FDA Approves Vaccine For Prostate Cancer

reverseengineer writes "The US Food and Drug Administration has given its first first approval for a therapeutic cancer vaccine. In a clinical trial 'involving 512 men, those who got Provenge (sipuleucel-T) had a median survival of 25.8 months after treatment, while those who got a placebo lived a median of 21.7 months. After three years, 32 percent of those who got Provenge were alive, compared with 23 percent of those who got the placebo. ... "The big story here is that this is the first proof of principle and proof that immunotherapy works in general in cancer, which I think is a huge observation," said Dr. Philip Kantoff, chief of solid tumor oncology at the Dana-Farber Cancer Institute in Boston and the lead investigator in Dendreon's largest clinical trial for the drug. "I think this is a very big thing and will lead to a lot more enthusiasm for the approach."'"

Comments

Statistically significant?

[Rene S. Hollan]

Is it just me or do those numbers look too close to be statistically significant?

For that kind of (small) difference to be statistically significant, I'd thing rather large sample sizes would be required.

Re:Statistically significant?

[Anonymous Coward]

According to my calculation, if the null hypothesis were true (i.e. the vaccine were just a placebo) there would be about a 1 in a million chance of a result this extreme (4.85 standard deviations above the mean). So it is highly significant statistically speaking. Whether it is clinically significant or not is a different question, of course.

Re:Statistically significant?

[Rene S. Hollan]

Hmm. How can you know this without knowing the standard distribution of mortality in the control group?

(Now I remember why I got a lowly B+ in statistics.)

Re:Statistically significant?

[TheMeuge]

Several major points:
1. There were 512 people in the trial. Assuming that these were split into two groups, that n=256. Of course it depends on the standard deviation, but you could get your p value very low with an n like that.
2. Human trials of drugs that treat potentially fatal conditions are generally only allowed for patients who've failed "best available" therapy at least once, because it would be unethical to deny standard therapy to someone in a trial. The relative risk reduction may get better when used outside the context of the trial because of that. Or not. Remains to be seen, as usual.

3. As our understanding of the immune system and the molecular processes underlying cancer improves, we will slowly unravel a huge potential for case-by-case-based treatment of cancer. As a matter of fact, I believe a recent study I am too lazy to look up to link has shown that people whose cancer therapies relied on analyzing the biochemistry of each individual tumor resulted in about a 50% increase in 5-year survival, compared to conventional pathology-based treatments. The future is bright for oncology.

4. The caveat of #3 is that such treatments are expensive, and will get progressively more expensive based on the degree of testing and individualization required (until the wide use and technology make them cheaper of course). This will necessarily introduce a further divide into the available treatments for the rich and the poor, and contribute to the class struggle that's already rather inflamed. The problem is that there's no OTHER way - giving everyone $100'000 treatments would bankrupt us rather quickly. Instead, similar to the case with electronics, we will simply have to suffer through the period of expensive first-adopter treatments, until the improvements in laboratory techniques and high-throughput testing make such treatments increasingly affordable.

Re:Statistically significant?

[Anonymous Coward]

If you assume each person has (independently) a 0.23 probability to survive 5 years, then the overall distribution must be binomial with standard deviation sqrt(n*p*(1-p)).

Re:Statistically significant?

[IorDMUX]

Is it just me or do those numbers look too close to be statistically significant?

The summary mentions a sample size of 512. The standard error of the mean decreases by the square root of the sample size. For 95 % certainty, if the standard deviation of their measured data is less than (32 percentage points - 23 percentage points)*sqrt(512)/1.96 = 104 "percentage points", which is quite likely, (see a tutorial), then you *can* say that this is statistically significant.

If you want some real details and not my back of the envelope calculations of dubious quality, you can see the actual slides [PDF], which does have details on the statistical significance of the results.

Long story short, they're significant at the level tested (95 %, generally good enough for these kinds of studies).

Re:Statistically significant?

[aurispector]

Bright indeed. The immune system has an amazing ability for specificity. Once we master the art of training the immune system to recognize and kill cancer cells the fight will be over. Interestingly, there was a cancer treatment in the late 1800's that relied on injecting cancer tumors with an infectious serum designed to elicit an immune response. The treatment had some success but was dangerous as the patient ran the risk of death from infection. I really think immuno therapy is the future of cancer therapy.

Re:Statistically significant?

[CorporateSuit]

4. The caveat of #3 is that such treatments are expensive, and will get progressively more expensive based on the degree of testing and individualization required (until the wide use and technology make them cheaper of course). This will necessarily introduce a further divide into the available treatments for the rich and the poor, and contribute to the class struggle that's already rather inflamed. The problem is that there's no OTHER way - giving everyone $100'000 treatments would bankrupt us rather quickly. Instead, similar to the case with electronics, we will simply have to suffer through the period of expensive first-adopter treatments, until the improvements in laboratory techniques and high-throughput testing make such treatments increasingly affordable.

But they can't. When Western Digital finally comes out with a Petabyte drive, it will cost a high price, but the next week, Seagate comes out with a Petabyte drive. Competition increases, prices drop, and the drives become increasingly affordable. In medicine, the patents are extended a little further. The patent holder can charge whatever he wants, because he needs to make back the money he spent on risky research, but for the next n+[too many] years, he gets to hold the sick of the world hostage. Well, what if company B wants to design a competitor drug?

1. Good luck to them.
2. View the #2 in your post. They have to struggle in a market that's immediately artificially saturated by Company A's wonder drug. This is like Pepsi trying to show up and claim "we can quench your thirst", but regulations say that, for the first n number of years, people have to drink a full coke before they can drink a Pepsi. Hope you're still thirsty after that coke, and if you're not, then hopefully the pepsi will quench your thirst when the coke did not!

