Interesting blog post, linked on the science daily
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Posted On: 02/23/2020 3:00:18 AM
Interesting blog post, linked on the science daily board I check. I copied just a few parts, if interested in the whole article, the link is below.
https://blogs.scientificamerican.com/cross-ch...s-reality/
The Cancer Industry: Hype vs. Reality
What’s the reality behind the hype? “No one is winning the war on cancer,” Azra Raza, an oncologist at Columbia, asserts in her 2019 book The First Cell: And the Costs of Pursuing Cancer to the Last. Claims of progress are “mostly hype, the same rhetoric from the same self-important voices for the past half century.” Trials have yielded improved treatments for childhood cancers and specific cancers of the blood, bone-marrow and lymph systems, Raza notes. But these successes, which involve uncommon cancers, are exceptions among a “litany of failures.”
The best way to measure progress against cancer is to look at mortality rates, the number of people who succumb to cancer per unit of population per year. The risk of cancer grows with age. (Although childhood cancer gets a lot of attention, Americans under 20 years old account for less than 0.3 percent of all U.S. cancer deaths.) Hence as the average life span of a population grows (because of advances against heart and respiratory disorders, infectious disease and so on), so does the cancer mortality rate. To calculate mortality trends over time, therefore, researchers adjust for the aging of the population.
With this adjustment—which, keep in mind, presents cancer medicine in a more favorable light--mortality rates have declined almost 30 percent since 1991. This trend, according to cancer-industry boosters, shows that investments in research, tests and treatments have paid off. What boosters often fail to mention is that recent declines in cancer mortality follow at least 60 years of increases. The current age-adjusted mortality rate for all cancers in the U.S., 152.4 deaths per 100,000 people, is just under what it was in 1930, according to a recent anal
The rise and fall of cancer deaths track the rise and fall of smoking, with a lag of a couple of decades. Cigarette consumption in the U.S. more than doubled between 1930 and the early 1970s and has fallen steadily since then, according to the nonprofit site Our World in Data. Smoking raises the risk of many cancers but especially of lung cancer, which is by far the biggest killer, accounting for more deaths than colon, breast and prostate cancer combined.
Pharmaceutical companies keep bringing new drugs to market. But one study found that 72 new anticancer drugs approved by the FDA between 2004 and 2014 prolonged survival for an average of 2.1 months. A 2017 report concluded that “most cancer drug approvals have not been shown to, or do not, improve clinically relevant end points,” including survival and quality of life. The authors worried that “the FDA may be approving many costly, toxic drugs that do not improve overall survival.”
Costs of cancer treatments have vastly outpaced inflation, and new drugs are estimated to cost on average more than $100,000/year. Patients end up bearing a significant proportion of costs. More than 40 percent of people diagnosed with cancer lose their life savings within 2 years, according to one estimate.
According to a 2018 report in Stat News, drugs firms aggressively market immune therapies, and patients are “pushing hard to try them, even when there is little to no evidence the drugs will work for their particular cancer.” A 2017 analysis by oncologists Nathan Gay and Vinay Prasad estimated that fewer than 10 percent of cancer patients can benefit from immune therapies, and that is a “best-case scenario.”
Immune therapies trigger severe side effects, and they are also extremely expensive, costing hundreds of thousands of dollars a year, oncologist Siddhartha Mukherjee, author of The Emperor of All Maladies, a bestselling history of cancer, reported in the New Yorker last year. “Subsequent hospital stays and supportive care can drive the total costs to a million dollars or more,” he writes. “If widely prescribed, immune therapies “could bankrupt the American health-care system.”
The desire of oncologists to produce monetizable findings might also compromise the quality of their research. A 2012 examination of 53 “landmark” cancer studies found that only six could be reproduced. The so-called Reproducibility Project: Cancer Biology has examined 14 more recent highly cited studies, and has confirmed only five without qualification.
https://blogs.scientificamerican.com/cross-ch...s-reality/
The Cancer Industry: Hype vs. Reality
What’s the reality behind the hype? “No one is winning the war on cancer,” Azra Raza, an oncologist at Columbia, asserts in her 2019 book The First Cell: And the Costs of Pursuing Cancer to the Last. Claims of progress are “mostly hype, the same rhetoric from the same self-important voices for the past half century.” Trials have yielded improved treatments for childhood cancers and specific cancers of the blood, bone-marrow and lymph systems, Raza notes. But these successes, which involve uncommon cancers, are exceptions among a “litany of failures.”
The best way to measure progress against cancer is to look at mortality rates, the number of people who succumb to cancer per unit of population per year. The risk of cancer grows with age. (Although childhood cancer gets a lot of attention, Americans under 20 years old account for less than 0.3 percent of all U.S. cancer deaths.) Hence as the average life span of a population grows (because of advances against heart and respiratory disorders, infectious disease and so on), so does the cancer mortality rate. To calculate mortality trends over time, therefore, researchers adjust for the aging of the population.
With this adjustment—which, keep in mind, presents cancer medicine in a more favorable light--mortality rates have declined almost 30 percent since 1991. This trend, according to cancer-industry boosters, shows that investments in research, tests and treatments have paid off. What boosters often fail to mention is that recent declines in cancer mortality follow at least 60 years of increases. The current age-adjusted mortality rate for all cancers in the U.S., 152.4 deaths per 100,000 people, is just under what it was in 1930, according to a recent anal
The rise and fall of cancer deaths track the rise and fall of smoking, with a lag of a couple of decades. Cigarette consumption in the U.S. more than doubled between 1930 and the early 1970s and has fallen steadily since then, according to the nonprofit site Our World in Data. Smoking raises the risk of many cancers but especially of lung cancer, which is by far the biggest killer, accounting for more deaths than colon, breast and prostate cancer combined.
Pharmaceutical companies keep bringing new drugs to market. But one study found that 72 new anticancer drugs approved by the FDA between 2004 and 2014 prolonged survival for an average of 2.1 months. A 2017 report concluded that “most cancer drug approvals have not been shown to, or do not, improve clinically relevant end points,” including survival and quality of life. The authors worried that “the FDA may be approving many costly, toxic drugs that do not improve overall survival.”
Costs of cancer treatments have vastly outpaced inflation, and new drugs are estimated to cost on average more than $100,000/year. Patients end up bearing a significant proportion of costs. More than 40 percent of people diagnosed with cancer lose their life savings within 2 years, according to one estimate.
According to a 2018 report in Stat News, drugs firms aggressively market immune therapies, and patients are “pushing hard to try them, even when there is little to no evidence the drugs will work for their particular cancer.” A 2017 analysis by oncologists Nathan Gay and Vinay Prasad estimated that fewer than 10 percent of cancer patients can benefit from immune therapies, and that is a “best-case scenario.”
Immune therapies trigger severe side effects, and they are also extremely expensive, costing hundreds of thousands of dollars a year, oncologist Siddhartha Mukherjee, author of The Emperor of All Maladies, a bestselling history of cancer, reported in the New Yorker last year. “Subsequent hospital stays and supportive care can drive the total costs to a million dollars or more,” he writes. “If widely prescribed, immune therapies “could bankrupt the American health-care system.”
The desire of oncologists to produce monetizable findings might also compromise the quality of their research. A 2012 examination of 53 “landmark” cancer studies found that only six could be reproduced. The so-called Reproducibility Project: Cancer Biology has examined 14 more recent highly cited studies, and has confirmed only five without qualification.
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