FDA Approves Vaccine For Prostate Cancer 194
reverseengineer writes "The US Food and Drug Administration has given its first first approval for a therapeutic cancer vaccine. In a clinical trial 'involving 512 men, those who got Provenge (sipuleucel-T) had a median survival of 25.8 months after treatment, while those who got a placebo lived a median of 21.7 months. After three years, 32 percent of those who got Provenge were alive, compared with 23 percent of those who got the placebo. ... "The big story here is that this is the first proof of principle and proof that immunotherapy works in general in cancer, which I think is a huge observation," said Dr. Philip Kantoff, chief of solid tumor oncology at the Dana-Farber Cancer Institute in Boston and the lead investigator in Dendreon's largest clinical trial for the drug. "I think this is a very big thing and will lead to a lot more enthusiasm for the approach."'"
wait (Score:5, Funny)
jenny mccarthy told me vaccines give me prostate cancer
no thanks, i'll pass. i get my health advice from mtv hosts
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Looks like someone watched this week's Frontline [pbs.org]...
W
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Wow.
I moved Jenny McCarthy to my "formerly hot" list along with Carol Alt and Deanna Troi (Star trek).
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She's still hot. Just in the "hot mess" category.
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Wow Jim Carrey, I didn't know you were a /. reader.
Re:wait (Score:4, Funny)
She probably won't anytime soon, because I'm betting her parents had her vaccinated.
Well I definitely hope it works (Score:2, Funny)
I also hope it gets rid of prostate exams :)
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I don't think you're seeing the bigger picture. That's what it has been approved for now. Give it ten years and they might be giving treatments like this one to people prophylactically the moment their PSA count starts up, just in case. And eventually, that could eliminate the need for any of those other treatments you mentioned.
Provenge? (Score:4, Funny)
I'm trying to figure out if "Provenge" is the most awesome or terrifying name for a drug I've ever heard. Also from the wikipedia page it "consists of a mixture of the patient's own blood cells" and their special "fusion protein".
I'm going with terrifyingly awesome!
I just hope the commercials feature Chuck Norris.
This is good news. (Score:3, Funny)
As someone who got hooked on ciggies about six years ago and actually enjoys the habit, news like this is promising to me. I hope the science behind this vaccine can be generalized to other forms of cancer, including lung cancer. I understand the reasons for banning smoking all over the place for reasons other than health, but it would be great to have advances in health technology to negate the effects of smoking. Since I have yet to quit and am not motivated to try again, I'm kind of banking on it.
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Nicotine does have cognitive enhancing effects and can also act as an anti-psychotic (in fact the only one that doesn't have potentially devastating side effects). Nicotine also helps considerably with irritable bowel syndrome. Smoking is a rough way to administer it though.
E-cigarettes are a much kinder and gentler route of administration, but sadly the FDA and the American Lung Association (of all things) seems determined to ban those so people go back to smoking cigarettes.
Proper snus might be good (I've
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I am not aware of any credible studies that show that combination to have any effects whatsoever beyond inducing people to buy energy drinks.
Nicotine, on the other hand has been shown to have the effects I mentioned in controlled clinical studies. In addition, there is no evidence whatsoever that nicotine by itself is any more harmful than caffeine. It's the smoking and nitrosamines that have the negative health effects.
Re:This is good news. (Score:4, Insightful)
Nicotine is a serotonine inhibitor, people with above average levels of this hormone tend to react emotionally, have trouble coping etc. (it's a known cause of at least some types of ADD). Among such people Caffeine and Nicotine addiction is incredibly common because it's effectively self-medicating. Caffeine doesn't inhibit serotonine but counteracts it a bit and helps focus, nicotine reduces it again helping focus and concentration.
This effect of course is completely zeroed out if you don't HAVE a naturally high serotonine level but there's a reason so many geeks and artists smoke and have among the lowest rates of successfully quitting. People with high serotonine are also highly creative and individualistic and thus drawn to such professions. With these legal drugs, they can balance the pro's and cons without it, they have serious difficulty adjusting and operating well - to them the "withdrawel effects" is huge. I put it in quotes because it isn't, the withdrawel is no worse than for any other person quitting, but it's massively aggravated by the fact that (probably for the first time since they were teenagers) they aren't supressing their serotonine levels.
