Same as mountainriver's comment. I really find strange how I've been reading news lines over the past years about great advancements in many incurable and chronic diseases (like Alzheimer's, diabetes, and cancers) yet after all that time people's treatment is not going any better. I'm not sure whether scientific journalism somehow delivered some unintended messages to me, or we're just supposed to experience these great advancements after couple of decades from the announcement.
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HIV has gone from death sentence to completely preventable with a single daily pill or every 6 months injection, and readily treatable to the point where we have geriatric HIV patients. Obesity is now effectively treatable even taking into account compliance. Hep C can be cured entirely with just six months of oral medication rather than a barely tolerable intravenous course that didn't work all that well. These are massive improvements that have changed how hundreds of millions of people are treated and their prognosis.
The road to the clinic is long, but there have been very big improvements.
And stage 4 melanoma used to mean you'd be dead in a year. I know someone who got diagnosed with it almost a decade ago, got three doses of immunotherapy, and is now cancer-free. Doesn't even have to get scans anymore.
Melanoma is the main cancer that responds well to immunotherapy, PD-1 inhibitors. Other solid cancers, not so much, although in combination with other therapies, is seeing some okay results.
They recently found some types of rectal cancer to be PD-1 sensitive.
It seems like stock markets, a lot of bubbles pop, and it's easy to miss the trend .. every 5 years some progress is made.
Two things. If you follow the news closely, but lack specific expertise or knowledge, you develop this nihilistic sense of doom to some degree. The narrative of our age is that everything is in decline. It pulls clicks.
The other thing is that cancers are not created equal, not all treatments are evolving quickly. Your loved one may be suffering, and that’s your world.
I will say that I lost my beautiful wife a little over a year ago. She had an aggressive cancer, for which the 10-year survival rate was zero. Thanks to the miracle of immunotherapy, the five year survival rate is about 65%. At the same time, my 78 year old aunt successfully fought lung cancer that was a death sentence 20 years ago.
I’ve nothing to add to the discussion but just wanted to say that, for what it’s worth, I’m terribly sorry for your loss.
I’m not sure I agree. We now have techniques like immunotherapy for some cancers. Cancer rates still continue to fall.
We have a drug now that you can take so you won’t catch HIV, as well as another drug for HIV+ that keeps it at bay.
We haven’t found a cure-all. Rather, now we have a lot more treatment options nowadays depending on your specific cancer or illness.
Cancer mRNA vaccines for solid tumors are administered to real patients in clinical trials right now.
And as always, when problems get solved, other problems get revealed. We didn't even really know about cancer until life expectancies got to the point where dying in your 30s is a tragedy instead of being fairly normal.
> people's treatment is not going any better
That's not true. It's improving steadily: https://progressreport.cancer.gov/after/survival , and with the newer advances it's going to become even better.
Yes, it's not like an exponential Moore's law graph, but there is a steady drumbeat of incremental steps. And they keep reinforcing each other.
Only for specific sites of cancer. Many others are just as deadly as they have ever been.
10ish years ago Myleoma was a semi death sentence, it’s now coming close to being treated like a chronic condition. There are definitely improvements happening, but we’ll often miss them because it’s incremental rather than “we developed this cure for lung cancer and it’s no longer a problem”
Edit: some of the replies below are pretty bleak “it’s just a few months that’s nothing”. The difference between a 5 year and 15 year life expectancy for a parent being diagnosed with blood cancer around 60 is huge.
I am curious: why would it make a difference for a 60 year old if they are a parent and have 5 or 15 years vs not?
I would have thought by that age children are long independent...
Why do you think “people’s treatment is not going any better”? As far as I know, cancer outcomes have greatly improved.
It's the articles that decry "Big discovery in X".
This could be because the researchers need funding so they will hype the results as much as possible.
Then the articles need as much readership so the journalists hype the results as much as possible.
Then the people suffering from the disease want as much help as possible so they push the articles/papers to the doctors.
