A couple of years ago, the American Cancer Society gaily reported that cancer survival rates have been improving dramatically and steadily. A few weeks ago, Cancer Research UK announced a similarly sunny prognosis for the public at large: UK survival rates have doubled in 30 years. Yes, we are all "surviving" longer with cancer …
This is a well written article that helps expose a major problem in modern medicine (propaganda). Thanks for a great article.
Excellent points, very well made
The fact is that medical treatment is expensive, and deciding whether it is worth paying for is difficult. Doctors use very obscure and hard to grasp measures of quality of life, and clarifying the use of words like "cure" and "survival" is just the start.
Perhaps once patients fully understand the implications of treatment, they'll be able to choose the level of quality and length of life they want, and doctors will be able to trust them to make their own decisions.
5 years of vomiting and pill-popping, or 1 year of normal life? Is "survival" worth it? Its worth giving it some thought...
Great article, but...
If the definition of "cure" becomes the patient dies of other causes, couldn't cyanide/mercury be then defined as a "100% cure" for cancer? Surely a cure could simply be defined as causing the cancer to go into remission or having it removed. In the same way that we can't "cure" AIDS, but modern drugs allow patients to survive longer with the disease.
As to the survival rate, the stage of the cancer should be taken into account, and each stage compared, rather than taking a mean of the whole lot.
As someone who has had cancer in the past and may face it again, I have to say this is an excellent article. I wish every article in the Science section of the Reg were this well written. Thank you Thomas!
Finally, somebody have got the guts to talk openly about this issue. I lost several members of my family to cancer - and have seen what it can do. I also have seen a cancer diagnosed at stage I kill a man in 4 month (i.e. from stage I to stage IV and on to death in 4 month).
I've heard too much b******t from doctors to simply believe everything that's being published - and I do know when I see something worthwile. Too bad you might get a lot of hate mail from doctors, pharmacists, etc. who profit greatly from the FUD surrounding any really non-curable diseases.
Another statistical item to watch for
Another thing to watch for is that drugs are often marketed touting their 'relative' benefit, not their 'absolute' benefit.
For example, you may hear that a cholesterol lowering drug reduces your risk of a 2nd heart attack by 40% over a 5 year span, which sounds wonderful. However, the absolute numbers don't sound so great. A group may be followed for 5 years and 97% of those on the drug will have gone without a second heart attack. However, 95% of the control group may have went with out a second heart attack as well. That's only a 2% ABSOLUTE change, but a 40% RELATIVE change.
If your doctor were to tell you that you have only a 2% better chance with the drug, but you will also have to pay $200 a month for the Rx, you may become impotent, you may have insomnia, etc, etc, it doesn't sound too great. But we need to be told the absolute benefit, not the relative one.
Another wonderful gem from El Reg. You guys surprise me all the time with stuff like this - not really IT, but well worth every moment you spend reading it.
Nice job Thomas, my cancer IQ just went up about 50 points.
What about studies starting at later stages?
Very nice article overall showing the tricky problems of conveying
stochastic information (and the stickier problem of having a vested interest
in conveying something other than the available information).
Are there no studies about survival rates of stage II or later cancers vs.
years ago? These would show more about the effectiveness of treatments
since the skewing caused by increases in early detection would be removed.
If there are such studies, you should report on them. If there are not such
studies, that is significant and should be noted as well. But you say nothing
about this either way.
When you need to know, you learn.
Cancer treatment is a depressing business but thing have improved in the last 30 years. Computer planning has drastically improved treatments and standard of life for many kinds of dissease. Staging is taken into account when people make summary statements and the summary is averaged over the most common kinds of cancer. Still, summaries can be misleading and the war is far from won. Lung cancer is steadily increasing as more women take up smoking and they don't have good prospects. Cancer is a life ender and the business is only bearable because you can give a few of your patients more life and reduce the suffering of the rest. Patients and relatives are gratefull for what little can be done.
The cynicism of this article can do some real harm. Early diagnosis is critical because people who are in better shape do better. If you let the dissease progress, there is little to be done. The end comes quickly and is just as miserable as the one that may come in five years. The jargon is complex, but doctors will give you reliable odds and statistics for your particular dissease if you ask for it. Indeed, many of the statistics and definitions are published on the web, which is how the author got the sad facts.