It's easy to judge and generalize.
Personally - I rate being able to get through the day without acting irrationally, excessively emotionally and being able to concentrate on my job for the next 40 years or so rather higher than the risk of living ten years less. It's genuinely a case of - as a smoker, my quality of life is so MUCH higher, that I'll accept the side-effects. Especially since those drugs that can have the same effect tend to have too much of it (thus removing the PRO'S of my serotonine level as well) and besides, generally have side effects not much better than those of ciggies (and frankly, they happen right NOW, not 30 years down the line).
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Re:This is good news. (Score:4, Interesting)
But smokers dying earlier helps reduce the "aging population" problem. It reduces the costs on average - since everyone is going to die anyway, and many nonsmokers still eventually get expensive to treat diseases (live long enough and you'll get something :) ).
Plus if the tobacco taxes are high enough, you can get smokers to pay for other stuff as well[1]
As a nonsmoker, I think smoking is good economics. Drug money and all that :). All these smoking bans (in restaurants, pubs etc) seem rather stupid to me. Just tax places that allow smoking higher compared to those that don't, then you won't lose another revenue opportunity ;).
[1] I saw some stats in the UK where the smokers cost the UK healthcare system 3 to 5 billion every year. But the tobacco tax revenue is 10 billion a year!
http://news.bbc.co.uk/2/hi/health/8086142.stm [bbc.co.uk]
http://www.the-tma.org.uk/tobacco-tax-revenue.aspx [the-tma.org.uk]
http://www.ecancermedicalscience.com/news-insider-news.asp?itemId=311 [ecancermed...cience.com]
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>As someone who got hooked on ciggies about six years ago and actually enjoys the habit
Of course you enjoy it. You're addicted to a chemical that affects mood. Your brain is forced to enjoy it. Enjoy!
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There is of course much truth to that. Yet I hear many smokers say "I don't even enjoy it anymore, I just feel shitty without it." That's not me. In fact I've gone on week-long trips where I could not smoke and had no problem doing so, no cravings or anything. Perhaps I'm just not to that point yet, or perhaps the nicotine affects different people differently.
Enjoy!
Thank you, I will. =)
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$93,000 for the treatment (Score:4, Funny)
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If they are all still in a bad state - just clinging on to life rather than seemingly healthy, I'd rather spend the 93K on making the last few months/years of my life more pleasant.
Or give it to some loved ones to have a nice holiday, if I'm in already a too screwed up a state to enjoy it much. Or give it to some charity.
huh? I'm supposed to do what now? (Score:2)
Oh, sorry. Missed the dollar sign. As you were...
sex (Score:2, Funny)
Very Glad (Score:2)
Re:Statistically significant? (Score:5, Informative)
According to my calculation, if the null hypothesis were true (i.e. the vaccine were just a placebo) there would be about a 1 in a million chance of a result this extreme (4.85 standard deviations above the mean). So it is highly significant statistically speaking. Whether it is clinically significant or not is a different question, of course.
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(Now I remember why I got a lowly B+ in statistics.)
Re:Statistically significant? (Score:5, Informative)
If you assume each person has (independently) a 0.23 probability to survive 5 years, then the overall distribution must be binomial with standard deviation sqrt(n*p*(1-p)).
Re:Statistically significant? (Score:5, Funny)
Re:Statistically significant? (Score:4, Funny)
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Ahh, I see we have a science fiction writer in our midst.
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Actually I am wrong.
As some people have pointed out below, the sample who received the vaccine was only of size 256, not 512. So the p value is not 1/1000000 but more like 3x10^-4. Still significant, but not what I said before. Sorry.