And there, spelled out in soda, we have the well-meaning recipe for disaster in American healthcare -- the one that isn't fixed by the government plan, but needs to be before the government plan sends us headlong into a depression because of this unresolved bug.

Re:Statistically significant?

[TheMeuge]

2. View the #2 in your post. They have to struggle in a market that's immediately artificially saturated by Company A's wonder drug. This is like Pepsi trying to show up and claim "we can quench your thirst", but regulations say that, for the first n number of years, people have to drink a full coke before they can drink a Pepsi. Hope you're still thirsty after that coke, and if you're not, then hopefully the pepsi will quench your thirst when the coke did not!

And there, spelled out in soda, we have the well-meaning recipe for disaster in American healthcare -- the one that isn't fixed by the government plan, but needs to be before the government plan sends us headlong into a depression because of this unresolved bug.

That's not at all a good understanding of the market or of biomedical research.

Anyone else is free to come up with a treatment that works better using the same principles. It just can't be the same exact protocol.

Similarly, to spell it out in soda for you, Pepsi can't produce soda using Coke's recipe and charge less for it.

Drug patents are woefully short-lived in the US, and only give the company a few years (unlikely to reach a decade, even under the fastest FDA review) to make their research money back, make a profit, and finance further research. For all the negative press patents get, the are still essential for stimulating development by rewarding innovation.

Unlike other IP, however, drug patent periods haven't been climbing up in duration, and as a result we can all enjoy levostatin, ezomeprazole, and the rest of the drugs that used to be sought-after prescription drugs, and are now cheap generics.

Re:Statistically significant?

[Anonymous Coward]

You don't understand. The costs the previous poster refers to are not drug costs, but extremely expensive lab costs during treatment, for example doing gene sequencing or custom drug synthesis as part of a single patient's treatment. These things may eventually get economy of scale as they are automated with gene-sequencing machines and better chemical processes.

The main idea is that this difference of 32% and 25% survivor rates may not indicate a "slight extension" due to a universal treatment, but rather a treatment that is very effective for one segment of the patient population and worthless for the rest. This is where evidence-based medicine and personalized medicine is meant to go in the end: focus the scientific process on the powerset of all possible experimental and control populations, so we can learn where our previously known disease conditions are actually an over generalization of several different disease conditions with different biochemical causes but nearly indistinguishable symptoms. Each sub-condition may need a different treatment which can potentially have much higher success rates than any one-size-fits-all treatment protocol.

Re:Statistically significant?

[Anonymous Coward]

Actually I am wrong.

As some people have pointed out below, the sample who received the vaccine was only of size 256, not 512. So the p value is not 1/1000000 but more like 3x10^-4. Still significant, but not what I said before. Sorry.

Re:Statistically significant?

[TheMeuge]

Bright indeed. The immune system has an amazing ability for specificity. Once we master the art of training the immune system to recognize and kill cancer cells the fight will be over. Interestingly, there was a cancer treatment in the late 1800's that relied on injecting cancer tumors with an infectious serum designed to elicit an immune response. The treatment had some success but was dangerous as the patient ran the risk of death from infection. I really think immuno therapy is the future of cancer therapy.

To be honest I find that unlikely. Unfortunately there is a reason why that cancer spread - it has already managed to evade the immune system.

Immune therapy is but one of the treatments that become available once you understand tumor biology. Even more promising are drugs that can have direct effects on the multiple pathways that have been disrupted or bypassed by the cells on their way to becoming cancerous. As we gain more complete understanding of these molecular mechanisms, as well as enhance our ability to identify the mutations or dysfunctions in each individual tumor, we'll be able to target them efficiently. For instance, we may be able to fix the "suicide" pathways (yes, I know it's called apoptosis) that were necessarily disabled in a particular tumor, and by treating the problem cause the tumor cells to destroy themselves and they were programmed to do by evolution.

Re:Statistically significant?

[oldhack]

Isn't that like saying we will conquer cancer once we defeat autoimmune diseases?

Re:Statistically significant?

[nanoakron]

It was the treatment of tonsillar squamous cell carcinoma but I can't find the reference at present. Read about it in med school.

However, may I draw your attention to a couple of other cancers that seem to benefit from localised immune activation due to injected bacteria:

Stomach: http://www.nature.com/bjc/journal/v84/n4/abs/6691599a.html
Mouth: http://www.springerlink.com/content/rw3kk056t4014t5j/
Bladder: http://www.ncbi.nlm.nih.gov/pubmed/20205607

Re:Statistically significant?

[jhoegl]

Ahhh yes, but if the hypotenuse to the quasar were perpendicular to the linear equation then wouldn't the gravitation of the median be devised by the quandary?

Re:Statistically significant?

[Anonymous Coward]

Only on Uranus (or prostate)...

Re:Statistically significant?

[forumsnow39]

I agree with your statement in number 3. With the increasing introduction of new pollutants in our environment as well as the constant move of young generations from raw foods to processed ones, cancer will keep occurring. It is important to remember that with these due to these continual elements, we will see new types of unidentified cancer in the future, therefore making it that much more important to treat them on an individual basis.

Re:Statistically significant?

[Anonymous Coward]

you're a dick.

Re:Statistically significant?

[vtcodger]

***The main idea is that this difference of 32% and 25% survivor rates may not indicate a "slight extension" due to a universal treatment, but rather a treatment that is very effective for one segment of the patient population and worthless for the rest.***

Prostate cancer is normally a very unaggressive and slow growing cancer. It's also very common. It often isn't treated in the elderly as the risks of treatment may outweigh the expected benefits. The feeling is that men over 70 with newly detected prostate cancer may well die of something else before the cancer becomes a health problem and that treatment is always an option if the cancer progresses more quickly than expected.

