Ha! I'm afraid to admit how much thought I've put into avoiding words that overlap with the "naughty list", like (statistical) bias and (electrical) polarization.
A dead comment says this is all a myth but from somebody in the trenches...it's not. No access to the Federal Register means no meetings to evaluate grants, which means no more grants going out at all.
I agree that Democratic reps don't have a ton of power right now, though some have voted to approve some poor Trump cabinet picks.
I think it's still important to call both them, and your Republican reps. They keep track of how many people call on issues, and what side they take. I think a lot of reps are worried about retaliation from the POTUS, and the only thing that gives them ammunition is constituents on their side.
> I think a lot of reps are worried about retaliation from the POTUS,
As they should be, everyone from the GOP who has ever crossed the golden boy was destroyed by him. And now he has the richest man in the world to finance a campaign to destroy them.
The constituents matter far less to them than those two things. They made a Faustian bargain, and they care about keeping their jobs, which means doing what he tells them, not what you tell them.
Every therapy works for someone spectacularly. This has been the case forever. It doesn't really prove anything/ main challenge is figuring out why it worked for this particular person when it fails for most. Cancer treatment has always been primitive throw shit at the wall and see what sticks. Still the case today.
If the therapy had not worked would that be evidence that the therapy is not effective? If so the fact that it did work must be at least some evidence that the therapy is effective. Simple Bayes factor, you can't have one without the other.
Additionally, if there is enough similar cancers we can know the rate of spontaneous remission within a particular band of time. This would be much lower than spontaneous remission at any time so that a spontaneous remission at the specific time of treatment could be a rather unlikely event and start to look like decent evidence.
Not disagreeing that cancer treatment isn't a shit show but I would suggest that such evidence cannot be easily dismissed due to the lack of the gold standard large scale double blind study.
You are partially correct. But here a broader picture - you may have to get in touch with the person(s) who is claiming the cure to draw a conclusion. Sometimes they may have done multiple trials within their own circle, or if it's a physician on his patients. They generally will have documented their patients. They generally will not have the means to do large scale trials. (I heard that it cost about 10 million, and about 10 years to get an FDA approval). When a unknown/non credentialed practitioners or a physician claim something it is generally ignored - as far as I'm concerned the cancer treatment cartel industry is real (As with almost every other industry), if by the rare chance it does get some publicity (as it happened with the Linus Pauling, Nicholas Gonzales), the cartel indulges in accusations of quackery and character assassination.
Now I'm not saying that the small time practitioners are always correct, in fact they are mostly wrong. But they deserve some investigation.
Recruiting immune cells for cancer intervention is the future, but it will still take a while to get there.
>> Over seven years that followed the therapy, 12 patients died due to relapsed neuroblastoma. Among the seven that survived beyond this point, five were cancer-free when given the CAR T-cell therapy but had previously been treated for neuroblastoma using other approaches and were at high risk of relapse. All five were disease-free at their last follow-up, between 10 and 15 years after the CAR T-cell therapy, although the team note they may already have been cured when the therapy was administered.
The problem is that cancer is your own cells, so immunotherapy solutions are always going to be balanced on a knife point. If you make the tiniest mistake it is Lupus.
I wonder if they could do two phases. Like first engineer T cells that mark the target cell but don’t kill it. And then, if the marked cells are sufficiently scoped to cancer cells, use the same targeting mechanism for cancer-destroying T cells.
Marking them is the challenge. Cells have expressions that we can engineer chemicals to bind with, but sometimes the cancer cells have no expression (Triple negative breast cancer for one). It just mutates and divides faster. This is why chemo works well, it is uptaken by cells that divide faster, like cancer, and hair, mouth cells, etc.
But chemo is general, it doesn't specialize. So thus, the new chemo called ADCs (anti-body drug conjugates), are really nice. They target AREAS and release generally.
A family member of mine is going through keynote 522, which is a clinical trial that combines 3 chemos and an immunotherapy prior to surgery.
The five year survival rate for stage 3 triple negative breast cancer is normally about ~60% but the clinical trials show with immunotherapy it exceeds 80%. So the survival rates you see online aren't capturing the progress we are making with these drugs. Hashimotos seems worth the risk.
An interesting aside is that the patients in the clinical trials who had adverse reactions to immunotherapy and came off the medication had higher survival rates than patients who stayed on it. The hypothesis is that stimulating an immune system overreaction also means it was also highly effective against the cancer.
Interesting theory, but not in my experience. My wife died of MBC and she had lots of reactions. Anecdotally, the pembro + chemo may have given her an extra year, she did well on it.
> "All five were disease-free at their last follow-up, between 10 and 15 years after the CAR T-cell therapy, although the team note they may already have been cured when the therapy was administered."
> "The other two surviving patients had cancer that was actively growing or spreading when they received CAR T-cell therapy, but subsequently went into complete remission. One of these patients stopped participating in follow-up sessions eight years after treatment, but the other continued and has remained cancer-free more than 18 years."
Based on these statements, the evidence for this treatment is anecdotal at best. Only 2/27 patients lived longer than 7 years.
(There are probably more advancements in the last 10-15 years that have increased efficacy)
There are companies pursuing CAR-T for veterinary treatments that are driving the costs down. One example I'm aware of is LEAH Labs (https://leahlabs.com) that is working on using CAR-T to make affordable cancer treatments in dogs.
The problem is Erooms law. Yes we need to invest more, but we also need to figure out why we're getting worse at doing it year over year. My hypothesis, many others, is that the models are flawed. We need better, more fluid models.
Why is that a better course of action than investing resources in making the existing and effective treatment more affordable?
