Is the war on cancer an utter failure?

[sweat209]

@robert_columbia

And that could have an effect on the apparent effectiveness of treatment. Maybe in the bad old days, only the biggest and baddest cancer was typically diagnosed. Now, better detection methods allow us to identify small, easy-to-treat cancers that would not have been noticed in, say, 1970. It’s sort of like fighting widespread crime by arresting and convicting more jaywalkers - yes you can say that we are making more arrests per capita nowadays, but are the streets really that much safer with all those muggers and rapists who aren’t getting arrested?

That is why I don’t like stats showing this many new cases this many deaths it not enough info to go on.

I like the cancer 5 and 10 year survival rate.That is what I’m looking for.

If Lung cancer had a 4% survival rate in the 70’s and now 2014 a 10% survival rate not that much has changed.

If breast cancer was at 50% in the 70’s and now 2014 85% that is change.

But I was going in these threads with mind set that not much of any thing changed from the 70’s to now 2014 . May be only a 5% or 10% increase.

I think this may be communication problem why I’m having trouble communicating in these threads.

My views on medicine is not much has changed from the 70’s to now. Where members posting are say it has changed. I think we need to define change. A little bit of change , big change or a lot.

If most cancers from the 70’s to 2014 only had 5% or 10% increase in 5 year or 10 year survival rate that is not much changed.

[Really_Not_All_That_Bright]

Did you have a lot of trouble with fractions at school?

[Smeghead]

Sweat - I’d really like to see you respond to post #35, please.

[Smeghead]

@sweat209

If Lung cancer had a 4% survival rate in the 70’s and now 2014 a 10% survival rate not that much has changed.

If breast cancer was at 50% in the 70’s and now 2014 85% that is change.

So, going from 4 to 10 percent is “not much change”, even though your odds of living have gone up by two and a half times, or 250%. But going from 70% to 85% IS “change”, even though your odds of living have only gone up by 21.4%.

I suppose we can add “statistics” to the list of topics you need to bone up on.

[susanlinda823]

Yes, because theres already a cure…

[Buck_Godot]

@Smeghead

In this case, yes, because those little easy-to-treat cancers would have gone on to be big, hard-to-treat cancers if they hadn’t been caught early.

Not always. A good example is prostate cancer. The US has a much better survival rates for prostate cancer than Europe, primarily because primarily because the Europeans are less likely to diagnose as cancer an indolent prostate tumor that won’t kill the patient before he dies of old age. There is some evidence suggesting that small indolent breast cancers may exist as well.
As to the OP, the kind of improvement you are looking for may be on the horizon. We are at the start of a revolution in terms of understanding cancer on a genetic level, which may show great promise in the coming years.

[Telemark]

@Smeghead

I suppose we can add “statistics” to the list of topics you need to bone up on.

Yeah, that pretty much sums things up for me too. Our OP doesn’t really understand enough to have a reasonable discussion at this level.

[Really_Not_All_That_Bright]

@Smeghead

So, going from 4 to 10 percent is “not much change”, even though your odds of living have gone up by two and a half times, or 250%.

Nitpick: the survival rate is now two and a half times the old one, but it has only gone up by one and a half times.

[robert_columbia]

@Buck_Godot

Not always. A good example is prostate cancer. The US has a much better survival rates for prostate cancer than Europe, primarily because primarily because the Europeans are less likely to diagnose as cancer an indolent prostate tumor that won’t kill the patient before he dies of old age. There is some evidence suggesting that small indolent breast cancers may exist as well…

Good point. If “cancer” is not a fixed concept, comparing survival rates becomes meaningless. To make an analogy, if one article on agriculture claims that orange farmers in Florida lost 10% of their crop to pests and another claims that they lost 35% to pests, the reason for the difference might be that one author defined “orange” to mean only Mandarin oranges as defined by the USDA’s 2012 Book of Crop Classifications and another author defined “orange” to mean all citrus fruits that are commonly considered to be oranges or at least orangelike by common people, including tangerines, clementines, navel oranges, bitter oranges, or bergamot.

