I thought that death risk was 100 percent, no matter what
99% of all non-smokers die
You need to update those stats
Lung cancer pill cuts risk of death by half
91–100 of 116 posts
Re: Lung cancer pill cuts risk of death by half
#92Earlier quoted context omitted.
The good thing is in most people (particularly smokers) it is very slow growing. We also have great non-invasive curative treatment options like stereotactic radiation.
Don’t smokers account for ~99% of cases of small-cell lung cancer, which is by far the worst type to have (very prone to metastasis and grows rapidly)?
Small-cell (SCLC) is definitely very aggressive and more strongly associated with smoking than non-small cell lung cancer (NSCLC), I'm not sure about 99% but that seems too high.
It's fairly rare though, the quoted numbers from SEER are 14% but from a clinical perspective most of us that deal with lung cancer feel that's discordant with our practices and likely an overestimate.
In either case, smoker or non-smoker you're far more likely to develop NSCLC with adenocarcinoma being more common than squamous cell (typically only in smokers for the latter but still less common than adenocarcinoma).
The typical adenocarcinoma most people get has a doubling time of roughly 1-2 years.
Re: Lung cancer pill cuts risk of death by half
#93Earlier quoted context omitted.
the FDA face an unenviable challenge: how to promote healthcare innovation without endangering patients? regulations that are too loose may cause suffering and death while regulations that are too strict will delay or block prevent helpful treatments. regulating healthcare is extremely difficult and largely a thankless job. one solution is to approach national healthcare like national security and let people voluntee…
> in short, overstate risks but let patients decide. Then you have to battle the people selling highly marked up snake oil as an 'experimental' treatment - when every expert could tell you this treatment is already well known to be ineffective.
indeed. this is a thorny problem with no perfect solution.
on the one hand, you may throttle promising treatments and on the other hand, you may increase useless treatments.
publishing results is one way to mitigate snake oil, though this obviously doesn't eliminate the problem.
the general framework is to maximize transparency and freedom.
letting people volunteer for national healthcare like they can for the national army increases freedom, but we must also increase transparency to combat snake oil.
Re: Lung cancer pill cuts risk of death by half
#94Earlier quoted context omitted.
My father is in this situation with prostate cancer. First line therapies have stopped working and now its on to chemo. I am hoping chemo won't damage him too much. There are also radioligand therapies like lutetium 177 but they haven't been sequenced on chemo naive patients yet. So soc is chemo first.
I wasn’t involved in this study but the cancer center I just left was one of the sites for the upfront Lu177 vs chemotherapy trial. Speaking casually with the physician involved recently he said the results weren’t promising thus far. I don’t think this is published yet and I’m not familiar with prostate ca treatment literature so take this with a grain of salt.
my father is in india where they've been giving lu177 ( and others) before chemo for quite a while ( other countries being germany and australia ) . Forums are awash with 'success stories' .
There are many clinical trials currently in US and canada. Some have published results showing 'non inferiority' in small sample sizes but most are in progress
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627907/
https://clinicaltrials.gov/ct2/show/NCT04647526 this one was supposed to publish some preliminary results in q1 2023 but i don't see any updates :/
Re: Lung cancer pill cuts risk of death by half
#95I just wonder how we've not been able to make a drug to increase lean mass without negative effect on cardiovascular system
Increase your natural T. Doubt you maxed it.
Re: Lung cancer pill cuts risk of death by half
#96This is a great example of where cancer treatment is headed and why it's so hard - namely that cancer isn't one disease, it's many thousands of diseases. This is a drug that targets lung cancer (~12% of cancers) and only one type of lung cancer (non-small cell lung cancer, ~80% of cases). It targets a particular mutated gene that occurs in about 30% of that subtype. And then, about 50% of those patients respond. So d…
"1.4% of all cancers" This actually seems large to me. Although that is suspiciously large. Looking at the numbers I think it should be much lower. A 51% reduction doesn't mean it helps 51% if the people. In this case it looks like about 10% of the people are effected given the 88% vs 78% survival rates, right? Maybe something like .28% of all cancer?