The very high mortalities in this study would seem to indicate that the subjects had very severe cases -- i.e. this may not be a valid sample of typical prostate cancer cases. The results may not tell us about the likelihood of the vaccine helping with more normal cases.

Still, though, it's an interesting and encouraging result doncha think?

Re:Statistically significant?

[Bengie]

I other OLD news, men who ejaculate 5 times per week had a 66% less chance of prostate cancer EVER in their life than men who only did once or less per week. They has to be started young and you must continue this into your 50s. 3 different studies on this from 3 different universities in 3 different countries and all 3 go roughly(damn near the same) the same results even though they went about different ways of testing. They one test alone was a periodic questioner that followed over 30,000 men. Is that a good sample size? There seems to be a semi linear link, so each day you clean the pipes per week gives you and ~X% reduced chance of getting this dreaded disease.

I say an orgasm of prevention is worth more than a pound of cancer.

The current theory is that the prostate is great at concentrating carcinogens because of how it excretes and re-absorbs fluids which essentially filters and captures bad crap. Gotta flush it out.

Remember, a 66% reduction of the chance of cancer is like saying "you have a 200% INCREASED chance of caner if you don't".

P.S. remember to tell your wife to put out or close the door, because you're busy curing cancer.

Re:Statistically significant?

[TheMeuge]

I agree with your statement in number 3. With the increasing introduction of new pollutants in our environment as well as the constant move of young generations from raw foods to processed ones, cancer will keep occurring. It is important to remember that with these due to these continual elements, we will see new types of unidentified cancer in the future, therefore making it that much more important to treat them on an individual basis.

1. The most poisonous, cancer causing toxin we can take into our bodies on an every day basis, we need to survive. O2
2. Cancer does not occur due to pollutants. It's a disease of old age. If we all go back to dying at 40 years old, it'll cease to be the problem.

Wth is it with you people coming out of the woodwork today...

Re:Statistically significant?

[PopeRatzo]

Is it just me or do those numbers look too close to be statistically significant?

It just has to be "significant" enough for Pharma to bribe a bunch of doctors into prescribing it. An alarming number of drugs have success rates so low as to give even sick consumers pause. Or, there are already more effective drugs on the market which are no longer protected by patent, so suddenly there's a "breakthrough" that's not really a breakthrough. The problem is that the "customer" of the drug companies is not the patient, but the doctor, and doctors, who very often don't have a really good solution, will prescribe something or recommend a vaccine just so they don't have to say "sorry, there's not much I can do". Very often basic preventative measures, like not being a fat pig, or not smoking, or not cooking your flesh in a tanning salon, or eating a more reasonable diet, or maybe getting your porky ass off the sofa once in a while, is much more effective way to prevent disease than anything the pharmaceutical companies can offer. But doctors, especially specialists, are afraid that their incomes might take a hit if a drug, or a surgery, or an expensive test is not required.

It's not about preventing disease, it's about boosting the stock price and keeping doctors' mistresses in brand new Audis.

Re:Statistically significant?

[Anonymous Coward]

2. Cancer does not occur due to pollutants. It's a disease of old age. If we all go back to dying at 40 years old, it'll cease to be the problem.

Tell that to my right testicle, that had to be removed when I was 26.

I'm not saying the previous poster was right, but I'm not saying you are, either....

Re:Statistically significant?

[Anonymous Coward]

>each day you clean the pipes per week gives you and ~X% reduced chance of getting this dreaded disease.

Ok. Fine by me, but who is this "not X percent", and why is he getting a free ride? Oh, I get it. You call the person in your fantasies "not X percent?" Weird.

Re:Statistically significant?

[Anonymous Coward]

If they had used this reasoning and allowed insurance to pay for full service massage parlors in the health care bill, it would have passed without anyone complaining. Now there's change I would believe in!

Re:Statistically significant?

[Anonymous Coward]

You can reject common node theory when calculating finite parallel tangents to said median's gravitation, meaning you can assume very small values of 1 are in fact zero.

Re:Statistically significant?

[Anonymous Coward]

P.S. remember to tell your mother to close the door, because you're busy curing cancer.

Fixed for slashdot. I assume nerds don't ever get prostate cancer thanks to the Internet and its unlimited bounty of porn.

Re:Statistically significant?

[grcumb]

I other OLD news, men who ejaculate 5 times per week had a 66% less chance of prostate cancer EVER in their life than men who only did once or less per week.

5 times a week?!?

How am I ever going to keep count, let alone get the number down to 5?

Re:Statistically significant?

[SpazmodeusG]

But further down this thread there's a study showing the opposite for those under 40. http://www.sciencedaily.com/releases/2009/01/090126082343.htm

Re:Statistically significant?

[sjames]

There was never a time in written history when we all died at 40 or so. The average lifespan figure was strongly skewed by a high infant mortality.

While cancer becomes more common in old age, it is hardly a disease of old age. Children get it, young adults get it, middle aged people get it and old people get it. Most notably for your argument, it happens all too often before age 40.

Re:Statistically significant?

[L4t3r4lu5]

So, I should get half way there and stop?

Unless your wife / mum walks in, that's really difficult to do...

Re:Statistically significant?

[Anonymous Coward]

The thing is, when such a link appears it doesn't mean that the linked events are the direct cause. It just points out an interesting correlation between the two phenomenons which demands further study. To put it in other words, correlation is not causation.