[sweat209]

Did you have a lot of trouble with fractions at school?

@Smeghead

So, going from 4 to 10 percent is “not much change”, even though your odds of living have gone up by two and a half times, or 250%. But going from 70% to 85% IS “change”, even though your odds of living have only gone up by 21.4%.

I suppose we can add “statistics” to the list of topics you need to bone up on.

No I mean 4% to 10% survival rate not a 4% to 10% percent increase medical progress.

An example the 70’a a 4% 5 year survival rate. And 2014 a 10% 5 year survival rate

[DSeid]

@sweat209

That is why I don’t like stats showing this many new cases this many deaths it not enough info to go on.

I like the cancer 5 and 10 year survival rate.That is what I’m looking for. …

If you understood the point then ypu’d get why that is exactly not what you want.

Questions:

1. For a given cancer at a given stage how much has survival improved?

2. How much has early detection resulted in greater cures (or in the case of colonoscopies, prevention by removing polyps before they are cancerous) vs how much has it lablled conditions as cancer that never would have progressed to diagnosis or at least to fatality prior to its being laballed? (The latter likely for much of the apparent increase in prostate cancer incidence and possibly a factor for carcinoma in situ of the breast.)

3. How much impact have public health initiatives had on preventing cancer? (For example decreased smoking.)

4. How many quality years of life have been saved by those interventions? Adding 3 months to the expected course of one cancer is “significant” but is not as meaningful as the tremendous gains in pediatric cancer survival rates in terms of life years saved per case. (“more than 80% of children with cancer now survive 5 years or more. Overall, this is a huge increase since the mid-1970s, when the 5-year survival rate was about 60%”) What is the change in deaths per 100K by age group? What is the quality of life associated with life years saved?

[sweat209]

@Really_Not_All_That_Bright

Nitpick: the survival rate is now two and a half times the old one, but it has only gone up by one and a half times.

Members are complaining that my views on medicine are faulty.I have mind set of little to any change. It is two things.

One communication problem understanding there have been lots of medical progress
Two my views on medical progress is not realistic.

This what I’m trying to determine in this thread.

That just make up some numbers as example here to explain it.

1970 of the 5 year survival rate of very bad cancers.Very bad 5 year survival rate.

Lung cancer 5%
stomach cancer 10%
Prostate cancer 2%
Brain cancer 8%

Now the year 2014 a 5 year survival rate

How much progressive we made.

Lung cancer 10%
stomach cancer 18%
Prostate cancer 8%
Brain cancer 15%

So not that much progressive.

Where if the numbers are like.

1970 of the 5 year survival rate of very bad cancers.Very bad 5 year survival rate.

Lung cancer 5%
stomach cancer 10%
Prostate cancer 2%
Brain cancer 8%

How much progressive we made.

Lung cancer 35%
stomach cancer 50%
Prostate cancer 40%
Brain cancer 45%

I’m trying to understand if this is communication problem not understanding your reply or my expectations of medical progressive is too high.

This chart here http://2.bp.blogspot.com/-Yn1crn6Gpak/T476j27qtQI/AAAAAAAAAz4/NhkYXSVFGBs/s1600/Survival+Rate+by+Cancer+Type.png
Saying 5 year survival rate

Prostate 98%
Thyroid 96%
Testis 94%
Malanomas 89%
Breast 86%
Hodgkin’s 85%
Corpus uteri, utterus 8$%
Urinary bladder 82%

Was those numbers in in 40’s and 50’s in the 70’s? If so that is medical progress.

If those numbers where much higher than my expectations of medical progress is too high and it has nothing to do not understanding what you saying.

[Chronos]

Wouldn’t the really meaningful statistic be “typical (mean, median, whatever) age of death by cancer”? If I live to be 120, it doesn’t much matter to me if that’s because modern medicine prevented me from ever getting cancer, or if it cured my cancer every time I developed it, or slowed its progress so much that I could live with it for decades. Either way, the result is the same. Get the age of death by cancer high enough, so that it’s enough above the age of death by other causes, and it becomes basically irrelevant. Of course, you’d have to pull some some fancy statistical tricks to determine the age of death by cancer for people who died of something else first, but it could be done.

