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Administering immunotherapy in the morning seems to matter. Why?

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Re: Administering immunotherapy in the morning seems to matter. Why?

#81

Post by irrational »

raylad wrote: post #48

My father was on chemotherapy with fludarabine, a dna base analog. The way it functions is that it is used in DNA replication, but then doesn’t work, and the daughter cells die. Typically, patients who get this drug experience a lot of adverse effects, including a highly suppressed immune system and risk of serious infections. I researched whether there was a circadian rhythm in replication of either the cancer cells…

Is it the time of day or how long the patient has been awake that matters? It seems like someone could change their sleep cycle to match the doctors schedule if the latter.

Re: Administering immunotherapy in the morning seems to matter. Why?

#82

Post by Kiyo-Lynn »

I once accompanied a family member through immunotherapy. The treatment times were mostly arranged by the hospital, and the doctor suggested doing it in the morning. We just thought it was to avoid the afternoon rush. Looking back, though, they really did seem to feel better with morning treatments. Now I realize the timing itself might actually affect how well it works. I really hope that in the future, doctors will consider not just the drug and the dosage, but also when it’s given.

Re: Administering immunotherapy in the morning seems to matter. Why?

#83

Post by Spooky23 »

tilne wrote: post #60
vkou wrote: post #55

Earlier quoted context omitted.

> And shameful (for them.) 1. A single positive outcome with N=1 should generally not be the basis for making a medical recommendation. 2. It takes a mountain of research work to go from that to a study that you can draw meaningful conclusions from. 3. The hospital is not in the business of doing research, it's in the business of treating patients.

Regarding 3: Shouldn’t the medical system be optimizing for patient outcomes rather than the business their in? Regarding the first two: I think the anecdote being from 1995 suggests there would have been time to put together said mountain of research. I’m not agreeing that this is shameful for the original doctor, but I do think it’s shameful if avenues for potential research are not taken because it’s inconvenient…

It is at cancer centers. Community oncologists don’t have the resources to do it.

Example: https://www.medicalnewstoday.com/articles/cancer-time-of-day...

Re: Administering immunotherapy in the morning seems to matter. Why?

#84

Post by Spooky23 »

Kiyo-Lynn wrote: post #82

I once accompanied a family member through immunotherapy. The treatment times were mostly arranged by the hospital, and the doctor suggested doing it in the morning. We just thought it was to avoid the afternoon rush. Looking back, though, they really did seem to feel better with morning treatments. Now I realize the timing itself might actually affect how well it works. I really hope that in the future, doctors will…

They do - for metastatic melanoma, the goal is before 4:30, which is linked to higher survival rates.

Re: Administering immunotherapy in the morning seems to matter. Why?

#86

Post by Kiyo-Lynn »

Spooky23 wrote: post #84
Kiyo-Lynn wrote: post #82

I once accompanied a family member through immunotherapy. The treatment times were mostly arranged by the hospital, and the doctor suggested doing it in the morning. We just thought it was to avoid the afternoon rush. Looking back, though, they really did seem to feel better with morning treatments. Now I realize the timing itself might actually affect how well it works. I really hope that in the future, doctors will…

They do - for metastatic melanoma, the goal is before 4:30, which is linked to higher survival rates.

I didn’t know there were already examples like metastatic melanoma where the timing is clearly defined. It makes me wonder if other treatments could also benefit from getting the timing right. Thanks for sharing this. I’ll definitely look into it more.

Re: Administering immunotherapy in the morning seems to matter. Why?

#87

Post by xvector »

_qua wrote: post #77
echelon wrote: post #75

Earlier quoted context omitted.

It's no wonder biology hasn't even entered into the punch-card phase. When I did my bio undergrad I was keenly aware our bodies are just scaled up molecular machines. I was hoping for a future where we'd grow MHC-neutral clonal bodies for organ harvesting. Nope. We're in the stone age.

Move fast and break things in human medicine means unethical researchers maim and kill people, often marginalized people. Nazis, Japanese experimenting on prisoners, Tuskegee airmen syphilis experiments, Cincinnati radiation experiments and many others stand as testament to what ambitious unethical scientists will do to further their knowledge and career. Thus we have strict guardrails that slow down how we do things…

I am close with a few folks in medical research and the broken nature of the system and sheer amount of red tape has broken their dreams. It is impossible to get anything done.

There is a difference between "reasonable guardrails" and suffocating progress until it's nearly impossible barring Herculean efforts by multibillion dollar entities. It cannot be understated how badly the current bureaucracy has destroyed medical progress.

We are seeing the same problem with nuclear overregulation result in worse outcomes and more deaths for people globally.

There is real suffering and a human cost, measurable in lives, to slowing down progress - just as there is one for reckless progress.

Re: Administering immunotherapy in the morning seems to matter. Why?

#88

Post by cannonpr »

echelon wrote: post #78
_qua wrote: post #77

Earlier quoted context omitted.

Move fast and break things in human medicine means unethical researchers maim and kill people, often marginalized people. Nazis, Japanese experimenting on prisoners, Tuskegee airmen syphilis experiments, Cincinnati radiation experiments and many others stand as testament to what ambitious unethical scientists will do to further their knowledge and career. Thus we have strict guardrails that slow down how we do things…

We've been able to clone mammals for 30 years and haven't acted on it. We're still toying with molecular systems beyond the limit of detection. Clone humans. Cut off their brain stem during development. Turn off cephalization signals for good measure. Scale it up to industrial scale. Research problems solved. We'd have every study at our fingertips. We'd have organs and tissue and blood for everyone. We could possibl…

You might be surprised at how little of the body still functions without brain function, well, some bits of the brain, including basic homeostasis and immune system function.

Re: Administering immunotherapy in the morning seems to matter. Why?

#89

Post by _qua »

xvector wrote: post #87
_qua wrote: post #77

Earlier quoted context omitted.

Move fast and break things in human medicine means unethical researchers maim and kill people, often marginalized people. Nazis, Japanese experimenting on prisoners, Tuskegee airmen syphilis experiments, Cincinnati radiation experiments and many others stand as testament to what ambitious unethical scientists will do to further their knowledge and career. Thus we have strict guardrails that slow down how we do things…

I am close with a few folks in medical research and the broken nature of the system and sheer amount of red tape has broken their dreams. It is impossible to get anything done. There is a difference between "reasonable guardrails" and suffocating progress until it's nearly impossible barring Herculean efforts by multibillion dollar entities. It cannot be understated how badly the current bureaucracy has destroyed med…

I don’t disagree but the guy below you wants to grow human shells and try head transplants.

Re: Administering immunotherapy in the morning seems to matter. Why?

#90

Post by owenthejumper »

Spooky23 wrote: post #85
owenthejumper wrote: post #62

Sicker patients get emergency treatment in the hospital in the afternoon while healthier ones in the morning in the clinic

Cancer treatments typically don’t happen in an inpatient setting.

Of course they do
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