
Breast-cancer death rate drops almost 40 percent - sethbannon
https://www.washingtonpost.com/news/to-your-health/wp/2017/10/03/breast-cancer-death-rate-drops-almost-40-percent-saving-32200-lives-study-says
======
dweekly
Great! Now can the people interested in helping fewer women (and men) die of
cancer please turn their attention to lung cancer, where there is far better
"bang for the buck" on research investment?

[https://www.cancer.org/cancer/non-small-cell-lung-
cancer/abo...](https://www.cancer.org/cancer/non-small-cell-lung-
cancer/about/key-statistics.html)

Most people who get and die from lung cancer are not smokers. Like my mom.

~~~
verelo
So i've become super interested in lung cancer, and recently found that radon
gas is the most common cause of lung cancer in non-smokers.

If you want bang for your buck, buy a radon detector and mitigate [slab vacuum
treatment or regular ventilation] where you find levels > 100bq/m^3 [probably
your basement]

~~~
the_cat_kittles
i see they are like 200 bucks on amazon- are those what i need to get?

~~~
gniv
I have the AirThings one. I like it. The biggest drawback is that there is no
easy way to automatically record readings, so I do it manually.

I move it from room to room every few days. I was surprised that the upstairs
bedroom read as high as the basement (but none are high).

Also, as every website points out, the readings vary quite a bit through the
day, and from day to day.

I also noticed that the readings increase when it rains (my current theory is
that the low pressure that precedes rain pulls more radon from the ground).

Opening windows helps a lot.

~~~
dagw
Upgrading our ventilation moved us from ~200-250 Bq (with windows being open
as much as possible) down to ~50-70 Bq

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stevenwoo
I don't know much about statistics - can someone tell me why five year
survival rates are always used for cancer? This seems kind of off, that
instead one should be using the average or median age to which one is expected
to live versus how long a cancer survivor lives. Five years seems most
misleading when applied to children that get cancer.

~~~
stewbrew
5-yrs mortality rates are a questionable statistic, especially when comparing
death rates in time. Critics would argue that the lead time (i.e. the time
between diagnosis and clinical symptoms) has changed in time due to earlier
diagnosis but the effective time of death has not. It's a long winded debate.

Breast cancer mostly affects women 45+ -- or younger women with a genetic
disposition.

~~~
dx034
But otherwise you'd get a lot of age related deaths? If you use a 15 year
window, many people with cancer treatment at the age of 70 won't survive the
15 year period. That makes cancers 'deadlier' where they affect older people.
A 5 year horizon is probably more suitable to reduce unrelated deaths.

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bandrami
This is controversial, because the study everybody was talking about last
year[1] concluded that there hasn't been a decrease in the breast cancer death
rate over that same period.

[1]
[http://jamanetwork.com/journals/jamainternalmedicine/fullart...](http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2363025)

~~~
neolefty
That study looks at something else entirely: The relation between screening
and mortality. It doesn't say anything about survival rates over time.

> _Conclusions and Relevance_ When analyzed at the county level, the clearest
> result of mammography screening is the diagnosis of additional small
> cancers. Furthermore, there is no concomitant decline in the detection of
> larger cancers, which might explain the absence of any significant
> difference in the overall rate of death from the disease. Together, these
> findings suggest widespread overdiagnosis.

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mter
Does anyone know when we decreased the age for recommended mammograms to 40?
My assumption is that it's in the time range of the article.

I can only find references to us raising the recommended age to 45 in 2015,
controversy over raising it to 50 in 2009 and how there are diverging opinions
on when they should be done.

~~~
sjg007
I think brca status matters more as that classified high risk.

~~~
astura
The GP is asking about recommendations for routine screening in asymptomatic
women at average risk of breast cancer.

Screening and/or prophylactic treatment for high risk women is a different
topic entirely and probably highly individualized.

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paulcnichols
What about the base rate of getting breast cancer? Am I to understand women
still get diagnosed at the same rate but the treatment has gotten better? What
happened in the 70s that made it so much more common?

~~~
zitterbewegung
I bet in the 70s it became easier to detect .

~~~
Retric
Deaths from cancer are not subtitle. This is measuring the number of deaths
not the rate of early detection.

~~~
thaumasiotes
"Deaths within 5 years" are strongly affected by when you start the 5 year
clock. The earlier you detect cancer, the better your 5-year survival rate
will be.

~~~
Retric
Without treatment they don't change much. It's detection followed by treatment
that changes anything. And discounting early detection as a part of treatment
is horribly misleading.