Re:Statistically significant? (Score:5, Interesting)
I other OLD news, men who ejaculate 5 times per week had a 66% less chance of prostate cancer EVER in their life than men who only did once or less per week. They has to be started young and you must continue this into your 50s. 3 different studies on this from 3 different universities in 3 different countries and all 3 go roughly(damn near the same) the same results even though they went about different ways of testing. They one test alone was a periodic questioner that followed over 30,000 men. Is that a good sample size? There seems to be a semi linear link, so each day you clean the pipes per week gives you and ~X% reduced chance of getting this dreaded disease.
I say an orgasm of prevention is worth more than a pound of cancer.
The current theory is that the prostate is great at concentrating carcinogens because of how it excretes and re-absorbs fluids which essentially filters and captures bad crap. Gotta flush it out.
Remember, a 66% reduction of the chance of cancer is like saying "you have a 200% INCREASED chance of caner if you don't".
P.S. remember to tell your wife to put out or close the door, because you're busy curing cancer.
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5 times a week?!?
How am I ever going to keep count, let alone get the number down to 5?
Re:Statistically significant? (Score:4, Informative)
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Unless your wife / mum walks in, that's really difficult to do...
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I always thought old guys were wankers.
Now I know why.
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I say an orgasm of prevention is worth more than a pound of cancer.
Mod: Pedantic...
40 years of ejaculating 5 times per week is 10,400 orgasms.
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Unknown quirks? (Score:2)
The difference between taking the drug and not taking it is tiny, according to the stated results of the experiment.
Quote: "The big story here is that this is the first proof of principle..." Translation: The big story is NOT that this drug works well.
Note that the U.S. government is very weak in regulating drug companies. For
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"We need to cut back on the quantity of medicine used, in order to improve efficiency." - Barak Obama last week. This vaccine won't be allowed to use except a few rare cases.
Re:Statistically significant? (Score:5, Informative)
Several major points:
1. There were 512 people in the trial. Assuming that these were split into two groups, that n=256. Of course it depends on the standard deviation, but you could get your p value very low with an n like that.
2. Human trials of drugs that treat potentially fatal conditions are generally only allowed for patients who've failed "best available" therapy at least once, because it would be unethical to deny standard therapy to someone in a trial. The relative risk reduction may get better when used outside the context of the trial because of that. Or not. Remains to be seen, as usual.
3. As our understanding of the immune system and the molecular processes underlying cancer improves, we will slowly unravel a huge potential for case-by-case-based treatment of cancer. As a matter of fact, I believe a recent study I am too lazy to look up to link has shown that people whose cancer therapies relied on analyzing the biochemistry of each individual tumor resulted in about a 50% increase in 5-year survival, compared to conventional pathology-based treatments. The future is bright for oncology.
4. The caveat of #3 is that such treatments are expensive, and will get progressively more expensive based on the degree of testing and individualization required (until the wide use and technology make them cheaper of course). This will necessarily introduce a further divide into the available treatments for the rich and the poor, and contribute to the class struggle that's already rather inflamed. The problem is that there's no OTHER way - giving everyone $100'000 treatments would bankrupt us rather quickly. Instead, similar to the case with electronics, we will simply have to suffer through the period of expensive first-adopter treatments, until the improvements in laboratory techniques and high-throughput testing make such treatments increasingly affordable.
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Bright indeed. The immune system has an amazing ability for specificity. Once we master the art of training the immune system to recognize and kill cancer cells the fight will be over. Interestingly, there was a cancer treatment in the late 1800's that relied on injecting cancer tumors with an infectious serum designed to elicit an immune response. The treatment had some success but was dangerous as the patient ran the risk of death from infection. I really think immuno therapy is the future of cancer th
Re:Statistically significant? (Score:5, Informative)
Bright indeed. The immune system has an amazing ability for specificity. Once we master the art of training the immune system to recognize and kill cancer cells the fight will be over. Interestingly, there was a cancer treatment in the late 1800's that relied on injecting cancer tumors with an infectious serum designed to elicit an immune response. The treatment had some success but was dangerous as the patient ran the risk of death from infection. I really think immuno therapy is the future of cancer therapy.
To be honest I find that unlikely. Unfortunately there is a reason why that cancer spread - it has already managed to evade the immune system.
