I was lucky enough to be seen by MD Anderson doctors for my rare type of cancer. Within hours of the first painless infusion, the large tumors I could feel and see from the outside were completely gone. Hours, truly.
Now, the rest of the chemo wasn't as easy as the first. But the miracles of modern medicine, thanks to dedicated researchers and medical teams, truly blew my mind and that was a decade ago.
I was told I was one of 42 people ever that MD Anderson had seen with this cancer, yet they were able to tailor a treatment. I think Vox is right about the progress being amazing, and I hope it continues.
The common cancer treatment modalities: surgery, radiotherapy, chemotherapy, targeted drugs and their combinations are very effective first line treatments. I agree the statistics are much better.
In the field of cancer research it has been focusing more on drug / treatment resistance, heterogeneous response to the same treatment and development of less invasive methods both in treatment and assessment (imaging and monitoring). We have made huge progress in terms of deeper understanding of cancer biology and human disease mechanism in general.
However we have a very long way to understand when things progress outside of our control how to respond. E.g the key cancer drivers have been identified long ago but how biology and evolution modulate its response to external treatment has so much unknowns. That requires large effort to push the whole foundation of science to elucidate the details of these processes in my opinion.
I take four pills a day and the primary side effect is weight gain. The earlier 1950s era treatment made me exhausted 24/7. There's a new trial that has a new target, and looks to solve the remaining symptoms of the disease, with effectively no side effects
The big problem is that it's a chronic blood cancer, so the pills have a list price of $180k/yr. Who knows if my insurance will cough up for a second big-money prescription/
My father is 15y out from a trial (at MD Anderson) that put his CLL into remission. You may already know about The Leukemia and Lymphoma Society[1] but they can help with the cost of prescriptions (including negotiating the prices down with the pharmaceutical companies!)
Are you talking about acalabrutinib and zanubrutinib? If so, have you looked into the chinese version Orelabrutinib? Chinese pharma has gone from backwater to competitive with US in like 5 years
At that cost it's worth looking into moving to a country that actually has reasonable medical costs instead of laws protecting those milking the system. a Plan B?
Some countries with publicly funded healthcare make immigration much more difficult if you have an expensive health condition. This is the case for Canada for example [1].
[1] https://www.canada.ca/en/immigration-refugees-citizenship/se...
This is why people need to think about these things when they are in full health.
My actual co-pay is $10/mo for the good stuff, plus warfarin (eliquiis/xeralto were too weak for me :/) which is ~$12 for a 90 day supply from the mail order PBM pharmacy. I average about $1500/yr in out-of-pocket medical expenses. My company self insures, and has an extremely generous insurance plan.
Plan B is wait until 2028, when it goes off patent. I think I can keep my job til then. I've learned from the HR folks that they just signed another 3 yr contract with the insurance company, so I'm not forseeing any major changes to coverage. This drug is super pricey, as it was originally targeted towards people with acute cancers, but now the largest market is the chronic disease patients, but they never lowered the price.
I suspect the insurer/PBM are making a small fortune off of my care. They are also being sued by the pharmaceutical industry for using a "co-pay maximizer" which caps (patients) out-of-pocket co-pays, and goes after the pharmaceutical companies' "charities" which help patients purchase their products, which the insurer then takes a cut from.
And the weight gain isn't fluid, it's definitely body fat. I think the weight gain is from the "baseline" treatment being a mutagenic chemotherapy, and the likely fact that my (previously) enlarged spleen was impinging on my stomach limiting my appetite, and the lived fact that it massively slows your metabolism, as I'm always a bit cold.
I'm not sure how that would work, do countries accept this kind of behaviour?
It's like you've been paying your (lower) taxes in country X and now come over to enjoy the saner system. I guess you should have chosen your priorities earlier?
Out of curiosity, when some medication causes weight gain, how does it work? Does it increase appetite? Or does it slow metabolic rate?
Prednisone is a pretty common drug with weight gain as a side effect, so that might be a good place to look further.
It increases water retention (obviously not permanent or unbounded), increases appetite, and redistributes fat (giving the appearance of weight gain).
Prednisone is usually not a treatment for cancer, but rather a treatment for the cancer treatment.
A potential side effect of immunotherapy is it can cause the immune system to go haywire and start attacking non-cancer cells.