These are ballpark numbers to be sure, and yeah, my off the cuff comment didn't get that exactly right. I also simplified things quite a bit to try to get the broader point across - Thanks for following up!
Re: Lung cancer pill cuts risk of death by half
#97My mother in law has stage 4 lung cancer. Tagrisso is extending her life. The cancer has been shrinking since going on it with few side effects. Unfortunately stage 4 cannot be cured, and at some point tagrisso stops working. My understanding is the cancer mutates and eventually develops resistance. Then she will go on chemo and her quality of life will go down. I am thankful for modern medicine that we get some extr…
advice on how to catch earlier?
Not really. Lung cancer is mostly due to smoking or radon. So don’t smoke and get your house tested.
Outside of that, it’s a crap shoot. My mom in law didn’t have either risk factor. PET scans can pick up but each one exposes you to radiation which can also cause cancer. So they generally don’t screen for low risk patients.
Re: Lung cancer pill cuts risk of death by half
#98Earlier quoted context omitted.
Technically true is how most science education got screwed up in every field of science. We went from educators like Carl Sagan and Feynman who would take great pains to make sure they don't just tell technically true statements to most researchers today blatantly saying misleading technically true statements for a living to get grant money. Every second grant and paper nowadays literally starts with a disingenuous g…
> They all literally share the same DNA, they can't be that different. They share the same DNA in the sense that every cell in that body does. But the different types of cancers have different mutations per cell type and the increasingly precise identification of those is the basis of the recent new treatment options. Histological classifications become less and less relevant, instead mutations and subtypes of mutati…
There are also cancers where the root cause is not a cell suddenly stopped functioning properly out of nowhere but instead the rootcause is a virus/chemical (that may or may not still be present in the body/cells).
Re: Lung cancer pill cuts risk of death by half
#99Earlier quoted context omitted.
The way forward then seems to be personalized therapy for each case. There have been some limited trials with CRISPR that look promising, but mainstream adoption is still likely years away.
Personalized therapy might possibly not work for a really long time. Consider each drug to be a code change at heart of the most critical code running the code of your body. Clinical trials are the integration testing and ab testing equivalent of making sure this change doesn't have side effects. Personalized therapy means you have no way of testing in a comparable system. Unless you're gonna clone babies of yourself…
I am not a scientist, but there are technologies like taking a specific mRNA or protein and making the immune system primed against it for a specific HLA. This makes it possible peptide and mRNA vaccines personalized for a person (you can choose a protein/mRNA specific to the cancer this person has and for her HLA type.
This looks as enough close to personalized therapy for me. There are prediction tools available online.
https://nextgen-tools.iedb.org
I even coded my own peptide prediction tool a few years ago:
https://padiracinnovation.org/News/static/design-your-own-pe...
Re: Lung cancer pill cuts risk of death by half
#100Earlier quoted context omitted.
I wasn’t involved in this study but the cancer center I just left was one of the sites for the upfront Lu177 vs chemotherapy trial. Speaking casually with the physician involved recently he said the results weren’t promising thus far. I don’t think this is published yet and I’m not familiar with prostate ca treatment literature so take this with a grain of salt.
my father is in india where they've been giving lu177 ( and others) before chemo for quite a while ( other countries being germany and australia ) . Forums are awash with 'success stories' . There are many clinical trials currently in US and canada. Some have published results showing 'non inferiority' in small sample sizes but most are in progress https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627907/ https://clinica…
> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627907/
Non-inferiority studies aren't sufficiently powered to answer the question but up-front Docetaxel is pretty old-school. My urology days are long behind me now but even in my residency abiraterone/enzalutamide had taken over as in:
> https://clinicaltrials.gov/ct2/show/NCT04647526 this one was supposed to publish some preliminary results in q1 2023 but i don't see any updates :/
This is the trial I was referring to, I don't think they're done with the analysis/writing yet.
I have no numbers or data hence my casualness but our nucs physician was really excited 5 years ago and lukewarm when I recently asked him if they were finally taking over mCRPC care over a beer.
Again grain of salt, but my impression from that convo was it's going to end up another line of therapy (mCRPC treatment is a game of kicking the can down the road as long as possible).