On the other hand, it's been my experience that GLP-1 agonsists weren't overhyped, I was completely surprised when my doctor prescribed Mounjaro for weight loss. Even after decades of articles about "NEW WEIGHT LOSS TREATMENT!" (See also phen-phen)
Depends. Early cancer? Yes, outlook is getting better. Metastatic cancer? It's still very bad outcomes. (Personal experience.)
Cancer detection/testing has gotten a lot more attention. Detected early, many victims are still alive after 5 years and considered "cured." But it still gets you in the end. A lot of expense and misery while under medication/chemo/rad/surgical therapy and in the end you are dead just the same.
Robust biomarker monitoring in toilets would lead to a 95% reduction in cancer deaths.
Robust biomarker discovery in toilets would let us take care of most of the other 5%.
That's the main obvious humanitarian purpose of our project www.molecularReality.com
How do I buy an anticancer toilet?
Each medical innovation overcomes but one hurdle on a path to a treatment/cure, often revealing new hurdles that weren't visible (or important) until the first hurdle fell.
A good example is lipid nanoparticles, which for the first 15 years or more of their existence were horrifically lethal in every hominid, making their potential for delivering transformative genetic or immune cargo into cells impossible. Finally, PEGylation was introduced into their formulation, bypassing the toxic effect they had in precipitating out nearly all of each animal's platelets upon treatment. Within just a few years, LNPs became a very effective way to deliver MRNA vaccines to BILLIONS of human patients, effectively ending the worst of the Covid pandemic.
Medical revolutions are like evolutionary punctuated equilibrium -- barriers to advancement are overcome nonuniformly and often incompletely, requiring a lot of continued effort even after a revolution begins. So it shouldn't be surprising that more battles are won than wars. We should celebrate whatever victories we can. Cancer promises to be a war to end all wars.
Cancer deaths have been falling since the 90's. Detection and treatments are improving.
We don't have a silver bullet because these diseases are so incredibly complicated. "Cancer" is a particular type of disease behavior, but is essentially a broad class of failure states across different types of cells and tissues, with different genetic, metabolic, biochemical, and molecular dysfunctions.
The decline in cancer deaths can almost entirely be explained by the decline in smoking. Getting from 40% of people smoking to 15% was probably the biggest public health victory of the latter half of the 20th century
> I've been reading news lines over the past years about great advancements in many incurable and chronic diseases
There is a lot of overhype in the news. When they claim that a new 80% improvement in batteries we all know it's a joke a laugh. When there is a similar exaggeration in cancer cures we get sad.
The saddest part is that the overhype shadows all the small/local improvements. They are better explained in sibling comments. Medicine is not my area so they give better examples than what I can choose.
When I read a new about my area or something close enough, it's fun to try to guess what was the original new before it was badly rewrote by the press and how interesting it is. But when there are lives related to the new, it's not fun to read post with unrealistic promises.
The thing about batteries is that those big discoveries in the lab take a long time to reach the market. By the time they do reach the market, they're just an incremental improvement over all the other big discoveries that are already in production.
So we never seem to get a dramatic breakthrough, but what we do get is steady improvement over the course of decades. And that's why we have electric cars now with ranges over 400 miles, while back in 1996 the EV1 had 70 to 100 miles.
I think cancer treatments are pretty much the same.
Ok are you fr? The phone I'm typing this on is superior to the computer in highschool to play video games on and it's my old phone that can't hold a candle to my new phone. The batteries in both devices are both MORE THAN 80% superior to the battery in my first phone.
F*ck. Progress does exist - life has got enormously better but people reuse to see it and focus their entire lives on living the same day over and over and wonder why they are unhappy.
When my Aunt was diagnosed with MS in the 80s it was a crippling and degenerative ailment.
When my brother was diagnosed with MS ~30 years later, it was a nothing burger. He gets an infusion monthly and suffers no significant impact on his quality of life.
This is great to hear. I had an Aunt that was diagnosed with MS around 40 and by 50 she was in long term care - it's the only place I ever saw her and she had a terrible quality of life, completely incapacitated. I've always had a fear of MS bc of this bc apparently she was completely normal before.
Thank you for that comment.
> great advancements in many incurable and chronic diseases (like Alzheimer'
There is virtually no new treatment for Alzheimer for 20 years and no progress in understanding its mechanism either.
