mahiwaga

I'm not really all that mysterious

Curing Cancer and Shooting for the Moon

The POTUS likens curing cancer to the moonshot. The thing is, cancer isn’t a single disease, it’s a collection of heterogenous, vaguely-related diseases that have multiple causative effects, widely varying pathophysiology, and widely different prognoses.

Trying to cure all cancer is like trying to cure all infection.

To put it into perspective, the CDC lists heart disease as the #1 cause of death in the U.S., with 611,105 deaths in 2013. Of these deaths, [the majority of them were caused by ischemia][2] (370,213 deaths in 2013). Ischemic heart disease is also a catch-all category, but they do tend to be managed similarly—the main difference is in prognosis, really. And the most common type of ischemic heart disease is acute myocardial infarction (116,793 deaths in 2013)—from which many of the chronic types of ischemia arise. So it makes sense that cardiologists focus on preventing and treating heart attacks in order to save the most number of lives.

[2]: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf “Deaths: Final Data for 2013 • CDC”

The CDC lists cancer as the #2 cause of pdeath in the U.S.]1, with 584,881 deaths in 2013. But there is a very wide range of different types of cancers. There is some overlap between different types, but in general, treatment courses vary greatly and they are highly dependent on staging and tissue type. [The form of cancer that is most likely to lead to death is lung cancer][2] (156,252 deaths in 2013) but lung cancer itself is a catch-all category for lots of different types of tumors with different treatment courses. (The main types are non-small cell and small cell, each with their own subtypes)

TL;DR, there’s no magic bullet, no final common pathway to cure all forms of cancer. Every type, indeed, every patient requires a different approach.

(crossposted on Facebook)

The easiest most cost-effective way of managing cancer is prevention, and we know the most common cause of non-small cell lung cancer….

(crossposted on Facebook)

We will make—and have made!—progress, but it will be slow, and people will continue to die, but it won’t be for the lack of trying. Thirty years ago, we didn’t even have any coherent theories that explained how cancer developed. Twenty years ago, gene sequencing was still arduous and we had barely started trying to map the entire genome. Fifteen years ago, the FDA just started approving molecular targeted drugs. While the death rates are still high, they are slowly, steadily declining.

(crosspossed on Facebook)

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