Right, but it's a well researched drug with a weight gain side effect, so it's probably a reasonable entry point for them to learn about the thing they asked (unless they happened to care about that cancer drug in particular, but that's not what it sounded like to me).
Usually, aside from water retention, it’s the appetite, I would assume. Lower metabolic rate by itself would lower the appetite because the person would feel less hungry.
Metabolic rate and appetite are loosely correlated at best. Most stimulants simultaneously reduce appetite, and increase metabolic rate. (in fact, that's where a significant portion of their negative side effects come from. Habitual meth users tend to become malnourished, mostly because of the appetite suppression, which combined with teeth grinding jitters, causes the iconic "meth mouth")
I’ve met people that have moved to Houston for cancer treatment there, were given 1-2 years to live, and they’re still here 15-20 years later. It is a really remarkable place.
MD Anderson is great.
The greater Houston area has too much cancer, in part caused by the many refineries and chemical factories. At least there are good treatment options nearby.
Any statistics on this claim?
Here in Norway there had been increasing focus on the long-term consequences of working on oil rigs.
There's been several studies[1] showing multiple different forms of cancer are over-represented among oil workers[2], and linked to benzene and crude oil exposure.
Granted Norway's oil is exclusively offshore, so exposure might be different.
But, contrary to what a former boss supposedly told his rig workers, just because oil is a natural product does imply it and its processing is harmless.
[1]: https://www.fhi.no/en/cancer/studies/cancer-among-offshorewo...
[2]: https://www.forskning.no/arbeidsvilkar-olje-og-gass/olje-pio...
'Cancer Alley' maps are generally just the same cherrypicked socioeconomic/ racial map you see everywhere- especially the refinery claims.
Adjust for those factors and the increased incidence disappears.
> Adjust for those factors and the increased incidence disappears.
'Adjusting' for those factors builds in the assumption that they're independent of the thing you're trying to measure. If living near a smokestack is undesirable, then poorer/marginalized people will live there even if it also causes cancer.
I assume they meant if you look at roughly the same socioeconomic group that lives 500 miles from refineries as opposed to 500 meters you'll find similar numbers for cancer/other stuff. I'm not on either side of the fence because I don't know, just pointing out what was meant. I'd welcome statistics from either case.
The challenge is that it’s very unlikely that race/socioeconomic factors are causal in and of themselves, the reason why you would adjust for those variables is because they are tightly correlated with other causal factors that aren’t being observed directly, e.g. poorer healthcare availability, poorer access to healthy foods, etc.
Environmental pollution very reasonably can be hypothesized to be a causal mechanism behind cancer rates. Exposure to which is going to be heavily correlated with race and socioeconomics.
I may be misinterpreting OP, but their statement came off as “cancer maps are just maps of where poor non white people live, so it’s not the pollution”, but you can’t just “control” for things that way. Given the fact that environmental pollution is a hazard, there’s a reason why that demographic lives there that makes the exposure to pollution not independent from the demographic characteristics of the population.
Isn't causality transitive though? It sounds like you're saying that low socioeconomic status causes poorer access to healthcare and healthy foods, and that those cause worse health outcomes. Yet you're claiming that low socioeconomic status doesn't cause worse health outcomes. That seems wrong to me.
If causality were transitive the phrase “correlation doesn’t equal causation” wouldn’t exist
Surely that's incorrect. The most obvious scenario is A causes B, B correlates with A, but B does not cause A. Whether causality is transitive is irrelevant.
The quote is typically brought up when there isn’t a direct causal relationship between two variables, not when the causality is reversed. e.g. ice cream sales and drownings. In both cases heat drives behavior, but neither cause each other.
I’d say reverse causality is a very common example, particularly in health and medicine (e.g. illegal drug use and psychiatric disorders).
Not really. It's just a widespread area that rolls up to zipcodes, etc.
My mom was in public health research -- there's a ton of cancer clusters tied to industry and other factors which don't get recognized because of the methology for defining place and jurisdictional boundaries. In rural areas you have population issues because environmental impacts can be localized due to low population density.