Immune therapy is but one of the treatments that become available once you understand tumor biology. Even more promising are drugs that can have direct effects on the multiple pathways that have been disrupted or bypassed by the cells on their way to becoming cancerous. As we gain more complete understanding of these molecular mechanisms, as well as enhance our ability to identify the mutations or dysfunctions in each individual tumor, we'll be able to target them efficiently. For instance, we may be able to fix the "suicide" pathways (yes, I know it's called apoptosis) that were necessarily disabled in a particular tumor, and by treating the problem cause the tumor cells to destroy themselves and they were programmed to do by evolution.
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It was the treatment of tonsillar squamous cell carcinoma but I can't find the reference at present. Read about it in med school.
However, may I draw your attention to a couple of other cancers that seem to benefit from localised immune activation due to injected bacteria:
Stomach: http://www.nature.com/bjc/journal/v84/n4/abs/6691599a.html [nature.com]
Mouth: http://www.springerlink.com/content/rw3kk056t4014t5j/ [springerlink.com]
Bladder: http://www.ncbi.nlm.nih.gov/pubmed/20205607 [nih.gov]
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4. The caveat of #3 is that such treatments are expensive, and will get progressively more expensive based on the degree of testing and individualization required (until the wide use and technology make them cheaper of course). This will necessarily introduce a further divide into the available treatments for the rich and the poor, and contribute to the class struggle that's already rather inflamed. The problem is that there's no OTHER way - giving everyone $100'000 treatments would bankrupt us rather quickly. Instead, similar to the case with electronics, we will simply have to suffer through the period of expensive first-adopter treatments, until the improvements in laboratory techniques and high-throughput testing make such treatments increasingly affordable.
But they can't. When Western Digital finally comes out with a Petabyte drive, it will cost a high price, but the next week, Seagate comes out with a Petabyte drive. Competition increases, prices drop, and the drives become increasingly affordable. In medicine, the patents are extended a little further. The patent holder can charge whatever he wants, because he needs to make back the money he spent on risky research, but for the next n+[too many] years, he gets to hold the sick of the world hostage. Wel
Re:Statistically significant? (Score:5, Interesting)
2. View the #2 in your post. They have to struggle in a market that's immediately artificially saturated by Company A's wonder drug. This is like Pepsi trying to show up and claim "we can quench your thirst", but regulations say that, for the first n number of years, people have to drink a full coke before they can drink a Pepsi. Hope you're still thirsty after that coke, and if you're not, then hopefully the pepsi will quench your thirst when the coke did not!
And there, spelled out in soda, we have the well-meaning recipe for disaster in American healthcare -- the one that isn't fixed by the government plan, but needs to be before the government plan sends us headlong into a depression because of this unresolved bug.
That's not at all a good understanding of the market or of biomedical research.
Anyone else is free to come up with a treatment that works better using the same principles. It just can't be the same exact protocol.
Similarly, to spell it out in soda for you, Pepsi can't produce soda using Coke's recipe and charge less for it.
Drug patents are woefully short-lived in the US, and only give the company a few years (unlikely to reach a decade, even under the fastest FDA review) to make their research money back, make a profit, and finance further research. For all the negative press patents get, the are still essential for stimulating development by rewarding innovation.
Unlike other IP, however, drug patent periods haven't been climbing up in duration, and as a result we can all enjoy levostatin, ezomeprazole, and the rest of the drugs that used to be sought-after prescription drugs, and are now cheap generics.
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and they drug companies are just doing the (relatively cheap) trials, I guess it all balances the fuck out.
Relatively cheap?
It's at least $100 million to take a single drug to stage 3.
I'm very sorry about your family, but you're speaking nonsense.
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The Wealth of Nations might well still apply today, but we wouldn't know because we have thrown out all but the most dumbed down bare bones parody of what Smith recommended (essentially all of the inconvenient parts about keeping businesses small to medium sized and not having publicly traded companies are ignored). As a result, most markets are rather unhealthy and competition is sparse.
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>>I'm fed up with nitwits who don't realize that a book written 200+ years ago (The Wealth of Nations) doesn't apply anymore.
Do you thatch your own roof, too?
