> and quadrupled the survival at 36 months compared to placebo-chemotherapy
There are lots of ways to slice the data. I think the one I quote is probably what got the researchers so excited.
The problem is that the 36-month survival is pretty low, so even quadrupling it only increases the average survival time by the 1.6 months or whatever.
Mesothelioma is one of the worst. My mom died of it at age 53, which is way too young.
When the heart-strings aren't being tugged, most people aren't totally stupid, and can understand basic statistics and probability distributions well enough, but those things are never given freely to the public when it comes to oncology. I can get a bell curve on different brands of hard drives or fuel injectors easily enough, but on a costly intervention that leads to much "collateral damage", that information is all behind a paywall in literal Greek. This is not an "oopsie". This is intentional.
You are looking at it from the point of view of population statistics.
But from the point of view of someone having only six months left to live, the extra 1.6 months is fantastic. (Yes, I know not everyone gets an extra 1.6 months, there is a distribution of outcomes averaging 1.6 months). The new treatment doesn't lower the quality of life for the patient, so this is a clear win.
Cynical takes are a dime a dozen; improvements in outcome for this type of cancer is apparently rare. Guess which has more value.
It isn't a cynical take. It is the experience of seeing several family members take the chemo, suffer, then die shortly thereafter. If it hits me, I intend to do like Christopher Lasch did--take some pain-killers and go out with some bit of my dignity left intact. I read so many oncology papers in those days, and was thoroughly scandalized by them. Think of all the broad-spectrum bullshit there is in the software space, the financial space, the political space... but! doctors and researchers would never stoop so low?
The average difference between chemo and no chemo at all is similarly underwhelming. Read just about any "when doctors die" piece, and it's clear that they rarely eat their own cooking, and with good reason. Given the choice between "death sentence" and "death sentence, with extra pain and suffering, and a fat bill for the family at the end", I think it's an easy choice.
My dad's cancer spread to the lungs so radiation was off, and his kind didn't respond well to any chemo at the time. He then got pneumonia and the docs told us he'd likely have many months left once the pneumonia was treated, but he would most likely have to stay at the hospital until the end.
He decided to ask them to stop the oxygen supply, and passed away peacefully the following day. It hit hard since it came earlier than expected, but I'm very grateful he was allowed to make that choice. I hope I get to make my own choice if the time comes.
There may be some combination of cancer and treatment where progress has been made, but the aggregates are unimpressive, and if oncology were operating in the light, we'd have more numbers and classifications, and fewer glossy brochures filled with vague bulleted lists. I'd have odds instead of marketing adjectives.
> 1.6 whole months! Of additional life on chemo! Will the miracles ever cease? /s
Thing is, as a species we got a lot of the old killers tackled that held back human lifetime expectancy rates for milennia - illnesses that used to decimate or even wipe out entire populations got stopped by vaccines, antibiotics and sanitation measures, workplace injuries by OSHA and friends as well as automation, transportation of all kind by (very) strict regulations, drug consumption-associated diseases (cancer, liver failure) by taxes and banning ads. Or basically, we've long since flown by the 80% pareto mark of stuff that killed people before they reached retirement.
Now, we have to deal with the hard stuff, that only shows up since people live long enough to experience it... cancers of all kind, the various forms of dementia (and these are nasty, I'd wager even worse than cancer!), retinal degradation, or bones getting brittle - many old but fit people tend to make a serious downturn after breaking a hip or whatnot from an unlucky fall and never recover from that.
And unfortunately, that takes time, and progress only comes in very slow increment.
Anyone who is familiar with the numbers knows that "sanitation measures" were more effective than all of the other interventions you listed combined. But I didn't criticize sanitation, or vaccines, or any of the other things mentioned. I criticized chemotherapy. If you're excited about the prospect of zeroing-out the estate and suffering for an extra month or two to be a martyr for science, that is your business. When I read articles like this poorly disguised pharma PR piece, all that comes to my mind is, "Don't piss on my head and tell me it's raining." It is that bad.
Thing is, on the way to eventually make cancer a treatable disease we will have to endure a few decades worth of extremely small steps. Maybe less, if BioNTech's mRNA bet actually goes through, but that's far from a given.
That is all PR. None of this is the slow steady march of science. It is commerce. Blow smoke up enough asses, scam it through the FDA, profit, and be sure to have the next "breakthrough" ready before the last one is reassessed and exposed for the p-hacked con-job that it was. Many editors of the top journals resigned over this a long time ago, and will complain at length to anyone who will listen.
