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[wierd]

CRISPR/CAS9 shows promise in forcibly removing HIV-1 infections, demonstrated with animal model trial.

http://www.sciencedirect.com/science/article/pii/S1525001617301107

[MetalSlimeHunt]

It's so cool, I can't wait for it to be indefinitely shelved by corporations and used as a political lever by religious extremists.

[wierd]

I like to think that the human race is capable of moving beyond primitive and idiotic notions like "We got to stop this amazing science, because it interferes with GOD'S WILL FOR GAY PEOPLE!"  or similar idiocy.

The ability to directly remove a provirus from a host genome is a DAMNED POWERFUL TOOL.  It could be what antibiotics did to germs a century ago, only for viruses.

[hops]

It's not like religious proponents were able to stop us from having cyborg rays and glowing puppies, so I highly doubt they can stop something that solves a problem that medical science has been researching hardcore for the past decades.

[inteuniso]

It's not like religious proponents were able to stop us from having cyborg rays and glowing puppies, so I highly doubt they can stop something that solves a problem that medical science has been researching hardcore for the past decades.

Cyborg rays and glowing puppies don't cure cancer. Healthy people don't pay medical bills.

EDIT: Maybe CYBORG rays and glowing puppies can cause cancer. Still doesn't invalidate the point.

EDIT2: I meant to point out that they, in fact, could cure cancer. Healthy people that make their own stuff can't be forced to buy slave-made products.

[hops]

I think developed countries are slowly building up a strong "fuck cancer" sentiment that will propel funding in cancer research very soon.

Since cancer is mostly dependent on genetics and age, rich people can get them too, and that means that they have more stake in it than other diseases.

[ChairmanPoo]

You're kind of obsessively paranoid with that you know? It's not like cancer diagnosis is something decided on one single test.

[MetalSlimeHunt]

We've actually made major strides in cancer treatments which haven't been covered much by the media. A lot of common cancers have arbitrarily high survival rates if caught at Stage I these days, and even something like Stage IV breast cancer which used to mean certain death now has decent odds.

I'm fairly confident that we don't even really need a paradigmatic advance. Refinement and moderate advancements in anti-cancer methods will mitigate the risk of nearly all cancers over the next few decades.

The real question is if we can prevent the wealthy from establishing barriers to receiving those treatments.

[ChairmanPoo]

We have paradigmatic advances though. CAR-T cell therapy is going to change a lot of things, and it's just around the corner.

Heck, you don't even have to get into cutting edge cell therapy to find interesting things. Bispecific antibodies are around the corner as well. Heck, even small molecules are getting very interesting lately, with some compounds being able to fullfill several roles (EG: ruxolitinib was born as a JAK2 inhibitor, in principle to treat JAK2-positive MPNs. Only, as it turns out, it also affects JAK2 negative MPNs because all MPNs have the JAK pathway upregulated.  On top of that it has a big impact on circulating cytokines, giving it interesting immunomodulatory properties that give it value in some autoimmune disorders, as well as management of GvHD)

You're kind of obsessively paranoid with that you know? It's not like cancer diagnosis is something decided on one single test.

And yet...

Spoiler (click to show/hide)

I'm not saying this stuff out of fear. I'm saying it out of frustration.

First, the source  of that study is about thyroid cancer overdiagnosis, not false diagnosis


Second: eh, even "overdiagnosis" is likely simplifying the matter too much, and does not necessarily mean it's wrong to at the very least keep track of these patients.
I found this interesting:

http://www.medscape.com/viewarticle/834450?pa=uGWUPu%2F0P%2BqBvC5BjtUnZXa6zDoDuCDftSexA3OoKz9feeMGfy8aq88yGPhQ7X8oJyGvMX%2Fu%2BWdIXoARf%2FT0zw%3D%3D

Dr Grogan also believes that "the term 'overdiagnosis' is being used incorrectly by this group."
Thyroid cancer has such a high 5-year overall survival rate (about 97%) that it cannot be expected that mortality will significantly increase as incidence climbs, he explained. "A concomitant mortality increase would be expected for, say, pancreatic cancer, but not thyroid cancer," he said. Thus, if a hallmark of overdiagnosis cannot be expected to be seen, then the term is not fitting, he suggested.
Dr Grogan believes that the paper's public health perspective is a limitation for clinicians. "The big question is: Do these patients need surgery?" he said. "The answer can't be that you do nothing."
At the same time, Dr Grogan advocates for clinical trials that explore other management options for patients with thyroid cancer.
Thyroid cancer is a candidate for active surveillance, but protocols are needed and must be investigated. Currently, researchers in Japan are "leading the way" with related prospective studies, he said.