Very good, very depressing - what about the charities?
Headline says it all really.
The one thing i'm ot entirely grasping however is how the charity fits into the equation? Are they just funded by the pharma industries? Or are they, as i've long suspected, simply pointless entities with no clear goals, no tangible knowledge providing jobs for people with double-barrelled names?
Obviously it's not directly related to cancer, but we really should ban these damned charities -- smeering the world in their particular brand of middle-class vanilla smiles and, it would appear, misinformation.
Article very misleading
Does the author know anything about multiple meyloma?
Its a very nasty blood protein disorder of a cancer.
My father was diagnosed in October of 1992. At the time, there were no "survivors" and the prognosis meant 36 months at best.
But because of the early detection, my father was able to last 5 years.
Within that period, the treatment options changed. Unfortunately because of early options, my father was unable to try the newer advances in treatment.
Fast forward almost 10 years since my father's death.
With newer treatments, there is now hope and a chance for remission. See:
So while the article wishes to be skeptical of the advances in science, they are truly there. I do agree that early detection is necessary in giving the patient the best chance of survival, but that doesn't mean that there haven't been advances in treatment.
Depends on what you call 'alive'
I didn't quite get the point the author was trying to make here.
It seems that the author was upset that people that study a specialised field use jargon to describe the technicalities of their field, and that, within the field, these terms have extremely well-defined and precise definitions. Unfortunately, when people who are not experts within the field try and interpret the field, they often misinterpret the findings, or misuse the jargon. According to the author, this is the fault of the experts and represents a deliberate attempt by the experts to confound the public to profiteer from their ignorance.
The author then gives some general hypothetical examples of the kinds of confusion that this could cause, without actually providing any hard data in favour of his hypotheses. This is presumably because it's already beyond question that anybody involved in the healthcare industry is motivated purely by personal gain. It is, after all, the healthcare INDUSTRY; QED.
Had the author been interested in presenting an argument, rather than an anti-science rant, he may have been interested in presenting, what we in the medical research field, call "facts". For example, he might have mentioned that five year survival statistics are grouped by stage (i.e. stage IV compared to stage IV), largely negating his key argument that the improvement in five-year survival is an artifact due to earlier detection. Oops.
He could have mentioned that acute lymphoblastic leukemia, a disease that was universally fatal 50 years ago, is now treated with 80% success. Yes, 'success' in this case may not be the same kind of success that the man on the street would associate with the word, but there are hard data that describe a real improvement in treatment however you cut it.
It is still the case that some forms of cancer (and other diseases) are very poorly treated. Taken together with the fact that the pharmaceutical INDUSTRY makes profits, this is taken by the author as a cause for submission and surrender. Diagnosed with something that was previously incurable (polio, perhaps?), he would presumably refuse any treatment that may line the pockets of the capitalist pharmaceutical death-merchants, roll over and wait for a miserable death. I hope that other readers of this article will see beyond his narrow-minded scepticism. Progress has been made, but more progress still needs to be made. Misrepresenting the data is not in anybody's interest.
Loved your article, but you should at least give the oncologists credit that there are cancers that can be cured: Hodgkins Disease has a 90% chance of definite cure in stages I and II, and I know of quite a few patients with stage IV who have a 30 years survival history (had Hodgkins Disease stage IIa myself 11 years ago and did some extensive research in this field).
The same figures are true for cancers caused by papilloma virus (uterus, throat).
But if I continue your way of thinking, there is one thing absolutely certain: 100% of mankind will die of cancer unless they are not killed by something else. Cancer is mainly a phenomenon of old age (setting aside the genetical disorders like breast and colon cancers as well as leukemia and myelomas in young people who definitely are genetical phenotypes) so the probability to die of cancer is very high. Statistically, and I can only give you figures for Switzerland where I live and have the statistics in memory, the probability to die of cancer is 30%, 40% of death is due to cardiovascular diseases and 30% for other reasons.
There is only one thing you can count on: life is ended by death for everyone.
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