And keeping that in mind, what the study states is that a very active sex life for teens and early 20s is linked to a higher risk of prostate cancer. It's an interesting correlation, but it's far from stating a causation. Yet, that link has been further studied and this has been found: there is a link between Trichomonas vaginalis Infection Prostate Cancer. For those who don't know, trichomonas vaginalis infection is one of the most common venereal disease, much to do with the fact that it is generally asymptomatic.

Re:Statistically significant?

[TheMeuge]

The above is not "informative" in any way, given that it contradicts both statistical data, and our understanding of the biology of cancer.

Re:Statistically significant?

[SimonInOz]

I always thought old guys were wankers.

Now I know why.

Re:Statistically significant?

[exekewtable]

They have to make the choice between arthritis and prostate cancer. It makes them cranky wankers.

Re:Statistically significant?

[rwv]

I say an orgasm of prevention is worth more than a pound of cancer.

Mod: Pedantic...

40 years of ejaculating 5 times per week is 10,400 orgasms.

Re:Statistically significant?

[ch-chuck]

I other OLD news, men who ejaculate 5 times per week had a 66% less chance of prostate cancer

Yes, but the chances of repetitive stress injury climbs significantly.
 

Re:Statistically significant?

[tehcyder]

Human trials of drugs that treat potentially fatal conditions are generally only allowed for patients who've failed "best available" therapy at least once, because it would be unethical to deny standard therapy to someone in a trial.

I did wonder when I read the summary "it seems a bit harsh on the half that only got a placebo."

Re:Statistically significant?

[commodore64_love]

"We need to cut back on the quantity of medicine used, in order to improve efficiency." - Barak Obama last week. This vaccine won't be allowed to use except a few rare cases.

Re:Statistically significant?

[sjames]

I'm guessing you believe you have 1 testicle 1 ovary and half a uterus?

Big note, when actual measurement is in conflict with theoretical understanding, reality wins and the theory is wrong.

Re:Statistically significant?

[jayme0227]

Ahh, I see we have a science fiction writer in our midst.

Re:Statistically significant?

[TheMeuge]

Actual measurement != media speculation or New Age conspiracy theories.

I'll give you the example of breast cancer:
http://www.cdc.gov/cancer/breast/statistics/age.htm

I could go on with more examples, but considering that I'm right, and I have to get back to work, I can't really be bothered.

Re:Statistically significant?

[sjames]

Yeah, the nerve of those stupid kids claiming they have cancer. They're probably just slacking. TheMuge has spoken!

Re:Statistically significant?

[TheMeuge]

Dude, seriously, let it go. I have no reason to argue with you, especially since you insist on being belligerent.

The fact is that cancer risk increases with age. Just like any distribution, it has a tail. That's unfortunate for those in the tail, but does nothing to disprove my point.

Re:Statistically significant?

[Anonymous Coward]

Except for when they get a chance to do something like change all CFC based inhaler delivery for drugs to HFA, then jack the prices up on the recently generic drug to 250 dollars. Yes, that's right, Albuterol, a generic asthma drug, used to cost about 7 bucks and now costs 250 bucks with its altered delivery system. There are now 3 variants of Albuterol and they all cost a fortune, the CFC inhalers have been taken off the market as they are "bad for the environment" (yeah right, more like bad for profits). This has happened to a ton of drugs lately.

Oh, btw, that 250 dollar Advair HFA inhaler goes for 16 cents in Cuba. Enjoy.

Re:Statistically significant?

[Belial6]

Which is how you explain to your wife why you need a couple of girl friends on the as well. After all, you are just making sure that her health isn't compromised by your necessary health regiment.

Re:Statistically significant?

[Anonymous Coward]

I know people like to throw around "correlation is not causation," but after reading your link, I think its an appropriate thing to say. From the study itself: “Hormones appear to play a key role in prostate cancer and it is very common to treat men with therapy to reduce the hormones thought to stimulate the cancer cells. A man’s sex drive is also regulated by his hormone levels, so this study examined the theory that having a high sex drive affects the risk of prostate cancer.” Basically this study does not say orgasms are the cause, but rather hormone levels. Simply masturbating every day without the hormone level that would drive one to do that shouldn't cause prostate cancer, probably...

lol vibrate was my captcha, vibrate your prostates for health AND success kids! :D

NOW!!!!

Re:Statistically significant?

[Bengie]

At first it *sounds* like ScienceDaily's report shows a negative link with masturbation and prostate cancer, but really it's just bad journalism. If you actually read past the journalist's bull crap and read what the research says you'll see that their result was that men with *high sex hormone levels* are more promiscuous more horny and tend to have higher prostate cancer risks.

Based on what the research says, it sounds more that men with higher hormones WANT to jack off more because of how horny they are. The masturbation isn't the cause, it's the hormones.

The journalist just wanted a catchy headline. Not to mention if this was true, I'd have a hard time taking a single research with a small group over multiple researches with MUCH larger groups and more diversity.

Few other points(quotes) in ScienceDaily's article:

#1. Men with prostate cancer were more likely to have had a sexually transmitted disease than those without prostate cancer.
#2. “Hormones appear to play a key role in prostate cancer and it is very common to treat men with therapy to reduce the hormones thought to stimulate the cancer cells
#3. “A possible explanation for the protective effect that men in their fifties appear to receive from overall sexual activity, and particularly masturbation, is that the release of accumulated toxins during sexual activity reduces the risk of developing cancer in the prostate area.
#4. (non quote) they also mention that younger men tend to have more partners than the older men. So it seems the risk of cancer is more of an issue of multiple partners and risky sex while older men tend to have safer sex typically with their wife or partner.

As you can tell, it's just a headline to grab attention and the 3rd point even agrees with the other previous studies, even though it has NOT be proven as of yet.