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***The main idea is that this difference of 32% and 25% survivor rates may not indicate a "slight extension" due to a universal treatment, but rather a treatment that is very effective for one segment of the patient population and worthless for the rest.***
Prostate cancer is normally a very unaggressive and slow growing cancer. It's also very common. It often isn't treated in the elderly as the risks of treatment may outweigh the expected benefits. The feeling is that men over 70 with newly detected pros
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I did wonder when I read the summary "it seems a bit harsh on the half that only got a placebo."
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I agree with your statement in number 3. With the increasing introduction of new pollutants in our environment as well as the constant move of young generations from raw foods to processed ones, cancer will keep occurring. It is important to remember that with these due to these continual elements, we will see new types of unidentified cancer in the future, therefore making it that much more important to treat them on an individual basis.
1. The most poisonous, cancer causing toxin we can take into our bodies on an every day basis, we need to survive. O2
2. Cancer does not occur due to pollutants. It's a disease of old age. If we all go back to dying at 40 years old, it'll cease to be the problem.
Wth is it with you people coming out of the woodwork today...
Re:Statistically significant? (Score:4, Informative)
There was never a time in written history when we all died at 40 or so. The average lifespan figure was strongly skewed by a high infant mortality.
While cancer becomes more common in old age, it is hardly a disease of old age. Children get it, young adults get it, middle aged people get it and old people get it. Most notably for your argument, it happens all too often before age 40.
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The above is not "informative" in any way, given that it contradicts both statistical data, and our understanding of the biology of cancer.
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Actual measurement != media speculation or New Age conspiracy theories.
I'll give you the example of breast cancer:
http://www.cdc.gov/cancer/breast/statistics/age.htm [cdc.gov]
I could go on with more examples, but considering that I'm right, and I have to get back to work, I can't really be bothered.
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Yeah, the nerve of those stupid kids claiming they have cancer. They're probably just slacking. TheMuge has spoken!
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Dude, seriously, let it go. I have no reason to argue with you, especially since you insist on being belligerent.
The fact is that cancer risk increases with age. Just like any distribution, it has a tail. That's unfortunate for those in the tail, but does nothing to disprove my point.
Re:Statistically significant? (Score:4, Informative)
Is it just me or do those numbers look too close to be statistically significant?
The summary mentions a sample size of 512. The standard error of the mean decreases by the square root of the sample size. For 95 % certainty, if the standard deviation of their measured data is less than (32 percentage points - 23 percentage points)*sqrt(512)/1.96 = 104 "percentage points", which is quite likely, (see a tutorial [wikipedia.org]), then you *can* say that this is statistically significant.
If you want some real details and not my back of the envelope calculations of dubious quality, you can see the actual slides [shareholder.com] [PDF], which does have details on the statistical significance of the results.
Long story short, they're significant at the level tested (95 %, generally good enough for these kinds of studies).
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It just has to be "significant" enough for Pharma to bribe a bunch of doctors into prescribing it. An alarming number of drugs have success rates so low as to give even sick consumers pause. Or, there are already more effective drugs on the market which are no longer protected by patent, so suddenly there's a "breakthrough" that's not really a breakthrough. The problem is that the "customer" of the drug companies is not the
Re:Placebo Effect (Score:5, Insightful)
You are an idiot and have no clue what 'the placebo effect' even is, and some of the pills during her regiment are not medical effective and are there just to keep her in the habit. That is NOT a placebo effect.
"Girls who get Pregnant like symptoms when they really want to be pregnant. People who catch an actual cold when they call in sick for work faking it"
neither of those are a placebo effect.
People like you are driving us back to the dark ages.
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>>>I'm still under 130 pounds
Ahhhh not so fast. Doctors are now saying there's such a thing as "thin fat" where you weigh few pounds, and appear slim, but your body's fat percentage is over 22%, and that's bad. I just saw a report about this on the Today Show - you can have a low BMI but still be fatty.
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Somehow, this sounds like the opposite of "I'm just big boned." I'm sure it exists, but it's probably a lot rarer than what most people need to be concerned about.