It's a very tough call to make TBH. Some years ago there were talks as well about "watch and wait" attitudes with prostate cancer, instead of treating all of them, because "the impact on mortality was little". Except... as it turns out, that's simplifying things a bit too much as well. Namely, it was shown that while survival rates were similar, bone methases were far less frequent in the treatment groups than in the treatment ones. And they had a huge impact on quality of life. Heck, even the "no impact on survival" was not completely true either. Part of it was because it's diagnosed in older people and it's sluggish... but people *are* living longer now, and there is an impact in survival as well.

[ChairmanPoo]

 A mammograph does not provide a breast cancer diagnosis. You need pathology for that. I think it works fine in that regard, and I don't regard a negative biopsy as "unnecessary". It was necessary in order to rule out having  CANCER.

Specifically. you get a 13% chance of actually being "saved" by breast cancer screening.

1: Even if we accept that number: You think 13% is small? That's one in ten women walking into an oncology consult. It's... quite a lot, really.

2: https://www.ncbi.nlm.nih.gov/pubmed/22972807

Valid observational designs are those where sufficient longitudinal individual data are available, directly linking a woman's screening history to her cause of death. From such studies, the best 'European' estimate of breast cancer mortality reduction is 25-31% for women invited for screening, and 38-48% for women actually screened. Much of the current controversy on breast cancer screening is due to the use of inappropriate methodological approaches that are unable to capture the true effect of mammographic screening.

[ChairmanPoo]

That study analyzes studies published before the one I linked to. The one I linked to is 2014; the one you linked to is 2012. Hence, not a good refutation.

That's not much of a refutation to begin with (being posterior doesn't necessarily mean it addresses the other article, let alone refute it), but the problem is that you're  wrong, to begin with.

Dec 12 2011
Likelihood That a Woman With Screen-Detected Breast Cancer Has Had Her “Life Saved” by That Screening
H. Gilbert Welch, MD, MPH; Brittney A. Frankel

The Impact of Mammographic Screening on Breast Cancer Mortality in Europe: A Review of Observational Studies
Show all authors
Mireille Broeders, Sue Moss, Lennarth Nyström, Sisse Njor, Håkan Jonsson, Ellen Paap, Nathalie Massat, Stephen Duffy, Elsebeth Lynge, Eugenio Paci, MD MPH
First Published September 12, 2012
PDF download for The Impact of Mammographic Screening on Breast Cancer Mortality in Europe: A Review of Observational Studies   Article Information

Notice the dates.

[Descan]

honestly, dude, nobody goes into chemotherapy or what-not on a single diagnostic test

two positive tests (that are otherwise unlinked, i.e. not having the same doctor/test/equipment used) bumps probabilities of a true positive up from "low teens" to "near certainty"

seriously, that's basic bayes, which *you yourself* brought up in the first place. :V that's what this whole thing is about, isn't it? that a positive on a single test doesn't actually increase your probabilities of having what the test was diagnosing? medical practitioners know that; That's why they call for more tests, from different labs, because they know false positives happen a lot more than true positives when only a single test is used

[Descan]

Okay, then focus on that. :v why'd you even start off with Bayesian theory if that wasn't what was bothering you?

[Descan]

Eh, fair enough.

[ChairmanPoo]

Look Ispil, you're beginning to stray into borderline-anti-vaxxer territory.  You're using broad-strokes factoids to rally against a 1A NCCN recommendation, which is based on very through reviews of the avaiable literature (you can check the NCCN guidelines at their official website, or go for the provided sources here and here, if you want to check their sources. I believe the review I posted earlier was also quite good because it examined several different studies for it's conclusion, but with the NCCN we are talking abouy using Cochrane as a source. You cannot go much harder than that as far as preventive medicine is concerned.

Anyway: Paraphrasing my former mentor, I believe if you want to change the S.O.P. in oncology, be it in the setting of treatment protocols (which was the original context of his comment) you have to be very experienced in the subject  and do a lot of background research before you start messing around with it. I mention this because you're rallying against iron-hard evidence, and I don't believe either applies to you. It is one thing to argue about data and quite a different one to preach around the "evils of mammography", when there's a possibility of actual, real harm.