From what I've heard the bottleneck for CAR-T is the lack of technicians who can do the work and automation it make more effective use of the technicians and their time.
It seems like there is a clear path to decreasing the cost of this.
Why not both? It's not like those are the only two things in the world. Maybe they're both way more useful than a thousand other ways we spend our money.
Perhaps I am missing something because to me, going 18 years without cancer after having cancer and going through treatment is...expected? Does canceer treatment not actually get rid of the cancer or something like that?
I know that's generally true, but apparently sometimes the odds of recurrence are so low they stop worrying about it. I have a relative who was diagnosed with stage 4 melanoma a decade ago. She got three doses of immunotherapy and her tumors immediately shrank by 2/3, and eventually disappeared entirely. For a while they kept scanning her twice a year, but several years ago they told her it was gone and stopped the scans.
Yes of course, even if all her cancer cells have been destroyed, she could still get an entirely new cancer, just like anyone else. She hasn't attained some kind of immunity.
you really have no way to know if cancer has been "gotten rid of". Presumably thing that went wrong in your body and gave you cancer is still wrong. remission = we can't see anything in this scan. you cannot assume scan can 'see' all cancer, there is no such scan.
Its no different than taking a pill for high cholesterol you are not cured of the disease .
Yeah, "remission" comes from the Latin "remit," which liter means "to return or restore."
When illness originates outside the body, it's usually possible to completely kill/eradicate it, at which point you're "cured." But some things either linger forever (certain viruses, like how chicken pox can come back as shingles) or originate inside your own body (cancer, lupus, rheumatoid arthritis). In the latter case, treatment makes it possible to return to a baseline normal, but there's no guarantee it's all the way gone or won't ever return, so we say it's in remission rather than cured. Cancer lurks; autoimmune diseases go dormant but don't die.
(One autoimmune exception: if you have ulcerative colitis, completely removing your colon cures most people, since the problem lies in that specific organ. But that goes to show how drastic a true cure is!)
There are also some conditions, notably MS, that are described as "relapsing/remitting" because they alternate between periods of relapse and remission. So you'll feel fine for a while, then the symptoms come back, then they go away again, etc.
I’ve been exposing myself to similar, vaccine induced T cell production to fight cancer, research recently due to a family member recently going through it with pancreatic cancer.
My family member was ineligible for the trial due to requiring chemo before surgery due to ca19-9 markers being above the limit for surgery eligibility.
Here are some of my observations as someone forced to the outside:
I read the 2017 and phase i papers.
They are both very mathy and talk more about the life spans of their induced T cells than their patients.
Looks like phase i was 19 patients (16 given the vaccine), 2 recurred, one died, they seem to want to blame the patients’ immune system.
The study is: surgery, vaccine, then 12 cycles of chemo regiment, then vaccine booster.
I was frustrated to see a lack of any search results for “diet”, “nutrition”, “sugar”, “glutamine”, in either paper.
I think the mathy science is cool, and a necessary component, but focusing on pharmaceutical solutions and calculating their efficacy based on if their intended biological reaction occurred, seemingly oblivious of, or defiantly ignoring, lifestyle change appears misguided.
Diet and exercise is insufficient on its own, but due to the vast differences in individual diets, studies like these should include lifestyle requirements as a control.
Especially if they are going to point at a patients immune system.
Diet effects on both immune system function and specifically targeting cancers is uncontroversial and scientifically supported.
Why are these two research efforts so siloed from each other?!
I think some people try to distance themselves from the diet and exercise parts because of how easy it is to sell quackery in that area. "Take this supplement to cure cancer", "Read my book about the exact diet to cure your cancer!", etc.
We'll probably start seeing more and more mixing of traditional or cutting edge treatments like chemo, radiation, and immunotherapy with having the right lifestyle choices to have a stronger immune system. There is research being done, even if limited.
Another interesting thing I'd like to see more research done on is metabolic therapy. Not just having a diet to boost the immune system, but targeting the metabolism of cancer cells. The Warburg effect[0] means a lot of cancer depends on glucose and glutamine for energy. Some researchers have tried using a ketogenic diet to reduce glucose, since normal cells can survive without it, plus using drugs to temporarily drop glutamine levels with the hope that the cancer cells starve first.
I appreciate your reply, but I think calling diet and exercise “traditional” and saying the research is “limited” plays into the downvoters’ prejudice.
I see this sort of sentiment a lot on this forum: it’s only “science” if it’s pharmaceutical, (see: any thread about semaglutides) when in reality cancer response to diet research is well trodden, and I would argue the better science.
Better science because it has stronger controls on variables.
When you read about diet research the patients are all given the same pharmaceutical regiment and the variable is the diet, whereas on the flip side the diets of the patients are completely ignored.
That’s bad science. It may be great research, but it’s still bad science.
It’d be like the diet researchers allowing the patients to choose their own doses for the pharmaceutical side of their treatment, which would be an absurd confounding variable.
Cancer cell metabolism is thoroughly researched.
The leading cause of death is heart disease, and the leading cause of heart disease is build up of fatty deposits, ie diet.
I’m unsure why people act surprised that the same factors play into the body’s ability to respond to cancer.
Read a study on chemo from the 90s and tell me what’s more “quackery”: the pharmaceuticals they tried back then that now would result in a malpractice suit if given to a patient today, or the diet guidelines that have remained consistent over the same time period?
I made it clear in my op that both are necessary, I just want the pharmaceutical side to acknowledge that reality too.
I have zero medical experience so take this question as it is in good faith.
Assuming the process to do this was known, how difficult would it be for a reasonably intelligent person to implement this procedure on their own
This particular work came out of at least 3 NIH grants and indirectly relies on a whole lot more.
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