With all the unmoving couch potatoes in modern society eating diet foods which don't nourish them I'm sure it's very common. If you have no muscle, you can have some fat and not look fat.
Re:It won't be allowed to be used. (Score:4, Informative)
That's not what he meant, and this isn't the same context and you know it.
SHAME on you for trying to pollute political discourse.
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>>>SHAME on you for trying to pollute political discourse
Jimmy Carter called me a racist. So have other high-ranking Democrats. What do you call that? Isn't that "polluting" the political discourse? But never mind; that's okay because they are on your team.
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National debt - $128,000 per US household and still rising + 10,000 per year.
You are including promised payouts which will be covered by future pay-in. Conservatives may bitch about SS all the time, but they love to use it when it comes to doing the numbers. It's paying in more than it's taking out, but it is still called
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>>>You are including promised payouts which will be covered by future pay-in
No. You're wrong. I'm taking the current national debt (12.8 trillion) and dividing by the number of households (100 million) and arriving at $128,000 per home. Simple.
As for rationing I'd rather see it happen naturally, through the free market, then via bribing politicians or administrators to gain "special favors". I'm also concerned about racism creeping-in, if those administrators don't like certain groups, like bla
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You're right. I stopped paying attention when I got permission to emigrate and didn't realize how bad the Bush bailouts hit his last fiscal year. $3 trillion in just over a year. I'm glad I got out. Though I'm still on the hook for taxes unless I renounce my citizenship.
As for rationing I'd rather see it happen naturally, through the free market, then via bribing politicians or administrators to gain "special favors".
I don't see how the "free market" being paying more for it getti
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We already ration healthcare here, we ration everything already we used money for this.
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And yet, even with all that rationing and those death panels working overtime, all of those countries have average life expectancies greater than the U.S., measured in years, while paying about 55% per capita of what Americans pay.
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One reason other countries life expectancies are higher is because they "massage" the numbers. Take infant mortality for example. Most countries don't include those deaths of individuals below age 1 in their life expectancy figures. The US does, and naturally that makes the overall number drop much, much lower.
Comparing stats is not enough. You have to make sure the stats were arrived at via the same methodology, and in this case, they were not. So no direct comparison can be made.
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And you have some cite for this, or perhaps a ranking of countries by an adjusted method that evens out the methodological differences?
Your own CIA Factbook [cia.gov] backs up what I'm saying, and I suspect they don't just call up the country's embassy and ask for the number.
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That article mentions differences in definitions of live births, but also cites real (and incompletely understood) factors in infant mortality (such as ethnicity) that are meant to question infant mortality as a proxy for the quality of the health care system. Fair enough. I'm not seeing how differences in infant mortality rate explain years of difference in life expectancy between the U.S. and Canada, England, France, or Switzerland (none of which are mentioned in Dr. Healy's article, so it's not clear t
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The U.S. has comparable or lower rates of violent crime than Canada, England, or France, so that's not it. Lifestyle differences undoubtedly have an impact--Sweden is notoriously active, for example--but Canada has a province where a quarter of the country's population thinks a good meal is plate of fries covered in cheese curds and drowning in gravy, and also has more smokers, and fives time the number of doughnut shops per capita that the U.S. has (and England's not better). Rates of disease outbreak ar
Re:It won't be allowed to be used. (Score:5, Insightful)
In this country, she was anemic the whole time of pregnancy, including during and after birth. She was asked whether she had symptoms. She suffered no dizziness, no fainting, or anything else. So they cleared her for release while failing a blood test. Her grandmother had a fit. She gets a new pill for every test she fails (regardless of whether it is even causing her symptoms) so, by God, that's just how it's done. To not give my wife something was neglect or malpractice or something, according to Grandma. I'd be interested in seeing the average number of pills per week of an American vs a European. My perception is that the US will be leading by far, even though the live expectancy doesn't reflect any better care.
In the US, they treat the test results, regardless of the condition of the patient. Outside the US, they treat the patient, using the test results as a tool to that end. That difference alone is a major factor as to why the US has the most expensive health care on the planet, yet a middle of the pack (for industrialized nations) life expectancy. Cutting the medication of everything, and instead identify problems with patients (rather than just failed tests) and treat the person, not just the diseases will reduce cost and improve care.
