Pancreatic cancer from a different perspective • Hacker News Board

Re: Pancreatic cancer from a different perspective

#41

Post by petercooper » Fri, Jun 16, 2017, 2:01 PM UTC

nerdponx wrote: post #40

petercooper wrote: post #39

Earlier quoted context omitted.

I would really love to be able to easily check my pancreas for any unhealthy changes as the inherited risk is pretty high. That sounds good, but it would be necessary to do this in a way where problems with only a low risk would not be highlighted. For example, to avoid a brain aneurysm, you might opt to be scanned on a frequent basis. Except what happens if they find a blood vessel with a 1% annual chance of rupture…

That doesn't make sense to me. What if that 1% chance suddenly turns into a 50% chance? If I suddenly present with symptoms of a risky aneurism, wouldn't having that "1% chance, last we checked" on my medical history help accelerate the correct diagnosis and treatment?

That's a great point, but then someone might be so panicked they take the more dangerous "fix" than just sit out the risk. I know I would totally obsess over it if I knew about that minor risk, for example. But this is why everyone should get the option, perhaps.

Re: Pancreatic cancer from a different perspective

#42

Post by lazerpants » Fri, Jun 16, 2017, 2:31 PM UTC

gms7777 wrote: post #22

lazerpants wrote: post #14

Earlier quoted context omitted.

The most promising early warning tests I've seen in the past few years look at degraded DNA fragments floating in the blood that have been shed by cancers. This will probably be the winning technology for all cancer early diagnoses, though genetic biomarkers will probably fail to catch all cancers.

Circulating tumor DNA has several challenges towards being an effective test. The first is just the relatively low proportion of it in the blood (especially before growth is significant) makes reliable detection fairly difficult. The bigger issue though will likely be managing the false discovery rate. Nearly everyone will have precancerous growths and benign lesions which may share many genetic biomarkers with poten…

All completely true. But I can easily imagine a near future in which some populations receive screening and then further investigation if something is found. Of course, that creates additional burden on radiology, which is unfortunate, but hopefully all the breakthroughs in ML will make those resources less expensive.

Re: Pancreatic cancer from a different perspective

#43

Post by nerdponx » Fri, Jun 16, 2017, 2:45 PM UTC

petercooper wrote: post #41

nerdponx wrote: post #40

Earlier quoted context omitted.

That doesn't make sense to me. What if that 1% chance suddenly turns into a 50% chance? If I suddenly present with symptoms of a risky aneurism, wouldn't having that "1% chance, last we checked" on my medical history help accelerate the correct diagnosis and treatment?

That's a great point, but then someone might be so panicked they take the more dangerous "fix" than just sit out the risk. I know I would totally obsess over it if I knew about that minor risk, for example. But this is why everyone should get the option, perhaps.

Isn't this the doctor's responsibility to say "I will not do this procedure because the risk is too great", then?

A friend of mine was in a similar scenario recently. He was tempted to do an aggressive and risky surgery to treat a chronic condition, out of sheer frustration. I couldn't talk him down. It was only once the surgeon said "I can't look you in the eye and tell you that this will be worth it" that he reconsidered.