One example at I can't find a free article online for was a 20-30 mile long county highway that was paved with oiled gravel in the 1960s and 70s. Incidence of lung cancer in non-smokers was higher than smokers in the general population, and with smokers significantly higher. Reason? A local industry donated waste oil from industrial processes to the county highway departments. They were laden with PCBs, dioxins and other goodies, delivered to your home in the form of road dust. Another was a plant that processed depleted uranium for munitions, that elevated kidney and bladder cancers in a narrow range across a few jurisdictions. The contractor settled claims there.
Around Houston, I'd expect what I experienced as a child downwind of the former Greenpoint garbage incinerator and Newtown creek refineries in NYC ... more childhood asthma, higher incidence of cancers of lung/mouth from long tenured residents, etc. Lots of nasty stuff is emitted in refining and chemical operations.
All these things people claim in the comments section seem like not very rigorous. Also, any increase in cancer cases has to be corrected for overweight people in the US.
You mention rapid debulking following an infusion. That must have been a surreal experience. Congratulations!
How does the treatment you received compare to the current standard of care? Would current therapies also result in rapid debulking as well?
I remember the little clear IV looked like saline and the nurse said, "Your insurance is getting billed $75,000 for this, so lay back and enjoy" - that was one of many expensive treatments, I was very lucky to have good insurance.
I was told the rapid debulking was because the first infusion I got was a targeted drug that specifically found and destroyed the cancer cells.
The follow up chemo was R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone), and my understanding this regimen is still being used.
My dad just went through lymphoma treatment using R-CHOP in 2024. It really is like a miracle. He felt like shit for a day after treatment (actually he felt like shit for one entire day, three days after treatment because he was pumped so full of steroids). Otherwise no real side effects.
Thing with any cancer treatment is that it works miraculously for someone somewhere and makes it to the news all over.
But it rarely translates to that level of success with masses of cancer patients.
That is overly reductive. Treatments are measured by metrics such as 5 year survival, 10 year survival, progression-free survival, overall survival, etc. Further, when evaluating a new treatment it will be compared against the current standard of care: does it provide better overall survival? if not, does it at least provide better progression-free survival?
right i wasn't talking about incremental improvements, Which there have been many. But there hasn't been a fundamental breakthrough to achieve what gp is describe for 99% of advanced cancers.
> Within hours of the first painless infusion, the large tumors I could feel and see from the outside were completely gone.
The breakthroughs have been happening right under your nose. For example, when they do a biopsy now you get incredible detail about the subtype of cancer/cells and details that help target treatment.
I'm not the only person with this kind of story of rapid debulking, that's why someone else chimed in with the medical term. The miracle isn't my one story; the modern miracle of medicine and the fight against cancer is that my story IS one of thousands every month that leave MD Anderson (just one hospital) and have their lives literally extended. In my case, a decade so far with no more trouble, knock on wood.
I think you cannot expect a blanket solution for cancer. Cancers are all extremely different. We will have thousands of breakthroughs for these myriad of cancer types.
you didn't share what exactly the miracle was in your case so let me pick the most common form of cancer.
What is the breakthrough for prostate cancer ?
LU-177? Abiraterone/*Lutamide?
> when they do a biopsy now you get incredible detail about the subtype of cancer/cells and details that help target treatment.
There is no such thing for prostate cancer. Yes you can target BRCA with olaprib but that only works for little bit. But median OS is an improvement of only 4 months ( 15 vs 19). Sure you can live extra 4 months with heavily compromised blood definciency but hardly a breakthrough.
> We will have thousands of breakthroughs for these myriad of cancer types.
Not sure what makes you say this? We've only had improvements in survival for prostate cancer for early detection. All other improvements have been marginal at best. Chemo and hormone supression therapy are still the mainstay since the 70s. Like you are literally getting the same treatment for prostate cancer that ppl were getting 50 yrs ago.
>the progress being amazing, and I hope it continues.
and that it does not require being lucky to receive, as you were.
All things have to start somewhere. My insurance paid the extreme prices that this rare treatment required at the time, and my treatment meant they had more data (and now a decade of follow up) to verify if the treatment works.
I didn't have a job with insurance because of luck, in fact I was aware enough of medical costs I chose which job I accepted based on the medical benefits.
I was lucky to be alive at a time treatment was available and within reach of a modern working person, not lucky like the Queen's nephew being promoted.
I think saying I was single and working my first job out of college should put it in perspective here. I didn't drive a Cadillac to my chemos. Stuff costs money, especially medical R&D, production, and care delivery.