But, the "easy way" is to give a pill for every failed test and then you can't be sued. That takes less time and effort too. The cost isn't borne by either the doctor or the patient, so neither really care it isn't cost effective. And you get an over-medicated society in poor health. I'd guess that Obama's comment is along those lines, where he wants to cut costs and improve service at the same time.
P.S. Comp Sci. Comp Eng is 50% comp sci and 50% EE, so EE+comp sci is everything comp eng can do plus more.
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>>They wouldn't let her go.
Hospitals are not allowed to hold patients against their will, generally speaking. The exceptions are:
-Mental illness (they can hold up to 72 hours without a court order)
-Public threat (you have ebola)
-You have diminished capacity (stroke victim, dementia, etc.)
-You're a criminal.
The way it came off, it probably seemed like the doctor wouldn't let her go, but if she wanted to walk out the door, they can't stop her, unless one of the above applies.
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That's sort of damning with faint praise, isn't it?
FYI, in Canada, we have a province with a quarter of the country's population (Quebec) that thinks a good meal is a plate of fries covered in cheese curds and drowned in gravy. We also have five times the number of doughnut shops per capita that you have in the U.S. I'm jes sayin'...
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Some doctors may feel the need to order more tests and treatments to avoid being legally vulnerable. That's a real issue. And while I'm not advocating caps on malpractice awards which I believe can be unfair to people who've been wrongfully harmed, I do think we need to explore a range of ideas about how to put patient safety first, let doctors focus on practicing medicine, and encourage broader use of evidence-based guidelines. That's how we can scale back the excessive defensive medicine reinforcing our current system of more treatment rather than better care.
but that doesn't support the statement by the GP. Or from this interview [go.com]
Well, let's take an example. And I -- they may be represented here, I wasn't sure, but the Mayo Clinic, everybody has heard of it. It has got some of the best quality care in the world. People fly from all over the world to Rochester, Minnesota, in order to get outstanding care. It turns out that Mayo Clinic oftentimes provides care that is as much as one-third less expensive than the average that's provided or -- or some other health care systems that aren't doing as good of a job. Now, why is that? Well, part of it is that they have set up teams that work together so that, if you go first to your primary care physician and they order a test, you don't then have to duplicate having two more tests with other specialists, because they were in the room when you first met with that primary care physician. They know how to manage chronic diseases in an effective way so that we have people who are getting regular checkups, if they're trying to manage diabetes, as opposed to us paying for a $30,000 foot amputation because we didn't manage the disease properly. So they are doing all kinds of smart things that we could easily duplicate across the system, but we don't. And our job in this -- in this summer and this fall, in which I think everybody understands we've got to move in a different direction, is to identify the best ways to achieve the best possible care in a way that controls costs and is affordable for the American economy long term.
Based on this, I'd say that Obama is right and the GP is full of crap.
Re:4 months? (Score:4, Insightful)
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Well, according to some of the best doctors in the U.S., prostate cancer is easily detectable at early onset and existing techniques prolong life closer to ten years.
This sounds like yet another modern-age snake-oil campaign. i.e. murder for profit by big pharma. It's just gonna get worse now that Obama has FORCED us to support them.
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Well, according to some of the best doctors in the U.S., prostate cancer is easily detectable at early onset and existing techniques prolong life closer to ten years.
This sounds like yet another modern-age snake-oil campaign. i.e. murder for profit by big pharma. It's just gonna get worse now that Obama has FORCED us to support them.
While prostate cancer may be easily detectable, this is not so for every prostate cancer case. Provenge is used for patients where the nice "live 10 years longer" treatments don't work, for some reason, and it's more like a few months until you're dead. But please, feel free to refuse the treatment and help with the budget.
And mind that it is only in recent years that life expectancy has gone to 10 years for 60% of patients. That means for about 40% they don't make it to the deadline, even with modern treat
Re: (Score:2)
I'm just wondering how effective the placebo is.
