One big problem is the FDA's slowness regarding treatments for otherwise fatal diseases like GBM (or recurrent / metastatic squamous cell carcinoma of the head or neck, which is killing me).
wittyusername 14 days ago [-]
Why are these trials organ specific? Lung cancer, pancreatic cancer, etc. Does it really matter?
jseliger 14 days ago [-]
Interestingly, this is a matter of debate right now: see "Forget lung, breast or prostate cancer: why tumour naming needs to change: The conventional way of classifying metastatic cancers according to their organ of origin is denying people access to drugs that could help them" https://www.nature.com/articles/d41586-024-00216-3
A number of companies have sprung up that'll try to a tumor sample to a variety of treatments in order to figure out whether treatments from other tumor sites may work better.
My own tumors originated in my tongue; now I don't have a tongue any more (https://jakeseliger.com/2023/09/09/life-swallowing-tasting-a...) and the tumors reside in my neck and lungs. A lot of oncologists who specialize in head and neck cancers also work in lung, since there seems to be a lot of overlap between the two.
I don't know this for sure, but I think DNA profiling is changing how oncologists, and people more generally, view cancers, or at least many cancers. Decades ago, it wasn't feasible to take molecular snapshots of cancers. Now it's still not quite standard, though it should be, via companies like CARIS: https://www.carislifesciences.com/
gcanyon 13 days ago [-]
I just wanted to say that I sympathize with many of the things you describe in your linked post. I didn't have it anywhere near as rough as you, but: I had a motorcycle accident: I've felt the strange cold of a nasal feeding tube filling with the neon blue fluid food; I lost something like 35 pounds spending a month in the ICU; I've experienced both an NG tube going in and coming out, and how weird that feels -- same for removing a chest tube: it doesn't really hurt, it just feels wrong; I've had a catheter, so I know all about how wrong that feels; and of course I know about the constipation as well.
I've felt hopeless as they dialed back the ventilator prepping to take me off it, and I've been so weak I got stuck in the bathtub.
So: best of luck, and best of doctors to you.
iroddis 14 days ago [-]
I read your linked article, and I’m so sorry for what you went through and what you continue to live with. Two members of my immediate family were diagnosed with cancer within a month of each other. One didn’t make it as a result of just how punishing the adjuvant treatments were. She succumbed to an infection and couldn’t fight it off.
Being in the treatment rooms for both people made surgery, chemo, and radiation all feel like blunt instruments that crushed the patients. Even 3 months post treatment, my surviving family member suffers from the effects of the treatments, and likely will for up to a year we’ve been told.
I hope you get some relief and hope for your situation. Your writing is exceptional.
halfmatthalfcat 14 days ago [-]
Cancer is cell-specific. Organs are made of different types of cells specific to that organ. Lung cancer is not the same as pancreatic cancer is not the same as breast cancer, etc. If cancer was not cell-specific, it would be much easier to synthesize treatments for.
glenstein 14 days ago [-]
>Organs are made of different types of cells specific to that organ.
I think I broadly agree but with the important caveat that organs frequently share cell types and therefore can share cancers specific to those cells, across organs.
cfu28 14 days ago [-]
They’re not organ specific, they’re disease specific. Despite all being called cancer, they’re not really the same disease and each variant might express different targets or react differently to the same treatment.
mbStavola 14 days ago [-]
Cancer isn't one disease, any cell could potentially become cancerous and they can potentially become cancerous in different ways. A universal cancer vaccine will probably never happen, but hopefully we'll be able to have enough coverage of the more common ones such that cancer is effectively eliminated.
Perhaps because there is not one disease named cancer but many diseases sharing the same umbrella name.
After all, cells in each organ have often specific shape, receptors, behavior, means to communicate with other cells, etc...
andyferris 14 days ago [-]
The mutations and vaccine are usually specific to the type of cancer, so yes one treatment won’t help a different kind of cancer. Unfortunately, of course, but that’s the way it is.
skhunted 14 days ago [-]
If they cure cancer with an mRNA vaccine will the morons opposed to the polio vaccine take it?
drpgq 14 days ago [-]
I'm guessing yes.
walterbell 14 days ago [-]
Who/what is opposed to the 1950s polio vaccine?
tombert 14 days ago [-]
I remember about ten years ago, back when I still had a Facebook account, I stumble onto a Facebook group titled something like "Moms concerned about Child Health" (or something similar). I was curious what that actually meant, and looked into it, and it was basically a big anti-vax group, and they didn't like the polio vaccine.
The sentiment there seemed to be "your kid isn't going to get polio, don't vaccinate them, vaccines cause autism". I don't know really how popular the sentiment was before the conservative idiots co-opted anti-vax rhetoric after COVID, but they definitely existed.