~~~
thaumasiotes
I'm finding it difficult to imagine how you think this could possibly work.

Cancers start small and develop into larger problems over time. Consider a
hypothetical patient who develops cancer at the age of 70 and dies of it,
untreated, at the age of 78.

If the cancer is detected at the age of 75, detection will lower the 5-year
survival rate, since the patient dies after three years of "having cancer". If
it is detected at 72, detection increases the 5-year survival rate, since the
patient now dies after 6 years. Without treatment, early detection has a _very
strong impact_ on 5-year survival rates.

~~~
Retric
Untreated cancer kills people very quickly effectively by definition.
Basically if you have a lump that's not going to kill you quickly it's not
cancer.

This is why Mammograms are every 1 or 2 years. If you could wait 4 years
without treatment early detection would be less of an issue.

PS: People generally assume a lump becomes cancer as soon as it starts to
form. But the general case is you get a lot of little growths from pre-
cancerous cells which are predisposed to cancer. Then one or more of those
cells become cancer and then you die fairly quickly after that transition.

~~~
thaumasiotes
Cancer is defined based on the growth rate of the tumor (some other
characteristics contribute, like propensity to spread from one area of the
body to another), not based on how long you can live with it. Even the xkcd
comic will tell you that no matter how bad your cancer currently is, you might
end up living for a long time to come.

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tuxguy
The study referenced in the article :
[http://onlinelibrary.wiley.com/doi/10.3322/caac.21412/full](http://onlinelibrary.wiley.com/doi/10.3322/caac.21412/full)

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SoulMan
Wondering if there is any global stats outside of US.

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lez
I wonder why iodine is not mentioned in the article, and how much its use has
contributed to the rate drop.

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bionicbrian
How strange to see this on the day that a friend of ~20 years passed away.
Breast cancer. She was 40.

~~~
zrail
Sorry for your loss.

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FireBeyond
Now perhaps we can start work on prostate cancer. Not as marketable a topic as
prostate cancer.

Breast cancer receives half a billion dollars more funding for research than
does the latter, despite the latter being more common:
[http://dailycaller.com/2010/10/05/breast-cancer-receives-
muc...](http://dailycaller.com/2010/10/05/breast-cancer-receives-much-more-
research-funding-publicity-than-prostate-cancer-despite-similar-number-of-
victims/)

I'm loathe to link to the Daily Caller, but it's a pretty neutral piece with
no politics, nonetheless:

[https://prostate.org.nz/2014/01/men-die-earlier-womens-
healt...](https://prostate.org.nz/2014/01/men-die-earlier-womens-health-gets-
four-times-funding/)

~~~
chowyuncat
Isn't this because prostate cancer is already far less deadly at this point?
Both by rate and absolute numbers. Most men will get prostate cancer if they
live long enough and we are constantly improving treatment.

~~~
j_s
Not to derail the entire discussion, but what is the current best practices
regarding treatment for prostate cancer?

Is there anywhere to keep up-to-date on this specific topic, if it is indeed
nearly inevitable?

~~~
aurelianito
A dead sibling post mentioned tomatoes. It is apparently supported by some
research but seems to be not conclusive.
[https://www.ncbi.nlm.nih.gov/pubmed/23883692](https://www.ncbi.nlm.nih.gov/pubmed/23883692)

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jack9
My first thought is that it didn't really save lives. 322k now die of other
causes.

~~~
copperx
Sure. When you die of other causes, you don't die of cancer. This is middle
school set theory.

~~~
criddell
I think you are agreeing with the parent. 300,000+ lives are saved... for now.

I've thought about this too. No life is saved, it is only prolonged.

If these people have been given an extra five years of life, that must be a
pretty spectacular return on investment. Compare how much was spent developing
and administering treatment to the value of 1.5 million years of life.

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shadykiller
Good to see the rates dropping but it is disappointing to see that alternative
treatment paradigms, like diet and fasting aren't given a serious look.

Relevant article: [http://www.npr.org/sections/health-
shots/2016/03/05/46828554...](http://www.npr.org/sections/health-
shots/2016/03/05/468285545/fighting-cancer-by-putting-tumor-cells-on-a-diet)

~~~
lwhalen
You know what they call alternative treatments that work? Treatments.

~~~
KekDemaga
Alternative medicine, the alternative to medicine.

