all too well. Mass screening of healthy people will result in extreme iatrogenics and unnecessary psychological damage and stress (which leads to physical effects as well), not to mention overwhelming the medical system.

The fact is that many things that could be detected will never result in symptoms or other noticeable problems. Further, for many things that can be detected we can't really do much about, so by detecting it early you are just reducing the amount of life they have left without worrying about their disease, or causing unnecessary treatment (which includes unnecessary damage, cost, stress, etc.)

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#97

Post by Guillaume86 » Fri, Jun 25, 2021, 1:05 PM UTC

jacquesm wrote: post #66

pieno wrote: post #63

Earlier quoted context omitted.

It seems like you and GP are agreeing on the fact that right now we don’t do too many preventive checks because the cost of testing is higher than the benefits (mainly because false positives could lead to risky and invasive follow-up testing to confirm that it’s indeed a /false/ positive; and knowing that you have something sooner rather than later may not meaningfully affect the outcome of the disease; and costs of…

Even 100% true positive rate would not guarantee improved patient outcomes with massive testing. This is grounded in a poor understanding of what improved patient outcomes are all about, which is fine with me but to see this so misunderstood is a bit disappointing. Better tests do not automatically lead to better outcomes. They will lead to many more cancers detected, and they will lead to more interventions. Just on…

Your point across this thread is weird because it's not the testing itself which is an issue (if we assume the testing has a negligible cost economically and is comfortable/easy for the subject).

We just need to improve the decision making after getting test results (one of these decisions is to decide to not do anything), and more data make improving it easier.

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#98

Post by TheHypnotist » Fri, Jun 25, 2021, 1:05 PM UTC

jacquesm wrote: post #46

reacharavindh wrote: post #3

This is one of those medical revolutions that I am waiting dearly for. Facilities that are not hospitals(to avoid the risk of occupying medical devices that sick people need) built to _regulary_ check up otherwise healthy people for preventive care. Heck, I have so many alerts defined on my monitoring setup for servers to watch for signals of failure before they get too big. But, my own body is not observed until som…

Regularly checking people that are otherwise healthy for cancer will turn up a lot of cancer through false positives or slowly growing ones, will lead to a lot of unnecessary intervention and will in fact lead to a reduction in quality of life and lifespan. This is one of the reasons why exhaustive cancer screening (which was more costly in the past but could have been done) was not promoted, it had nothing to do wit…

Slowly growing cancer still sounds bad enough to get some of that "unnecessary" intervention. I'm no doctor, but my understanding is that the aggressive cancers typically get discovered due to a symptom of sorts and thereabout is your 6 month countdown. Again, from a layman's perspective and understanding, those cancers need to start somewhere. What's the harm in catching them as early as possible? If a blood test leads to a scan and the scan turns up negative, what's the issue?

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#99

Post by jacquesm » Fri, Jun 25, 2021, 1:07 PM UTC

laputan_machine wrote: post #92

jacquesm wrote: post #80

Earlier quoted context omitted.

The problem is not my mindset, but your understanding of the subject material. Patient outcomes have very little to do with the quality of the tests, even a 100% accurate test would not necessarily lead to improved patient outcomes because these are defined independent of the tests. You are treating this like a software problem, but it isn't, it's a medical problem, and medical problems tend to be complex because the…

For someone who has no medical background, you are certainly spouting a lot of nonsense as if it was fact. The WHO, for example, disagree. https://www.who.int/activities/promoting-cancer-early-diagno...

The fact that you link to that and apparently do not understand it combined with a personal attack is enough to disregard your comment for me.

But let me stress this in case it wasn't clear to you: screening and early diagnosis are not the same thing.

If you screen a large population for cancer you will turn up a lot of cancers that may never become a problem, or that may even end up being re-absorbed without the need for intervention, as well as a large number of false positives.

Early diagnosis means that there are already symptoms.

Please don't confuse the two.

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#100

Post by jacquesm » Fri, Jun 25, 2021, 1:09 PM UTC

TheHypnotist wrote: post #98

jacquesm wrote: post #46

Earlier quoted context omitted.

Regularly checking people that are otherwise healthy for cancer will turn up a lot of cancer through false positives or slowly growing ones, will lead to a lot of unnecessary intervention and will in fact lead to a reduction in quality of life and lifespan. This is one of the reasons why exhaustive cancer screening (which was more costly in the past but could have been done) was not promoted, it had nothing to do wit…

Slowly growing cancer still sounds bad enough to get some of that "unnecessary" intervention. I'm no doctor, but my understanding is that the aggressive cancers typically get discovered due to a symptom of sorts and thereabout is your 6 month countdown. Again, from a layman's perspective and understanding, those cancers need to start somewhere. What's the harm in catching them as early as possible? If a blood test le…

Depends on your age, genetic disposition and many other factors besides. Once you have symptoms your oncologist would be the only person qualified to determine what for you in particular is the best course forward.

In some cases that 6 months might be very generous, in other cases you are better off to do nothing (especially if you are advanced in age and the cancer is growing slowly). It all depends.