Re:Statistically significant?

[fishexe]

Only on Uranus (or prostate)...

Professor Farnsworth: That planet was renamed in the 24th Century to put an end to that joke once and for all.

Fry: What did they call it?

Professor Farnsworth: Urectum!

Re:Statistically significant?

[fishexe]

I other OLD news, men who ejaculate 5 times per week had a 66% less chance of prostate cancer EVER in their life than men who only did once or less per week.

5 times a week?!?

How am I ever going to keep count, let alone get the number down to 5?

Hey, for all you know, each additional 5 times might reduce your risk by another 66%. The reference category was 0-1 ejaculations per week. So go nuts!

Re:Statistically significant?

[fishexe]

There was never a time in written history when we all died at 40 or so. The average lifespan figure was strongly skewed by a high infant mortality.

Also, tigers.

Re:Statistically significant?

[Jerry]

If your "fact" is actually true then some report somewhere should state the men who have had vasectomies have a (insert number here)% greater change of Prostate cancer.

Then, there is this pesky fact: http://www.cancer.gov/cancertopics/factsheet/Risk/vasectomy
"In 1997, the NCI convened the prostate cancer Progress Review Group (PRG), a committee that included members from the scientific, medical, industrial, and advocacy communities. This group was charged with developing a national plan to outline scientific efforts involving prostate cancer research. The PRG's final report, published in August 1998, concluded that the evidence supporting a role for vasectomy in the development of prostate cancer is weak.

Researchers continue to investigate the possible relationship between vasectomy and prostate cancer. The majority of studies conducted thus far have upheld the conclusions made at the 1993 NICHD conference. Although a few studies have reported a link between vasectomy and prostate cancer, it is possible that other factors, including chance, may be responsible for the association suggested in these studies."

Opps!

Re:Statistically significant?

[Jerry]

If your "fact" is actually true then some report somewhere should state the men who have had vasectomies have a (insert number here)% greater change of Prostate cancer.

Then, there is this pesky fact: http://www.cancer.gov/cancertopics/factsheet/Risk/vasectomy
"In 1997, the NCI convened the prostate cancer Progress Review Group (PRG), a committee that included members from the scientific, medical, industrial, and advocacy communities. This group was charged with developing a national plan to outline scientific efforts involving prostate cancer research. The PRG's final report, published in August 1998, concluded that the evidence supporting a role for vasectomy in the development of prostate cancer is weak.

Researchers continue to investigate the possible relationship between vasectomy and prostate cancer. The majority of studies conducted thus far have upheld the conclusions made at the 1993 NICHD conference. Although a few studies have reported a link between vasectomy and prostate cancer, it is possible that other factors, including chance, may be responsible for the association suggested in these studies."

Oops!

Re:Statistically significant?

[Bengie]

???

if you knew the anatomy of male plumbing, you'd notice that a vasectomy disconnect the testicles from the prostate. No, you can't remove sperm from the testicles anymore, but an orgasm still removes fluid from the prostate just no more sperm.

Re:Statistically significant?

[Anonymous Coward]

Still trolling that line around, huh?

http://slashdot.org/comments.pl?sid=1636390&cid=32038602

You got smacked down, so you're going to try again. You ARE a troll. The quote references the overuse of medications like antibiotics, which has resulted in antibiotic-resistant strains, lowering the efficiency of the medications we have to combat the diseases. We do not to stop overprescribing, or else an infinite supply would have no effect.

Go troll somewhere else.

Re:Statistically significant?

[Alinabi]

Yeah, but that come at the cost of going blind.

4 months?

[iceOlate]

It extends life by 4 months, and they are calling it a vaccination? That's hardly a vaccination or a cure... Hell, the herb "saw palmetto" has a much greater success rate than that. But you don't hear about it, because it can't be patented and sold at really high prices.

Re:4 months?

[CorporateSuit]

That was just the median. What you should focus on more is the 3-year survival rate: 34% vs 23% -- almost a 50% increase in long-term survival.

Re:4 months?

[iceOlate]

Its 32% (provenge) vs. 23% placebo... But what of the other 45%? The side-effects don't sound good either, nor does it mention how long those last... Saw Palmetto (as well as other natural remedies) don't have any unpleasant side effects, and are proven to prevent prostate cancer. I swear, pharmaceutical corporations will do anything to make money these days, and the FDA is their bitch.

Re:4 months?

[commodore64_love]

Saw palmetto doesn't do crap. And it's never been "proven" to prevent prostate enlargement or cancer. It's nothing but hearsay.

Propecia on the other hand (the stuff for baldness) has been shown to help the prostate.

Re:4 months?

[drjoe1e6]

Propecia on the other hand (the stuff for baldness) has been shown to help the prostate.

Not surprising at all. Proscar, a prostate medication, had the side effect of making people grow extra hair. So Merck marketed a lower dose of the same substance, and called it Propecia.

Re:4 months?

[harley78]

The other 45%?...-blink- Are you being sarcastic? 34% survived on the drug, 66% died.(of a presumed 256) 23% survived on the placebo, 77% died.(of a presumed 256)

Re:4 months?

[timmarhy]

you lost me when you started talking about herbal cancer cures. what a load of shit.

Re:4 months?

[h4rr4r]

And it can make you impotent. Which is great because now that your new hair can attract women, you can't take advantage of the situation.

Re:4 months?

[Alien Being]

Well, according to some of the best doctors in the U.S., prostate cancer is easily detectable at early onset and existing techniques prolong life closer to ten years.

This sounds like yet another modern-age snake-oil campaign. i.e. murder for profit by big pharma. It's just gonna get worse now that Obama has FORCED us to support them.