> yet after all that time people's treatment is not going any better.
What is your basis for this claim?
> I really find strange how I've been reading news lines over the past years about great advancements in many incurable and chronic diseases (like Alzheimer's, diabetes, and cancers) yet after all that time people's treatment is not going any better.
... I mean I think you are possibly not just paying attention. All sorts of things that were absolute death sentences within recent memory are now very treatable. News articles tend to overhype, of course, but cancer treatment now is a different world to a few decades ago.
Yep, breakthroughs get announced, but the real-world impact can feel slow
Remember Calico and Altos Labs which were moonshot cure longevity companies? After years they emerge out of stealth and all they got is some cancer drugs. The gravitational pull of the billions of dollars to treat cancer patients and extend their lives a few more months eats up all the attention of the biotech world because there is such an astronomical amount of money in it and you'll just have to come up with a new way to kill cells which is relatively easy.
So usually when people talk about new cancer drugs it meant that great scientists will make billions wasting their lives barely improving the quality of life for some terminally ill cancer patients and it's just kind of sad, honestly.
Or maybe heroic efforts are being made to solve a very hard but worthwhile problem?
You don’t get to decide how long the road is to a complete solution. Just whether it will be worth it incrementally and in the end.
You don’t propose any constructive alternative.
Life, even just extending life of millions of people a bit, survival rates just a bit, is worth a lot.
I don’t think we’ve made any progress in Alzheimer’s. Where did you read that we have?
There have been a fair number of announcements about possible progress, and even several recently related drugs. The research and drugs continue to focus entirely on beta amyloid buildup in the brain:
https://www.science.org/content/article/new-alzheimer-s-drug...
There's not a shortage of debate on whether they are effective, ought to have gotten any approval, or if beta amyloid buildup is even a cause or contributor to Alzheimer's disease, so whether we've actually made progress remains debatable for the short term until results on these drugs are in.
Well, let's see.
Some drug company or group of investors must think it's potentially profitable to develop into a real treatment.
Then they have to move up the trials ladder, from mice to humans and the steps in-between.
Then they have to get regulatory approval.
Finally, assuming the steps prior didn't fail horribly, they need to set up the manufacturing for the drug.
All the meanwhile handing off money to a bunch of people who, more likely than not, never worked for the company in the form of earnings-per-share.
So, yeah, a couple decades.
The missing ingredient that makes it make sense is the profit motive.
A lot of it is the case of bad science being popularized and then blindly built upon. This is exampled by the recent redaction of a huge amount of Alzheimer's papers which formed the nucleus of Alzheimer's research. Academia and science are often the largest purveyors of misinformation despite.
mrna vaccine had big “breakthroughs” during the 80s and 90s and yet it took quite a while for it to be a viable thing. some things take time and some things never pan out past the in a pitri dish stage.
Blame the FDA. It is near impossible to get these treatments out to patients.
Are you not aware of the FDA’s Investigational Drugs program?
Can other countries conduct trials for these treatments at the patient's own risk?
This all makes sense once you consider health as a business. There is no great interest by business in a cure to this or that. However, an expensive perpetual treatment (lifetime service contract) is far more appealing - the revenue stream is superior.
What we call a 'health' industry is a misnomer - it is a sickness industry, like the ministry of defence is really the ministry of attack.
If you want to really get cynical, you can consider the possibility that a lot of treatments are not only unnecessary, but actively detrimental to the person receiving the "treatment". The person in future may develop diseases that will then open further revenue streams from what would otherwise be a healthy individual. This would assure a healthy pipeline of future revenue for the pharmaceutical companies.
Luckily we have government agencies to manage the pharmaceutical products we are given. Unfortunately, it is something of an open door policy as senior government staff are then given senior positions in pharmaceutical companies.
I'm sure it all works out in the end!
> There is no great interest by business in a cure to this or that
Of course there is. Cures make billions.
This might be a conspiracy theory stupider than flat Eartherism. It requires not only every Western pharmaceutical company’s collaboration, but also every one in every other country, and also all the public labs, and every world leader and their families to suck it up for the conspiracy’s sake.