[ChrisMarshallNY]

"Death rate" != "Cancer Rate."

Cancer is much more treatable, these days.

I had a friend that just underwent seven months of chemo for colorectal cancer. Looks like he'll be fine, but it was Stage IV, when it was discovered. Had a couple of surgeries, and radiation. The chemo was the worst, though. He channeled Uncle Fester, and this was a fairly robust, somewhat overweight chap.

So he would not go in the "death" column, but I guarantee that he would not be one to dismiss the seriousness of the disease (or its treatment).

[jrochkind1]

I guess the question is if the scan makes a difference in intensity of treatment, if people who got a colonoscopy had fewer surgeries or fewer/less radiation. It doesn't say, I think? It's not at all obvious it would.

(In general, one would think people who got the colonoscopy got more treatment -- in this case despite having no lower a death rate -- but perhaps it does not include as much intense treatment).

[ChrisMarshallNY]

In my friend's case, it was Stage IV, before it was found.

That may have had something to do with him not getting a gerbillcam until he started having symptoms.

I will say his treatment wasn't fun, at all, although he'll be OK, in the long run (but chemo never leaves you the same).

[sillystuff]

> chemo never leaves you the same

For the chemo your friend likely experienced, this is especially true.

Colorectal cancer is often treated with the chemo cocktail, FOLFOX. The "OX" stands for oxaliplatin which causes nerve damage-- hearing loss (less than cisplatin, though), peripheral neuropathy, etc. The second half-life, in the body, of oxaliplatin is 535 months (44 years). And, the platinum remains in a reactive form.

I'd love to hear a professional chime in on if there are ways to speed the elimination. E.g., something like extended/extreme fasting (to free oxaliplatin from tissues) + sodium thiosulfate + blood plasma donation, or something?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2559818/

Some choice quotes from the link:

"The first elimination half-life (t1/2) for cisplatin was 5.02 months and the second 37.0 months. For oxaliplatin, these half-lifes were 1.37 and 535 months."

"...it was shown that Pt species in pUF were still present in a reactive form."

Edit: just submitted the above article:

https://news.ycombinator.com/item?id=33154606

[hef19898]

IMHO it is chemo and the fact you very seriously face the prospect of an ugly, and lengthy, death that changes you. You and your loved ones, it affects everyone, I know it does.

Good for your friend to be on the way of recovering!

[refurb]

Yeah, it's pretty complicated.

I'm not that surprised death rates were similar. Colonoscopies will catch pre-cancerous masses like polyps, so I can see the cancer rate being lower.

But if diagnosed with cancer, treatments are quite good for colorectal cancer, so you may not see that much of a difference in death rate on a 10 year horizon.

[eecc]

Well then the title is indeed misleading. It's not the colonoscopy that's failing to reduce cancer death rates, treatments are. Indeed the title should have been: with colon cancer deaths unchanged, screening and pre-malignant treatments are ever more important.

[pessimizer]

This is nonsensical. Any number of things are failing to reduce cancer death rates, including professional football and jelly donuts. This study is about colonoscopies also failing to reduce cancer death rates.

Changing the title to Don't Worry About Colon Cancer Death Rates, Just Continue To Do What You're Told would not have been better or more accurate.

[eecc]

> This is nonsensical.

Can you please keep it civil and avoid devolving into insults? I don't spend my time online to get treated like a fool. Now please restrain yourself from trolling even further and say "well, then don't say foolish things" because I'd flag you.

If you bothered reading the article, a paragraph reads that this particular form of screening did have an impact. Just not as significant as the community thought.

The study is about _one particular form of screening_ that might might have been oversold. Perfectly consistent with the parent observation and my own: screening is significant, curing cancer isn't as easy as avoiding it altogether.

Now, if you have something constructive to add please do so. Otherwise, please shut up and move on to some Reddit sub.

[refurb]

I think that would be editorialized.

What would be more accurate is to say the title is incomplete. Te details matter.

If the claim was "Voluntary colonoscopy screening does not reduce the risk of death over a 10 year period" it would likely be more accurate and at least calls out the "voluntary" nature of the patients examines and the limited time span of the analysis.

No study is ever perfect and everyone has limitations. You usually learn more by investigating the limitations than poking holes in the conclusions.