 

Re:4 months?

[TheLink]

What would be interesting is a comparison of those who didn't get any treatment at all with those who got the placebo or the drug.

I'm just wondering how effective the placebo is.

Of course, that's not going to happen, since there's lots of existing treatment for prostate cancer that works (and probably better than this drug).

But perhaps could be done for other sorts of cancer - e.g. end stage etc.

Re:4 months?

[fahrbot-bot]

It extends life by 4 months, and they are calling it a vaccination?

An *average* of 4 months. Not only that, the treatment -- which consists of 3 infusions of your own treated white blood cells over one month -- will cost $93,000. Seriously, the ROI seems pretty low.

Re:4 months?

[Anonymous Coward]

Impotent, or infertile? Because the former would suck, the latter is a benefit! :)

Re:4 months?

[St.Creed]

Well, according to some of the best doctors in the U.S., prostate cancer is easily detectable at early onset and existing techniques prolong life closer to ten years.

This sounds like yet another modern-age snake-oil campaign. i.e. murder for profit by big pharma. It's just gonna get worse now that Obama has FORCED us to support them.

While prostate cancer may be easily detectable, this is not so for every prostate cancer case. Provenge is used for patients where the nice "live 10 years longer" treatments don't work, for some reason, and it's more like a few months until you're dead. But please, feel free to refuse the treatment and help with the budget.

And mind that it is only in recent years that life expectancy has gone to 10 years for 60% of patients. That means for about 40% they don't make it to the deadline, even with modern treatments.

Here's a link: http://info.cancerresearchuk.org/cancerstats/types/prostate/survival/

Re:4 months?

[skids]

The way I read it it looked like that was an average of 4 months among the study participants, who were very terminal. While the article says the procedure is only approved for terminal cases, that definition of "terminal" is, correct me if I'm wrong, a bit more lax than the criteria they were using to select study participants.

We don't know yet if there will be more than 4 months benefit for people who receive this treatment slightly earlier in the course of the disease than the study participants did. If they do, and if patients continue to tolerate the drug, then they can seek to ratchet down how sick you have to be to get the drug prescribed.

We can hope the company also brings its prices down as they streamline the process and recapitalize to finance research on future drugs and pay off investors. It's a slow process, which is awful for people who "miss the bus" so to speak.

Plus given the mess that is our health care/insurance billing structure, there is way less transparency in the whole process so it leaves A) people hearing monthly about new cancer cures while their relatives die without getting treatments they heard about 5 years ago, and B) legislators with no real clue where to inject public funds to optimize the speed these treatments get to market versus the safety with which they are brought to market versus sustaining future progress.

Now if we could get the paper pushers at insurance companies to push follow-up study paper instead of murder by spreadsheet paper, we could capitalize on the fact that we have so many paper pushers in our workforce, instead of falling victim to that fact.

Re:Placebo Effect

[geekoid]

You are an idiot and have no clue what 'the placebo effect' even is, and some of the pills during her regiment are not medical effective and are there just to keep her in the habit. That is NOT a placebo effect.

"Girls who get Pregnant like symptoms when they really want to be pregnant. People who catch an actual cold when they call in sick for work faking it"
neither of those are a placebo effect.

People like you are driving us back to the dark ages.

Re:Placebo Effect

[commodore64_love]

>>>I'm still under 130 pounds

Ahhhh not so fast. Doctors are now saying there's such a thing as "thin fat" where you weigh few pounds, and appear slim, but your body's fat percentage is over 22%, and that's bad. I just saw a report about this on the Today Show - you can have a low BMI but still be fatty.

wait

[circletimessquare]

jenny mccarthy told me vaccines give me prostate cancer

no thanks, i'll pass. i get my health advice from mtv hosts

Re:wait

[geekoid]

Well done. I wish that bitch would die.

Re:wait

[Anonymous Coward]

I just wish she would stop getting people killed.

Re:wait

[commodore64_love]

Wow.

I moved Jenny McCarthy to my "formerly hot" list along with Carol Alt and Deanna Troi (Star trek).

Re:wait

[Anonymous Coward]

Wow Jim Carrey, I didn't know you were a /. reader.

Re:wait

[VValdo]

Looks like someone watched this week's Frontline...

W

Re:wait

[tool462]

She probably won't anytime soon, because I'm betting her parents had her vaccinated.

Re:wait

[Anonymous Coward]

Wait, what about Marina Sirtis?

Re:wait

[Dahamma]

She's still hot. Just in the "hot mess" category.

Re:wait

[fishexe]

jenny mccarthy told me vaccines give me prostate cancer

no thanks, i'll pass. i get my health advice from mtv hosts

Good plan. You might catch The Autism, too.

Re:wait

[Hurricane78]

What is a MTV? Can you eat that?

Oh, wait... it was a “TV channel” back when people still watched TV over some old pre-Internet network, right?
Man, the 80s were crazy times... Bad hair, only five music companies, leggins, landline phones, and TV stations with people calling themselves “producers” for doing nothing. Oh, and MTV still played music too! ^^

Re:It won't be allowed to be used.

[geekoid]

That's not what he meant, and this isn't the same context and you know it.

SHAME on you for trying to pollute political discourse.

Re:Placebo Effect

[Anonymous Coward]

I call BS...

My girlfriend always told me that eating chocolate actually burned more calories than the amount that was actually in the chocolate itself.

Guess what, she weighs at least twice what you do.

Re:Placebo Effect

[Anonymous Coward]

Are you suggesting that the results are due to a placebo effect? This is why the results were obtained using double-blind experiments, where both the researchers administrating the doses and the patients receiving them did not know which they were getting. It can't reasonably be claimed that the placebo effect was in any way causing the huge difference between those receiving medication and those who weren't.

