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Death rates are declining for many common cancers in the U.S., report finds

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Re: Death rates are declining for many common cancers in the U.S., report finds

#2
There was a giant uptick in personalized treatment for cancer[1] that coincided with the end of the Obama era (Biden driving it after his son's death, in 2015).

I saw bits of it in my space with large scale analysis of genomic testing - particularly things like analyzing old drugs with new genomic data (drugs which failed in the past, retesting for the combo of the cancer:personal-genome SNPs).

My friend went through a Car-T recently for a lymphoma and something like that is near SciFi-tech in discussion when Steve Jobs had cancer, but available through the FDA today.

[1] - https://www.cancer.gov/research/key-initiatives/moonshot-can...

Re: Death rates are declining for many common cancers in the U.S., report finds

#3
post #2

There was a giant uptick in personalized treatment for cancer[1] that coincided with the end of the Obama era (Biden driving it after his son's death, in 2015). I saw bits of it in my space with large scale analysis of genomic testing - particularly things like analyzing old drugs with new genomic data (drugs which failed in the past, retesting for the combo of the cancer:personal-genome SNPs). My friend went through…

CAR-T therapy is absolutely how we imagined the “genetic age” would be. However, its applications to liver cancer (as well as other solid tumors) are far away from clinics.

Some cancers haven’t seen much progress in the last 30 years. For example, uveal melanoma is a death sentence, same as 30 years ago. Liver metastases don’t give you any chance.

Re: Death rates are declining for many common cancers in the U.S., report finds

#4
post #3
post #2

There was a giant uptick in personalized treatment for cancer[1] that coincided with the end of the Obama era (Biden driving it after his son's death, in 2015). I saw bits of it in my space with large scale analysis of genomic testing - particularly things like analyzing old drugs with new genomic data (drugs which failed in the past, retesting for the combo of the cancer:personal-genome SNPs). My friend went through…

CAR-T therapy is absolutely how we imagined the “genetic age” would be. However, its applications to liver cancer (as well as other solid tumors) are far away from clinics. Some cancers haven’t seen much progress in the last 30 years. For example, uveal melanoma is a death sentence, same as 30 years ago. Liver metastases don’t give you any chance.

Similarly, glioblastoma (a brain cancer) is still a death sentence. My dad died of it a little over 5 years ago, lasting about a year and a half from initial diagnosis.

Maybe a year later, John McCain came down with the same thing. In a weird way it was comforting to know that all the money and power in the world didn't make any difference in the outcome.

Re: Death rates are declining for many common cancers in the U.S., report finds

#5
A close family member has stage 4 cancer.

Even if the absolute death rates for some cancers are relatively unchanged, one of the amazing things I’ve observed is that medical advances have increased the long term survival rates of terminal/metastaticized cancers. It’s partially due to the development of various drugs that have been identified as effective against various specific mutations. Even if the cancer is incurable with existing technology, they can extend lives by years, which is nothing to sneeze at. Especially considering many people get diagnosed with cancer once they are elderly already, it can mean the difference between dying directly of cancer and living long enough to die of something else - ie the cancer becomes something more like a chronic condition than it does a direct threat (for a period of time).

Re: Death rates are declining for many common cancers in the U.S., report finds

#6
post #2

There was a giant uptick in personalized treatment for cancer[1] that coincided with the end of the Obama era (Biden driving it after his son's death, in 2015). I saw bits of it in my space with large scale analysis of genomic testing - particularly things like analyzing old drugs with new genomic data (drugs which failed in the past, retesting for the combo of the cancer:personal-genome SNPs). My friend went through…

Does anything in this study confirm that personalized treatment or any cancer treatment is moving the needle? The minor decrease in overall cancer rate seems to be driven by fewer diagnoses rather than increased survival, at least for lung cancer, which is the single biggest change. Skin cancer death rate is lower and that does coincide with the one major technological advancement against cancer that has happened in decades: immune checkpoint inhibitors. Immune checkpoint inhibitors are not very personalized. In general personalized corresponds to a focus on cancer genetics and has had an extremely disappointing outcome (helps a few percent of people a lot or helps more just a little) compared to what was hoped for.

Re: Death rates are declining for many common cancers in the U.S., report finds

#7

A close family member has stage 4 cancer. Even if the absolute death rates for some cancers are relatively unchanged, one of the amazing things I’ve observed is that medical advances have increased the long term survival rates of terminal/metastaticized cancers. It’s partially due to the development of various drugs that have been identified as effective against various specific mutations. Even if the cancer is incur…

One of the interesting developments is precision medicine: we can now use genomic sequencing and AI to "search" for the treatment that is most likely to be effective against a particular individual's cancer rather than following the rough "standard of care" playbook (for example, depending on the type of cancer, the standard of care might be 6 months of chemo, and if that doesn't work try something else, repeat until cancer goes away or patient dies). The precision medicine approach at this point seems to be among the things that we try if the standard of care doesn't work, but hopefully one day it will be step one (chemo sucks and it is an expensive use of precious time). In addition to searching for treatments, we can also search for clinical trials for which a patient is a good fit--this helps both the research side (it's very hard to find qualified patients) and possibly patients who don't have better options (and of course the research itself benefits future cancer patients).

Re: Death rates are declining for many common cancers in the U.S., report finds

#9
Ok, but hardly shocking, given the zillions of dollars and person-hours spent on cancer research and related public health initiatives...

Perhaps the most interesting tidbits here are regarding the increases in mortality from particular cancers, which seem in most cases to be related to increasing numbers of diagnoses of the relevant cancer types.

Re: Death rates are declining for many common cancers in the U.S., report finds

#10

A close family member has stage 4 cancer. Even if the absolute death rates for some cancers are relatively unchanged, one of the amazing things I’ve observed is that medical advances have increased the long term survival rates of terminal/metastaticized cancers. It’s partially due to the development of various drugs that have been identified as effective against various specific mutations. Even if the cancer is incur…

One of the interesting developments is precision medicine: we can now use genomic sequencing and AI to "search" for the treatment that is most likely to be effective against a particular individual's cancer rather than following the rough "standard of care" playbook (for example, depending on the type of cancer, the standard of care might be 6 months of chemo, and if that doesn't work try something else, repeat until…

> repeat until cancer goes away or patient dies

This sounds very similar to participating in a clinical trial and to me ironically seems to be the opposite of precision medicine.

The Nagourney Cancer Institute cultures live cancer cells from the patient to test for what drugs may work. Doesn't work for everyone, but seems more in line with precision. Whereas genomic sequencing hasn't produced the amazing results that were expected.

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