Of course, that's not going to happen, since there's lots of existing treatment for prostate cancer that works (and probably better than this drug).
But perhaps could be done for other sorts of cancer - e.g. end stage etc.
Re: (Score:3, Informative)
Saw palmetto doesn't do crap. And it's never been "proven" to prevent prostate enlargement or cancer. It's nothing but hearsay.
Propecia on the other hand (the stuff for baldness) has been shown to help the prostate.
Re:4 months? (Score:4, Interesting)
Propecia on the other hand (the stuff for baldness) has been shown to help the prostate.
Not surprising at all. Proscar, a prostate medication, had the side effect of making people grow extra hair. So Merck marketed a lower dose of the same substance, and called it Propecia.
Re: (Score:3, Funny)
And it can make you impotent. Which is great because now that your new hair can attract women, you can't take advantage of the situation.
Re:4 months? (Score:4, Insightful)
really? (Score:3, Insightful)
You got a (well conducted, well documented, and peer reviewed) study to cite on the saw palmetto helping cancer survival rates?
Cause I'm pretty sure that's bullshit.
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Recent Results do not look good for Saw Palmetto.
http://www.medpagetoday.com/Urology/BPH/2643 [medpagetoday.com]
I'm on HRT so I take it. It looks like it may not have made a difference.
When I ever get Prostate Cancer, I'll be taken off HRT and life will turn back to the hell it was before I went on HRT.
So the prostate cancer vaccination news was nice in some regard.
HRT does not cause prostate cancer but it accelerates it once you get it.
Re: (Score:2)
An *average* of 4 months. Not only that, the treatment -- which consists of 3 infusions of your own treated white blood cells over one month -- will cost $93,000. Seriously, the ROI seems pretty low.
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The way I read it it looked like that was an average of 4 months among the study participants, who were very terminal. While the article says the procedure is only approved for terminal cases, that definition of "terminal" is, correct me if I'm wrong, a bit more lax than the criteria they were using to select study participants.
We don't know yet if there will be more than 4 months benefit for people who receive this treatment slightly earlier in the course of the disease than the study participants did. I
Re:Again... (Score:5, Insightful)
Again fucking statistics used as proof. No knowledge of how chemicals interact within the body, how and why the reactions that cause cancer occur, no fucking nothing. Just the damn statistics.
Again someone who has no idea how drug development and clinical trials work shooting his mouth off.
Re: (Score:2)
Is that not his point? He wants to know more about how the drugs were developed and why they work they way they do. Instead he is given a brief line about the success rate in clinical trials and not much else.
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Is that not his point? He wants to know more about how the drugs were developed and why they work they way they do.
No, I don't think he does. His contempt for the single most important item to be reported in any clinical trial says he doesn't really give a damn, but just wants to indulge in an ill-informed rant.
Re: (Score:2)
I still feel that he does have a point, even if it was, perhaps, not presented in the best manner.
If this was about a "cure" for a computer virus we would get long winded explanations about how the virus was able to attack the system, which systems are vulnerable, and exactly how the fix is able to remove the virus.
Instead we are told that researchers were able to successfully remove the virus from 32% of the computers in the lab. Encouraging, perhaps. But it does not help anyone better understand the hows
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Just because the article doesn't contain it, doesn't mean there's no theory behind the function of the drug, it's not as if it's created by randomly pouring stuff in a jar and shaking it about.
In any case, knowing statistically -that- something has an effect, and search for the reason why, is a hell of a lot better than what the alternative world typically does; which is have a lot of explanations (bullshit ones: water has memory etc) for how something is supposed to work, but not the tiniest hint of eviden
Re: (Score:3, Informative)
It's a clinical trial, so it doesn't matter why it works. It's a study to determine if it works.
They could have designed it based on deep knowledge of the workings of body chemistry, or they could have noticed that people on a treatment for something else don't seem to die from prostate cancer as often as you would expect and decided to try and confirm that with absolutely zero knowledge of mechanism.
It doesn't fucking matter, because explaining the workings isn't the aim of the trial.
But in this particular