Source?

[Anonymous Coward]

Do you have a link for that Obama quotation? I'd love to see the full context for a project. :-)

Re:Source?

[Beezlebub33]

I can't find it, and I've looked pretty hard. Here's a speech by him on the subject. The best that I could find was:

Some doctors may feel the need to order more tests and treatments to avoid being legally vulnerable. That's a real issue. And while I'm not advocating caps on malpractice awards which I believe can be unfair to people who've been wrongfully harmed, I do think we need to explore a range of ideas about how to put patient safety first, let doctors focus on practicing medicine, and encourage broader use of evidence-based guidelines. That's how we can scale back the excessive defensive medicine reinforcing our current system of more treatment rather than better care.

but that doesn't support the statement by the GP. Or from this interview

Well, let's take an example. And I -- they may be represented here, I wasn't sure, but the Mayo Clinic, everybody has heard of it. It has got some of the best quality care in the world. People fly from all over the world to Rochester, Minnesota, in order to get outstanding care. It turns out that Mayo Clinic oftentimes provides care that is as much as one-third less expensive than the average that's provided or -- or some other health care systems that aren't doing as good of a job. Now, why is that? Well, part of it is that they have set up teams that work together so that, if you go first to your primary care physician and they order a test, you don't then have to duplicate having two more tests with other specialists, because they were in the room when you first met with that primary care physician. They know how to manage chronic diseases in an effective way so that we have people who are getting regular checkups, if they're trying to manage diabetes, as opposed to us paying for a $30,000 foot amputation because we didn't manage the disease properly. So they are doing all kinds of smart things that we could easily duplicate across the system, but we don't. And our job in this -- in this summer and this fall, in which I think everybody understands we've got to move in a different direction, is to identify the best ways to achieve the best possible care in a way that controls costs and is affordable for the American economy long term.

Based on this, I'd say that Obama is right and the GP is full of crap.

Pass

[Anonymous Coward]

A vaccine that gives me prostate cancer? Honestly, the whole "make work" ethic is being taken a little too far by the medical community.

Well I definitely hope it works

[youn]

I also hope it gets rid of prostate exams :)

Re:Well I definitely hope it works

[zero_out]

It won't, because it does not prevent cancer. It is used when you have an advanced stage of cancer, and all other methods fail (including chemical castration). It's only a vaccine in the sense that it teaches your body to fight off the cancer, not in the sense that it prevents it. So you'll still be getting those exams.

Re:Well I definitely hope it works

[dgatwood]

I don't think you're seeing the bigger picture. That's what it has been approved for now. Give it ten years and they might be giving treatments like this one to people prophylactically the moment their PSA count starts up, just in case. And eventually, that could eliminate the need for any of those other treatments you mentioned.

Re:It won't be allowed to be used.

[commodore64_love]

>>>SHAME on you for trying to pollute political discourse

Jimmy Carter called me a racist. So have other high-ranking Democrats. What do you call that? Isn't that "polluting" the political discourse? But never mind; that's okay because they are on your team.

I'm still waiting on ...

[Anonymous Coward]

An actual vaccine. Can we focus on prevention rather than expensive treatments?

Re:I'm still waiting on ...

[Anonymous Coward]

We have that treatment already! It involves a knife.

really?

[Anonymous Coward]

You got a (well conducted, well documented, and peer reviewed) study to cite on the saw palmetto helping cancer survival rates?

Cause I'm pretty sure that's bullshit.

Re:really?

[Maxo-Texas]

Recent Results do not look good for Saw Palmetto.

http://www.medpagetoday.com/Urology/BPH/2643

I'm on HRT so I take it. It looks like it may not have made a difference.

When I ever get Prostate Cancer, I'll be taken off HRT and life will turn back to the hell it was before I went on HRT.

So the prostate cancer vaccination news was nice in some regard.

HRT does not cause prostate cancer but it accelerates it once you get it.

Re:Placebo Effect

[rattaroaz]

Somehow, this sounds like the opposite of "I'm just big boned." I'm sure it exists, but it's probably a lot rarer than what most people need to be concerned about.

Provenge?

[adenied]

I'm trying to figure out if "Provenge" is the most awesome or terrifying name for a drug I've ever heard. Also from the wikipedia page it "consists of a mixture of the patient's own blood cells" and their special "fusion protein".

I'm going with terrifyingly awesome!

I just hope the commercials feature Chuck Norris.

Re:Provenge?

[taoye]

When you need to get revenge, take Provenge!

Re:Provenge?

[HamburglerJones]

I'm 95% certain that this 'Provenge' drug will turn everyone into zombies.

Re:Provenge?

[fishexe]

I'm trying to figure out if "Provenge" is the most awesome or terrifying name for a drug I've ever heard. Also from the wikipedia page it "consists of a mixture of the patient's own blood cells" and their special "fusion protein".

I'm going with terrifyingly awesome!

I just hope the commercials feature Chuck Norris.

For those with naturally low levels of "fusion protein", they also feature a version made with Stephen Colbert's Formula 401 Premium Man Seed, from Prescott Pharmaceuticals. Side effects include horny blood, elephant lung, and crystal methods.

Re:Provenge?

[Hurricane78]

Provenge — a professional, hired for revenge... in a pill!
Now also in “hooker” flavor! (But you must provide the “protein” ;)

yeah, I guess rationing for money is better

[Anonymous Coward]

I mean, if your'e poor, why should you get equivalent healthcare resources to someone who's not?

