A cancer trial’s unexpected result: Remission in every patient • Hacker News Board

Re: A cancer trial’s unexpected result: Remission in every patient

#221

Post by Wowfunhappy » Mon, Jun 06, 2022, 4:18 PM UTC

hp48fan wrote: post #219

scoopertrooper wrote: post #208

Earlier quoted context omitted.

It seems like you want to create a general rule entirely based on your own personal experience.

You are correct. I arrive at conclusions based on my life experiences and what I've learned along the way. We literally give industrial quantities of antibiotics to animals. So antibiotic preservation is not an honest reason to lock them up Tylenol and Advil can very quickly mess up your kid's liver and kidneys if you misdose. Yet, they're over the counter. So safety does not appear to be an honest reason either. Iro…

> We literally give industrial quantities of antibiotics to animals. So antibiotic preservation is not an honest reason to lock them up

We desperately need to stop doing that too, but at least it optimizes for bacteria that infects animals rather than humans.

I don't think you (and most other people) are anywhere near scared enough of returning to a world without antibiotics.

Re: A cancer trial’s unexpected result: Remission in every patient

#222

Post by Wowfunhappy » Mon, Jun 06, 2022, 4:21 PM UTC

hp48fan wrote: post #218

Wowfunhappy wrote: post #186

Earlier quoted context omitted.

Then the doctor is doing a bad job. Making all antibiotics available over the counter would not improve the situation.

Im on my fifth (?) pediatrician. This one's the first one I even like as a person.

You said in a sister comment that your doctor wouldn't prescribe antibiotics until a culture came back. Isn't that precisely the opposite of giving them out freely in the same situations you would?

Yes, in your case the culture came back positive. But, you're not psychic, you didn't really know that, and you're biased by the fact it's your own child.

Re: A cancer trial’s unexpected result: Remission in every patient

#223

Post by hp48fan » Mon, Jun 06, 2022, 5:47 PM UTC

Wowfunhappy wrote: post #221

hp48fan wrote: post #219

Earlier quoted context omitted.

You are correct. I arrive at conclusions based on my life experiences and what I've learned along the way. We literally give industrial quantities of antibiotics to animals. So antibiotic preservation is not an honest reason to lock them up Tylenol and Advil can very quickly mess up your kid's liver and kidneys if you misdose. Yet, they're over the counter. So safety does not appear to be an honest reason either. Iro…

> We literally give industrial quantities of antibiotics to animals. So antibiotic preservation is not an honest reason to lock them up We desperately need to stop doing that too, but at least it optimizes for bacteria that infects animals rather than humans. I don't think you (and most other people) are anywhere near scared enough of returning to a world without antibiotics.

"optimizes for bacteria that infects animals rather than humans."

But then there is horizontal gene transfer.

The world has a lot to be scared of. Ive had an easy life, save for one or two experiences that have dwindled what truly frightens me a lot:

- Dying after my kids (unless my kids have a tremendous disability. Then my fear is reversed)

- Facing God, if He exists. If He doesn't, the nothingness of space.

Pain was on the list, but a bone marrow biopsy knocked it off. A world without modern antibiotics doesn't scare me. Much anyway.

Re: A cancer trial’s unexpected result: Remission in every patient

#224

Post by scoopertrooper » Mon, Jun 06, 2022, 6:00 PM UTC

hp48fan wrote: post #219

scoopertrooper wrote: post #208

Earlier quoted context omitted.

It seems like you want to create a general rule entirely based on your own personal experience.

You are correct. I arrive at conclusions based on my life experiences and what I've learned along the way. We literally give industrial quantities of antibiotics to animals. So antibiotic preservation is not an honest reason to lock them up Tylenol and Advil can very quickly mess up your kid's liver and kidneys if you misdose. Yet, they're over the counter. So safety does not appear to be an honest reason either. Iro…

> Btw, antibiotics are available over the counter in Europe. The ones Id use and feel comfortable using

What are you talking about?

> Over-the-counter (OTC) sales of antibiotics is forbidden by law in all countries, but it is allowed for some specific formulations (creams in Norway and Denmark or eye drops in the UK)

https://www.escmid.org/escmid_publications/escmid_elibrary/m...

Re: A cancer trial’s unexpected result: Remission in every patient

#225

Post by X6S1x6Okd1st » Mon, Jun 06, 2022, 6:58 PM UTC

Aransentin wrote: post #188

X6S1x6Okd1st wrote: post #53

Earlier quoted context omitted.

Pretty sure the base rate you'd want to compare against is either placebo given -> remission or simply spontaneous remission. It appears that spontaneous remission is really quite rare. > [sponanteous remission of cancer] incidence is roughly one in every 60 000–100 000 cancer patients, but the true figure is unknown (2). Spontaneous regression of colon cancer seems to be particularly rare https://academic.oup.com/jj…

If spontaneous remission is super rare it does change the conclusion, yeah. (Tangentially I think your stats are a little messed up there - you calculated the expected number of people out of 43000 surviving, not the trials returning a false positive. Assuming 0.0016% that chance is astronomically small, so your argument is stronger.)

whoops good point!

Re: A cancer trial’s unexpected result: Remission in every patient

#226

Post by Gordonjcp » Mon, Jun 06, 2022, 7:00 PM UTC

rjm226 wrote: post #182

Gordonjcp wrote: post #72

I'm not sure which immunotherapy drug my mother has been receiving, but after being diagnosed with lung cancer nearly two years ago - a tumour roughly the size of a tangerine right in the top corner of one lung, utterly inaccessible by surgery, in absolutely the wrong place to attempt radiotherapy - it's now gone, save for a little bit of scarring and fibrosis where it used to be. The treatment has left her tired and…

Any idea what cancer she had and what treatment? My mom is currently battling stage 4 metastatic neuroendocrine primary lung cancer atypical carcinoid and being treated with Lutathera, a nuclear injection that targets the somatostatin receptor on the cancer cells and hopefully shrinks, slows, or kills them off. The treatment is 1 injection every 2 months over the course of 8 months. So 4 total injections. She has alr…

I'll find out. How's your mum doing?

