

Winning the war on cancer? US death rates show broad decline  - cwan
http://arstechnica.com/science/news/2010/03/winning-the-war-on-cancer-us-death-rates-show-broad-decline.ars

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chubbard
I remember reading a story a while back about progress made on deaths from
heart attacks versus progress made on deaths from cancer. The key thing they
zeroed in on was the fact that heart research focused on prevention first.
They determined early on that it was too late to do anything once someone
shows up in the ER with a heart attack. So, heart research focused on
prevention.

While cancer was stuck in trying to cure the disease once someone had it.
Overall the article stated not much progress had been made on cancer relative
to progress made in heart attacks.

So I'm a little suspicious that cancer can now claim we're winning because of
prevention. If you stop smoking it's helps BOTH cancer and heart attacks. I
remember the group who pushed people to stop smoking, forever, was the heart
association. Remember that little heart logo on all the ads?

This is overall good news, and I hope the researches focus more on prevention
and research into what causes it. I find it tremendously interesting that "the
cure" has been our focus for so long in medicine. I think drugs like
Penicillin that cure got us stuck in that meme because they were so much a
miracle. However, prevention is another tactic that's probably not been
effectively utilized to keep us healthy.

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ben1040
I'm somewhat encouraged by the way that cervical cancer has been approached as
a model of prevention. We've seen huge declines in death rates because of
effective screening and management, and hopefully the HPV vaccine will push
this even lower.

I'm also hopeful for the results of the whole-genome analysis of cancers that
are going on right now. Hopefully we'll have some better ideas of the factors
that might predispose you to a given tumor, and can find ways to manage the
risk and catch this earlier.

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jswinghammer
I have a friend who is in his 30s with stage 4 colon cancer and it's pretty
hard to get excited about the progress that's being made. They told him when
they started that 5 years ago he would have been expected to live under a year
and now it's 3-5 years. That's great but still not what anyone hopes for. He
has kids who are all under 10.

I wonder if early screening will become more of a normal thing for people who
can afford it. I'm not sure my friend could have afforded it but for cancers
where the first signs of it indicate that it's too late it might make sense
for some people.

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chubbard
That's a horrible story I'm so sorry to hear that about your friend. I think
you're right on track that prevention and screening is our weapon against
these things. Screening and prevention costs way less than "the cure".

If you read Christensen's latest book "Innovator's Prescription" he analyzes
the medical industry through the lens of disruptive technology, and concludes
that the forces of disruptive technology have been dismantled which keep
prices high. The is such a unique perspective in this health care debate
because it's basically been framed as "You pay the high price", or the
"Government pays the high price". However, Christensen is giving us a third
option saying fix the economic engine and disruptive technology will drive
prices down over time and things will get better too. Neither side of the
debate can guarantee this either.

His idea is that Doctor's cost a lot of money, but when you have to have the
very best analyze what's wrong with you have to pay it. Doctor's jobs are very
hard and time consuming. However, certain types of care can be provided
without a doctor for things that are well defined. Prevention is just such a
thing. Screenings are just such a thing.

The problem right now is that technologies that enable us to screen better are
often wrapped up so that you can only go to a doctor to get them. Things like
MRI's and CAT scans require prescriptions from doctors. The price of a CAT
scan has remained the same since it was invented. 1970 technology the same
price!? Where else in our free markets does this happen?

Prevention is more easy to provide without having to tackle the prescription
system, but screenings are very important part of medicine in the 21st
century.

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RK
A CT from today is _very_ different from the first CT scans in the 1970's.

<http://www.imaginis.com/ct-scan/history.asp>
<http://en.wikipedia.org/wiki/File:Ct-workstation-neck.jpg>

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chubbard
The only difference being image clarity, 3D? Yes it's improved since then, but
so does everything we create. The underlying technology hasn't changed that
much. By this logic we should continue to pay 1950s prices for a TV because a
cathoray tube today is different from a cathoray tube from 1950. What's
interesting about our TVs, VCRs, computers, etc is that not only do they get
better, but they get cheaper too. Ever noticed how LED and plasma TVs existed
before 2006, but it wasn't until their price dropped below a certain level
that everyone started getting them? Point being that these technologies have
to come down in price before we can scale them to a large audience. Right now
they cost way too much, and are not available to a large enough audience to
really start making health care better overall. Lowering disease prevalence,
raising life expectancy, etc.

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kmak
Interesting thing to note is that even if cancer rate is "steady", it means
we're doing better in general. More people are dying from cancer because
people are living longer to die from cancer, with lower risk of dying from
other things. Great to see it go down in addition to this, of course!

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kingkongreveng_
I've heard there's malarkey to do with how they account for deaths and cures.
If you survive a diagnosis for five years or something they count you as
cured. In a lot of cases what we really have is a lot of technology that give
people six extra years of life, at high cost and a lot of discomfort.

~~~
jerf
That's called looking a gift horse in the mouth. Progress requires the
intermediate steps. Complaining that we're not making progress because all
we've done is gotten closer to conquering cancer and we aren't actually done
yet is a great way to ensure we stop making progress, at least if the people
allocating money start thinking that way.