[sweat209]

Other thing to illustrate what I was saying.

5 year survival rate http://2.bp.blogspot.com/-Yn1crn6Gpak/T476j27qtQI/AAAAAAAAAz4/NhkYXSVFGBs/s1600/Survival+Rate+by+Cancer+Type.png

it is saying

Cervix,Utteri 70%
Larymx 68%
Rectum 62%
Kidney,renal pelvis 61%
Colon 61%
Non-Hodgkins 57%
Oral cavity,pharynx 56%
Ovary 55%
Leukemia 42%
If those numbers where like this in the 70’s
Cervix,Utteri 30%
Larymx 40%
Rectum 40%
Kidney,renal pelvis 45%
Colon 15%
Non-Hodgkins 15%
Oral cavity,pharynx 20%
Ovary 15%
Leukemia 15%

That is medical progress!! If those numbers where higher than that it is medical progress but slower.

That is why I’m trying find out if this is English language barrier understanding your reply and you understanding what I’m saying.

Or my expectations of medical progressive is too high.

[naita]

@sweat209

No I mean 4% to 10% survival rate not a 4% to 10% percent increase medical progress.

An example the 70’a a 4% 5 year survival rate. And 2014 a 10% 5 year survival rate

Yes, that’s two and a half has many people surviving in 2014 as in 1970. A huge increase to anyone who understands high school math. (Which admittedly excludes a great many people who get good grades in high school math.)

Then you compare it to an increase from 50 % to 85 % and call that a big increase, when in fact it’s not even a doubling of the number of people surviving, you show a very poor understanding of the sort of numbers you keep saying would be a big help to you.

You need to stop thinking you know what would be a good way to look at this and start reading all of what people here are explaining to you.

[sweat209]

@naita

Yes, that’s two and a half has many people surviving in 2014 as in 1970. A huge increase to anyone who understands high school math. (Which admittedly excludes a great many people who get good grades in high school math.)

Then you compare it to an increase from 50 % to 85 % and call that a big increase, when in fact it’s not even a doubling of the number of people surviving, you show a very poor understanding of the sort of numbers you keep saying would be a big help to you.

You need to stop thinking you know what would be a good way to look at this and start reading all of what people here are explaining to you.

Okay may be there is English language barrier and understanding fractions. To mean 50% 5 year survival rate to 85% 5 year survival rate seem like bigger number than 4% 5 year survival rate to 10% 5 year survival rate. If every 10 years it goes up by 8%

That means 85% in 40 years from now will be close to 100% and the 10% only 20%

[naita]

@sweat209

Okay may be there is English language barrier and understanding fractions. To mean 50% 5 year survival rate to 85% 5 year survival rate seem like bigger number than 4% 5 year survival rate to 10% 5 year survival rate. If every 10 years it goes up by 8%

That means 85% in 40 years from now will be close to 100% and the 10% only 20%

So what? There’s no reason to expect an even 8% change in the survival rate across all cancers. Of course 10 % is a horrible survival rate and would feel like a death sentence to many, whereas 50 % not to say 85 % would look like a fighting chance, but 10 % is still an incredible improvement on 4 %, and only your preconceived notions of what progress “should” have been made is preventing you from seeing that. Not language barriers, not poor math skills, but simple bias.

[DSeid]

Trying to answer my own questions I found the graphic at the bottom of this page.

Note that what has happened (this in the U.K. but likely the same in the U.S.) is the (expected) increase in cancer deaths in those 80+ as more reach that age, while all other age groups have seen highly significant declines. The younger the age group the bigger the impact has been with roughly half as many deaths due to cancer in those under 50 and roughly 30% fewer deaths due to cancer in those 60 to 69.

sweat209, you do seem to have an unrealistic bar for defining lots of progress. Doubling survival rates and more does not impress you.

