Linda and Viv Hailwood on a hard hike over Howgill Fell, Yorkshire Dales National Park. Linda had a small stream named after her on that occasion ("Linda Beck", Beck being the local dialect for small stream.
The group I work with at the Hutch has as one of its
principal interests the development of tests to permit early detection of
ovarian cancer. I have just run on a
review article on the need for such tests for cancer in general. In case you want to read it yourself, the
citation (done like a geologist would do) is Etzione, R., et al, The case for
early detection: Nature Reviews, v. 3, pp. (well, they don’t give the page
numbers) April 2003. It is well written,
comprehensible for the most part, and blessedly short. My only real complaint (more of a peevish
quibble, really) is that it is hard to read on a computer. For you Kindle experts it should be a piece
of cake.
I have several things from this article to pass on. By this time it should not be necessary for
me to remind you that I am a geologist, not a biochemist, and may occasionally
(or more often ?) get things wrong. This
is your last warning; don’t believe anything I say without serious thought, and
don’t act on anything I say without consulting an expert.
The first thing, I can’t get wrong. The authors present us with a graph showing
the 5- and 10-year survival frequencies of victims of breast, colorectal, lung
and prostate chance, contrasting these frequencies in people whose cancers were
discovered when they were localized with frequencies after the cancer had
spread. As you might expect, the former
had a much better result than the latter.
Consider breast cancer for example.
For women diagnosed in the period 1993-97, the five-year survival
frequency was about 20% if the cancer had spread (was “distant”) but 95% if it
hadn’t (was “local”). For prostate
cancer the benefit of early detection was even more pronounced. Even lung cancer showed this trend, but the
actual numbers were definitely pretty dismal. My
take-home from this is that what we (my group, at the Hutch) are doing is worth
the time, effort and money – and then some.
Those same graphs showed how survival numbers increased in
the interval 1972 to about 1997. This must reflect improvements in treatment –
drugs, radiation, surgery, voodoo, whatever.
There was noticeable, consistent improvement shown – but in terms
of years of life saved it couldn’t compare
to the benefit of early detection.
I have a few more things to say, but I am getting impatient
with my typing problems and a gin and tonic is waiting. I may post more on this article in a day or
two.
Yes we need easy blood tests for ALL cancers that can be taken every 6 months and detect all cancers in their very earliest stages. Why is that so hard??? :o)
ReplyDeleteYou know the saying, “Beer is proof that God loves us?” Well, cancer might be described as evidence that God holds us in mild distaste. Or, alternatively, that He has set us a test that few of us will pass. If it were possible to detect the onset of cancer by a simple blood test the world would be a far different and more comfortable place. The contribution of medicine to the national debt would be cut in half. Barak Obama would be re-elected in a landslide. And Linda would still be alive.
DeleteKristen, you have had more biology than almost anybody, so you know how difficult it is to detect cancer early enough for an easy, or at least effective, cure. At times it seems to me that every cancer is unique. Even within a single category – ovarian, say – there are many sub-types, and within those subtypes the genomes of individual cancer cells may differ. They speak of “targeted therapies”, by which I think they mean studying the genetic makeup and proteins of an individual’s cancer, then building a therapy specific to that tumor. This has got to be insanely expensive, and unfortunately what will work for Judy won’t serve for Jane. God has set the bar awfully high.
I’m resting my hopes on immunotherapy, which I blogged about yesterday, I think – and on early detection, which is what my group is doing.