Tuesday, June 3, 2014

INCREMENTALISM & ZENO'S PARADOX


I am surrounded by beautiful women.
Kristen, Karen, Linda (wife) and Linda (daughter)
Our first house, 501 Cowgill, in the background.
 
Carolyn has sent me a link to a Yahoo news article that is meant to be encouraging – its title is New drugs may make a dent in lung, ovarian cancer    I find it slightly depressing.
These new drugs – specifically the one aimed at lung cancer – give the sufferer a few more weeks of life, at considerable cost in comfort as well as wealth.  Despite this some medical types purport to be excited: incremental progress is better than no progress at all, they say.  I would agree, of course.  However, if your goal is to eliminate cancer then one of Zeno’s Paradoxes comes into play.  If you go half the remaining distance toward your goal every year, how long does it take to get there?
Here is the link:
A side bar to this article led to another, this one specifically aimed at ovarian cancer.  The British drug company AstraZeneca has announced*the results of a small trial using two of their drugs in tandem.  One is a PARP inhibitor; that is, a drug which impedes the ability of fast-dividing cancer cells to repair “mistakes” in the duplication of their DNA.  Presumably if a cell finds itself with DNA that is sufficiently messed up it spontaneously croaks.  The other drug inhibits “angiogenesis”; the process whereby cancerous masses recruit new blood vessels to provide themselves with everything they need to thrive.  Used individually on patients who had relapsed after standard chemo, each of these drugs prolonged the period of remission.  Used together they did an even better job.  What is called “progression-free survival” was increased by over eight months by use of the combination of drugs.  The effect on ultimate mortality has yet to be established.
Again I could invoke Zeno’s Paradox, but I won’t.  Linda had a long period of remission.  It was among the best periods of our life together. 
Here is the link:
My attitude toward incrementalism is shaped by arguments in The Truth in Small Doses, which I promise to review properly very soon.  I need to read it for the third time and write notes in the margin.
*AstroZeneca is under “attack” by Pfizer, which wants to devour it.  It seems that the early disclosure of these drug-trial results was meant to reassure stockholders that all is well.  That doesn’t mean that the results are flaky, of course – just hastily revealed.


2 comments:

  1. Here is another news article designed to be encouraging but – in my view – isn’t.
    http://www.nytimes.com/2014/06/03/business/cancer-researchers-report-longer-survival-rates-with-immunotherapy.html?_r=0
    The article concerns the use of immunotherapy to combat various kinds of cancer, principally melanoma. Again, “progress” is highly incremental and even more highly sporadic: not all patients experience the salutary effect. Nasty – very nasty – side effects are present, and as always expenses are horrendous. I am tempted to apply the famous Saul Rivkin dictum: “So what?” We need to insure life, not postpone death. Sure, there are some areas of cancer wherein real cures are possible, and others in which our “incremental” efforts result in 20-30+ years of disease-free life, but there are others – ovarian is one – where meaningful progress just doesn’t seem to be occurring. Should our strategy be to concentrate on “interdiction”; preventing the cancer in the first place? Interdiction backed up by early detection seems to be a viable approach to me. But, as I’ve said many times before: What do I know?

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  2. Here is a difficult-but-informative take on angiogenesis research. It is mildly discouraging.

    http://www.news-medical.net/life-sciences/Angiogenesis-Research-An-Overview.aspx

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