Re: A cancer trial’s unexpected result: Remission in every patient

#227

Post by hp48fan » Mon, Jun 06, 2022, 9:03 PM UTC

Wowfunhappy wrote: post #222

hp48fan wrote: post #218

Earlier quoted context omitted.

Im on my fifth (?) pediatrician. This one's the first one I even like as a person.

You said in a sister comment that your doctor wouldn't prescribe antibiotics until a culture came back. Isn't that precisely the opposite of giving them out freely in the same situations you would? Yes, in your case the culture came back positive. But, you're not psychic, you didn't really know that, and you're biased by the fact it's your own child.

Do you know how many Dr.s a parent deals with? After hours, you don't go to your family Dr. This year alone Ive probably seen a dozen Dr.s

Ive had some Drs push antibiotics after they literally just said a persistent cough is probably viral.

Ive had my daughter with blood curdling screams told her urine came out negative and her urine would have to be cultured. They can culture it all they want but I didn't leave without the antibiotic. Guess how the cultures come out? Plural because it happened more than once and the quick test at the Dr. has a high false + rate. Btw, untreated UTIs cause scarring.

Btw, Dr. dont pearl clutch when it comes to their loved one. My colleague, who's married to a physician, got started on antibiotics for Lyme disease before the cultures came back positive. Just in case.

"But, you're not psychic, you didn't really know that,"

No, Im not. I just happen to have a neural network on the top of my head with hundred of millions (billions?) of years of evolution to spot trends.

Re: A cancer trial’s unexpected result: Remission in every patient

#228

Post by hp48fan » Mon, Jun 06, 2022, 9:06 PM UTC

scoopertrooper wrote: post #224

hp48fan wrote: post #219

Earlier quoted context omitted.

You are correct. I arrive at conclusions based on my life experiences and what I've learned along the way. We literally give industrial quantities of antibiotics to animals. So antibiotic preservation is not an honest reason to lock them up Tylenol and Advil can very quickly mess up your kid's liver and kidneys if you misdose. Yet, they're over the counter. So safety does not appear to be an honest reason either. Iro…

> Btw, antibiotics are available over the counter in Europe. The ones Id use and feel comfortable using What are you talking about? > Over-the-counter (OTC) sales of antibiotics is forbidden by law in all countries, but it is allowed for some specific formulations (creams in Norway and Denmark or eye drops in the UK) https://www.escmid.org/escmid_publications/escmid_elibrary/m...

You're right; since I last visited Greece they've tightened their antibiotic policy (2020).

Re: A cancer trial’s unexpected result: Remission in every patient

#229

Post by brigandish » Tue, Jun 07, 2022, 12:40 AM UTC

jlarocco wrote: post #117

brigandish wrote: post #42

Earlier quoted context omitted.

> That's always stuck with me -- the problem with American healthcare is the American interpretation of capitalism. What should it cost instead? > Dude was living off of government research grants. Let's imagine his work comes to fruition. The drug is expensive but efficacious - is this not a good thing? Should the government have not helped fund this drug because now it's expensive? The alternative is a world withou…

> Should the government have not helped fund this drug because now it's expensive? If he wants to charge "what the market will bear," then he should fund the research through the market. If he wants government handouts to do the research then the public deserves to get the benefit that it's paying for - we're not funding it to make some guy rich. I'm not saying it should be free, but he's already opted out of the mar…

I'm all for cutting subsidies, but the problem is that if you want risky things then investors might decide it's better not to invest and the drugs never appear.

The government (which is really a government of and for the people, right?;) gets what it wants - a new drug - and jobs are created, trade happens, taxes are levied, health improves leading to (theoretical) money saved, more hours worked, more taxes… There's no need to punish the creator by not letting them make money off of their creation just because the government was involved, the government is getting plenty out of their investment.

Re: A cancer trial’s unexpected result: Remission in every patient

#230

Post by brigandish » Tue, Jun 07, 2022, 12:46 AM UTC

klyrs wrote: post #103

brigandish wrote: post #42

Earlier quoted context omitted.

> That's always stuck with me -- the problem with American healthcare is the American interpretation of capitalism. What should it cost instead? > Dude was living off of government research grants. Let's imagine his work comes to fruition. The drug is expensive but efficacious - is this not a good thing? Should the government have not helped fund this drug because now it's expensive? The alternative is a world withou…

> Should the government have not helped fund this drug because now it's expensive? No, the government should set a reasonable price for the product they funded. A high enough price to fund manufacturing, a low enough price to ensure that people who need the treatment have ready access to it. If the upper bound on price is too low for universal access, that's what subsidies are for. Instead, we have free money to boot…

> No, the government should set a reasonable price for the product they funded.

Do the investors at the company you work at set the prices for the products you produce? That would be strange.

> Instead, we have free money to bootstrap extractive capitalists, at cost and detriment to people who need care.

It's "free" money because the capital costs are high and it's risky. I don't think it's the only or the best way but it is a valid way, but it doesn't remove the right to make a profit.

As to it being "detriment[al]" to the people who need care, they're getting a drug that didn't exist before, right? And this also should (generally) make existing drugs cheaper, right?