No question cancer is still a bad disease especially if it has already spread before it is diagnosed. The biggest impact has been in the cases completely avoided (lung and colorectal most notably and over a much longer time period stomach cancers which back in the 1930s were 10 times as common as they are now). Doubling survival once diagnosed (or more) aint bad though even if you are not impressed until the vast majority diagnosed survive.

This article might help give a more realistic set of expectations … or not.

… Cancer is, by far, the harder problem — a condition deeply ingrained in the nature of evolution and multicellular life. Given that obstacle, cancer researchers are fighting and even winning smaller battles: reducing the death toll from childhood cancers and preventing — and sometimes curing — cancers that strike people in their prime. But when it comes to diseases of the elderly, there can be no decisive victory. This is, in the end, a zero-sum game.

The rhetoric about the war on cancer implies that with enough money and determination, science might reduce cancer mortality as dramatically as it has with other leading killers — one more notch in medicine’s belt. But what, then, would we die from? Heart disease and cancer are primarily diseases of aging. Fewer people succumbing to one means more people living long enough to die from the other. …

… Though not exactly consoling, the fact that we have reached this standoff is a kind of success. A century ago average life expectancy at birth was in the low to mid-50s. Now it is almost 79, and if you make it to 65 you’re likely to live into your mid-80s. The median age of cancer death is 72. We live long enough for it to get us. …

… Faced with this inevitability, there have been encouraging reductions in the death toll from childhood cancer, with mortality falling by more than half since 1975. For older people, some early-stage cancers — those that have not learned to colonize other parts of the body — can be cured with a combination of chemicals, radiation therapy and surgery. Others can be held in check for years, sometimes indefinitely. But the most virulent cancers have evolved such wily subterfuges (a survival instinct of their own) that they usually prevail. Progress is often measured in a few extra months of life.

OVER all, the most encouraging gains are coming from prevention. Worldwide, some 15 to 20 percent of cancers are believed to be caused by infectious agents. With improvements in refrigeration and public sanitation, stomach cancer, which is linked to Helicobacter pylori bacteria, has been significantly reduced, especially in more developed parts of the world. Vaccines against human papilloma virus have the potential of nearly eliminating cervical cancer.

Where antismoking campaigns are successful, lung cancer, which has accounted for almost 30 percent of cancer deaths in the United States, is steadily diminishing. More progress can be made with improvements in screening and by reducing the incidence of obesity, a metabolic imbalance that, along with diabetes, gives cancer an edge. …

FWIW.

[sweat209]

@naita

So what? There’s no reason to expect an even 8% change in the survival rate across all cancers. Of course 10 % is a horrible survival rate and would feel like a death sentence to many, whereas 50 % not to say 85 % would look like a fighting chance, but 10 % is still an incredible improvement on 4 %, and only your preconceived notions of what progress “should” have been made is preventing you from seeing that. Not language barriers, not poor math skills, but simple bias.

Members have been saying medical progress have been going up over the years. I wanted to know what do you mean medical progress going up? They replied to my thread many times and posted links , but I seem confused not understanding the reply or my expectations of medical progressive is too high.

It could be not English language barrier but my expectations of medical progressive is too high.

There’s no reason to expect an even 8% change

Well predicting the future is hard but my point was medical progress has not changed much.

My expectations of numbers may be higher than what people are saying here.And that may be contributing to confusion.
Looking at http://2.bp.blogspot.com/-Yn1crn6Gpak/T476j27qtQI/AAAAAAAAAz4/NhkYXSVFGBs/s1600/Survival+Rate+by+Cancer+Type.png

It saying the 5 year survival rate for.

Brain,nervous system 32
Multiple myeloma 29
Stomach 23
Lung and Brochus 15
Esophagus 14

If this was 10% in 70’s the medical progress is slow.

[sweat209]

sweat209, you do seem to have an unrealistic bar for defining lots of progress. Doubling survival rates and more does not impress you.

I think is may be English language problem of me not phrasing the question better and asking is cancer progress not doubling survival rate every 10 to 15 years.

Go up by 8% every 10 years?

Because those numbers did double but where all the way from the 70’s