ETA:
Not saying being conservative makes you an idiot, but I do think that it was primarily conservative idiots that spread anti-vax propaganda during and after COVID.
toast0 14 days ago [-]
I don't know about popular, but they were certainly around. Probably a factor in the ending of use of thimerosal, an ethylmercury based preservative, in vaccines. It was easier to remove that, then to convince some of the anti-vax people that ethylmercury is rapidly eliminated from the body and does not go back in time to give someone autism before they got a vaccine.
That said, the medical community and the internet are not always kind and empathetic. Some kids are really miserable when they get a vaccine and when they do their job and induce an immune reaction, that can be miserable too. If your kid has big reactions, spacing out and prioritizing the vaccines a bit can be helpful. Delayed compliance is better than non-compliance. And there's a lot of people who refuse to accept that there's any risk; it's managable and reasonable, but it's still there and pretending there's no risk plays into the narrative when someone does have a complication.
tombert 14 days ago [-]
I dispute that last point. Literally every vaccine I've ever seen has exemptions for medical reasons. That's why medical professionals always strive for herd immunity.
I'm sure there are a few idiots that claim that there's never been a side effect for anyone from a vaccine, but I've never met them.
skhunted 14 days ago [-]
Disinformation campaigns can be powerful and effective. See the sites below for examples of this disinformation. There are fools that believe this stuff.
They will oppose it until they get cancer and then it will be too late and they will cry about government conspiracy keeping them from accessing life saving vaccines.
peteradio 14 days ago [-]
I know its fun to beatoff dead horses.
14 days ago [-]
Rendered at 01:29:41 GMT+0000 (Coordinated Universal Time) with Vercel.
MRNA and personalized cancer vaccines are showing tremendous potential in a lot of cancers: https://jakeseliger.com/2024/04/12/moderna-mrna-4157-v90-new... GBM is particularly gnarly; one of the few other treatments in trials I'm aware of is DCVax: https://www.uclahealth.org/news/article/fda-approval-brain-c...
One big problem is the FDA's slowness regarding treatments for otherwise fatal diseases like GBM (or recurrent / metastatic squamous cell carcinoma of the head or neck, which is killing me).
A number of companies have sprung up that'll try to a tumor sample to a variety of treatments in order to figure out whether treatments from other tumor sites may work better.
My own tumors originated in my tongue; now I don't have a tongue any more (https://jakeseliger.com/2023/09/09/life-swallowing-tasting-a...) and the tumors reside in my neck and lungs. A lot of oncologists who specialize in head and neck cancers also work in lung, since there seems to be a lot of overlap between the two.
I don't know this for sure, but I think DNA profiling is changing how oncologists, and people more generally, view cancers, or at least many cancers. Decades ago, it wasn't feasible to take molecular snapshots of cancers. Now it's still not quite standard, though it should be, via companies like CARIS: https://www.carislifesciences.com/
I've felt hopeless as they dialed back the ventilator prepping to take me off it, and I've been so weak I got stuck in the bathtub.
So: best of luck, and best of doctors to you.
Being in the treatment rooms for both people made surgery, chemo, and radiation all feel like blunt instruments that crushed the patients. Even 3 months post treatment, my surviving family member suffers from the effects of the treatments, and likely will for up to a year we’ve been told.
I hope you get some relief and hope for your situation. Your writing is exceptional.
I think I broadly agree but with the important caveat that organs frequently share cell types and therefore can share cancers specific to those cells, across organs.
After all, cells in each organ have often specific shape, receptors, behavior, means to communicate with other cells, etc...
The sentiment there seemed to be "your kid isn't going to get polio, don't vaccinate them, vaccines cause autism". I don't know really how popular the sentiment was before the conservative idiots co-opted anti-vax rhetoric after COVID, but they definitely existed.
ETA:
Not saying being conservative makes you an idiot, but I do think that it was primarily conservative idiots that spread anti-vax propaganda during and after COVID.
That said, the medical community and the internet are not always kind and empathetic. Some kids are really miserable when they get a vaccine and when they do their job and induce an immune reaction, that can be miserable too. If your kid has big reactions, spacing out and prioritizing the vaccines a bit can be helpful. Delayed compliance is better than non-compliance. And there's a lot of people who refuse to accept that there's any risk; it's managable and reasonable, but it's still there and pretending there's no risk plays into the narrative when someone does have a complication.
I'm sure there are a few idiots that claim that there's never been a side effect for anyone from a vaccine, but I've never met them.
https://yandex.com/search/?text=polio+vaccine+harmful&lr=212...
See this article on the increase in polio cases:
https://www.cbc.ca/news/health/polio-spread-vaccines-1.65472...