Re: Will we ever be able to cure cancer?

bae@xxxxxxxxxxxxxxxxxxxxx wrote:
In article <hFvCl.2072$Q52.1912@xxxxxxxxxxxxxxxxxxxx>,
Mark & Steven Bornfeld <bornfeldmung@xxxxxxxxxxxxxxx> wrote:
Unsettling (esp. to someone with plenty of cancer in his family) are the steady drumbeat of studies failing to demonstrate increased longevity with recommended cancer screening procedures. This was in Newsweek last week:

http://mobile.newsweek.com/detail.jsp?key=45182&rc=he&p=1&pv=1

Note that the screening tests which apparently HAVE been associated with greater longevity are PAP for cervical cancer and occult stool blood for colon ca. Amazing to me that this has apparently NOT been demonstrated for colonoscopy.

Unfortunately, there aren't good tests for many cancers, especially good
screening tests to be used on healthy people at relatively low risk.
Such screening tests should be inexpensive, not dangerous to the patient
and not have a very high false positive rate. Pap and fecal occult blood
are reasonable screening tests. In the profit-oriented,
litigation-prone environment in the US, very expensive tests may be used
for general screening, while in the rest of the developed world, these
tests are mainly used for people at relatively high risk. The result is
that the rate of early detection of cancer, and survival rate are about
the same, but costs are dramatically lower.

This apparently is the finding of various studies. I can understand why this is not intuitively true for doctors OR patients. Occasionally you'll get the GI people railing against "virtual colonscopy". You'll also get reports that colonoscopy is far more effective at detecting polypoid than sessile lesions. This shouldn't be surprising at all, but apparently the more invasive lesions often do not form polyps.



Mammograms are mainly useful for screening women over age 50, since the
breasts of younger women are difficult to image effectively by this
technique, and most breast cancer occurs in older women (IIRC, median age
is 65 or 70). Manual examination is more effective than mammography in younger women.

Obviously, this is controversial. I don't pay close attention, but of course the recommendations from on high keep changing.

Colonoscopy makes most sense for people with symptoms and
for people with a family history of colon cancer.


A younger cousin of mine died in the past year of colon cancer. His father had had a colostomy maybe 25 years before, and still is alive. The deceased apparently did have a colonoscopy at age 40. Of course, the recommendation is to have one every 5 years if you are high risk, but his doc said 10 years--he didn't make it.


As far as 'recommended' screening tests, these recommendations may be
quite different between specialist medical associations in the US, and
in other parts of the developed world. Effectiveness (or
ineffectiveness) of a screening test can most readily be determined when
you've got the long term medical records of the entire population
available, as is the case when there's a single-payer system -- this gives
you enough data to do good statistical work.

The search for good tests continues. Some, like PSA for prostate cancer
and CA-125 for ovarian cancer, have been shown as mainly useful for monitoring effectiveness of treatment in people who already have the
condition, rather than screening the general population. These tests
have too many false positives, since a number of common benign conditions
can cause elevated values.

What I've read seems to agree with this.

You may recall the conflict between two studies a couple of years back about the value of CAT as a screening tool for lung ca. The parameters were different--IIRC one looked at overall death rate from lung cancer, the other looked at longevity. I can't claim to understand the distinction, but that was credited with the diametrically opposed results of the two studies.

As for longevity vs death rate, I'm not sure what they meant, but
consider this: Lung cancer is very hard to treat effectively. If a CAT
scan makes it possible to detect the cancer at an earlier stage, but
treatment is still not very effective, the patient may appear to have
greater longevity (length of survival after diagnosis) because he was
diagnosed earlier, but the earlier diagnosis may not have much effect on
the rate of cure.


I remember this precise point being made in the discussions of the studies.


So there's a question of whether the test was
useful, or just caused a longer period of anxiety and misery for the patient, especially considering that CAT scans are not benign -- there's
a substantial exposure to radiation, far more than in a simple x-ray,
and a screening test is something you'd want to repeat at intervals.
Is the substantial radiation exposure, and risk of causing cancer, worth
it if it doesn't aid effective treatment? Not to mention, of course,
the substantial expense.

Both my father and mother in law had lung cancers picked up on a standard chest film. In my father's case it was a screening x-ray, in the case of my mother in law an incidental finding when she fell in her apartment, and had an x-ray to evaluate her injuries. My dad is doing well 3 years after a lobectomy; my mother in law has Stage IV ca with hepatic involvement. She claims to be symptom-free and is not being treated.


BTW, thank you, thank you THANK YOU for injecting a legitimate intelligent post into the quagmire that this ng has become. I cannot account for its sudden and steep decline, and welcome the few posts from experts (you know who you are) that still occasionally show up.

You're welcome. The original post I replied to looked like it could be
from a troll, but it's Morally Good ;-) to give people the benefit of
the doubt, at least occasionally, even if one risks starting a cascade
of sewage posts about the Evil Medical Conspiracy that is purposefully
trying to make us all sick and miserable and dead when there are safe
and effective simple cures being maliciously suppressed. Oh for the
good old days before modern medicine, when everybody lived forever and
died in perfect health!

Were there alternative shamans?

Steve

.

Relevant Pages

  • Re: Will we ever be able to cure cancer?
    ... longevity with recommended cancer screening procedures. ... Note that the screening tests which apparently HAVE been associated ... screening tests to be used on healthy people at relatively low risk. ... monitoring effectiveness of treatment in people who already have the ...
    (sci.med)
  • Re: the best health care in the world
    ... cancer screenings, according to the American Cancer Society's ... screening program in St. Lawrence County. ... says women have a 98 percent survival rate when breast cancer is ... free mammograms for the fiscal year ending April 2010, ...
    (soc.retirement)
  • Re: the best health care in the world
    ... cancer screenings, according to the American Cancer Society's ... screening program in St. Lawrence County. ... says women have a 98 percent survival rate when breast cancer is ... free mammograms for the fiscal year ending April 2010, ...
    (soc.retirement)
  • Re: Healthcare: 38% Favor, 56% Opposed
    ... Cancer screening: What could it hurt? ... health officials ended the program. ... mammograms, and then get them only every other year. ...
    (soc.retirement)
  • Re: Sad news
    ... mom had been diagnosed with colon cancer. ... Like with other cancer screening tests, do get your check ups, all of ... I have to putt strength by believing that she is now at peace ...
    (rec.crafts.textiles.quilting)