If you really think that we're not rationing healthcare in the US, you're either astoundingly naive or deliberately ignorant. We just do it according to who can pay for it or who has a job where the benefits will cover treatment. Unlike France, Germany, the UK, and Canada where they ration according to need, which is totally bullshit, cause rich people deserve to live more than everyone else, cause they're the best part of society.

You're just dumb as fuck.

Re:yeah, I guess rationing for money is better

[Anonymous Coward]

In the United States, and specifically in the English language, there is something called "irony." This is when you say one thing, but mean the opposite. In this context, the GP is clearly using this literary tool. The .... symbols imply a pause in speech, as if thinking. This is a deliberate clue as to potential irony. Then the content states that other countries do something, but the US is different, without providing any basis for this. Combining these together, the reader should interpret this as irony. The GP says that the US is different, but does not really mean it. English is neat, isn't it?

Re:yeah, I guess rationing for money is better

[Anonymous Coward]

Yeah.

Re-read the post being responded to, and the one by the same poster a bit up in the same thread. A person with actual reading comprehension skills in English plus adequate world knowledge about the state of politics in the US would deduce that he's implying that Obama wants to take over medical care in the US and make it like the aforemetioned foreign nations (which all have some form of nationalized healthcare and/or single payer system).

This is when you say one thing, but mean the opposite. In this context, the GP is clearly using this literary tool

So, in the context of what I point out above, re-examine this statement. What the poster was actually saying was very much different from your interpretation. He was actually saying "yes, all these other nations do bad stuff by rationing healthcare, but Commie Obama says it won't happen here, cause it wont." There was irony in play (I'd call it facetiousness, but that's a terminological preference), but it was in fact entirely different from how you interpreted it.

So, to conclude, English is neat, isn't it? It's even better when it's coupled with some reading comprehension skills and a bit of understanding about the world.

Re:yeah, I guess rationing for money is better

[stupid_is]

In the UK they ration according to postcode (aka zipcode). Some regions allow the NHS to spend shed loads of cash on expensive drugs, others don't - it all depends on their regional budget. Herceptin was a recent headliner in that a woman with breast cancer had to go to the High Court to get a prescription for it as the local authority thought it was too expensive. She died recently.

Re:yeah, I guess rationing for money is better

[Anonymous Coward]

Oh you're just too smart. You should be proud to have such great reading comprehension skills.

Re:yeah, I guess rationing for money is better

[Anonymous Coward]

Really, they're not great. I have average reading comprehension skills for an educated and literate American citizen with a native level comprehension of English.

What's your excuse for not being at my level?

Re:Placebo Effect

[Anonymous Coward]

Not to go off topic, but if something you're eating CAN'T be classified in the Food Pyramid, it means it's something you shouldn't be eating because it is, in fact, not food. (Twinkies, I'm looking at you.)

The intent isn't just to eat them, its to eat them in the right proportion and total amount.

Re:It won't be allowed to be used.

[AK Marc]

I am currently in a country with socialized medicine. The grandparents of my wife came to witness the birth of their great-grandson. My wife is anemic on a good day. She's turned away from donating blood almost every time unless she remembers to take an iron pill the day before and eat an abnormally large breakfast. In pregnancy, it gets worse. When she had a kid in the US, they held her in the hospital because her count was low. They wouldn't let her go. She had no symptoms of anything, but they didn't release her until her insurance ran out, then, without having the issue fixed, they discharged her. They treated the "disease" of anemia without regard to the patient. There were no symptoms and no reason to hold her other than one test.

In this country, she was anemic the whole time of pregnancy, including during and after birth. She was asked whether she had symptoms. She suffered no dizziness, no fainting, or anything else. So they cleared her for release while failing a blood test. Her grandmother had a fit. She gets a new pill for every test she fails (regardless of whether it is even causing her symptoms) so, by God, that's just how it's done. To not give my wife something was neglect or malpractice or something, according to Grandma. I'd be interested in seeing the average number of pills per week of an American vs a European. My perception is that the US will be leading by far, even though the live expectancy doesn't reflect any better care.

In the US, they treat the test results, regardless of the condition of the patient. Outside the US, they treat the patient, using the test results as a tool to that end. That difference alone is a major factor as to why the US has the most expensive health care on the planet, yet a middle of the pack (for industrialized nations) life expectancy. Cutting the medication of everything, and instead identify problems with patients (rather than just failed tests) and treat the person, not just the diseases will reduce cost and improve care.

But, the "easy way" is to give a pill for every failed test and then you can't be sued. That takes less time and effort too. The cost isn't borne by either the doctor or the patient, so neither really care it isn't cost effective. And you get an over-medicated society in poor health. I'd guess that Obama's comment is along those lines, where he wants to cut costs and improve service at the same time.

P.S. Comp Sci. Comp Eng is 50% comp sci and 50% EE, so EE+comp sci is everything comp eng can do plus more.

This is good news.

[FiloEleven]

As someone who got hooked on ciggies about six years ago and actually enjoys the habit, news like this is promising to me. I hope the science behind this vaccine can be generalized to other forms of cancer, including lung cancer. I understand the reasons for banning smoking all over the place for reasons other than health, but it would be great to have advances in health technology to negate the effects of smoking. Since I have yet to quit and am not motivated to try again, I'm kind of banking on it.

Re:This is good news.

[timmarhy]

lung cancer isn't the only health effect of smoking you know, stroke and cardiovascular are also high risk if you smoke. frankly i can't see the attraction of smoking, it's expensive risky and what does it give you? a high? choke yourself for 30 seconds it'll give you the same head rush.

Re:This is good news.

[TheLink]

But smokers dying earlier helps reduce the "aging population" problem. It reduces the costs on average - since everyone is going to die anyway, and many nonsmokers still eventually get expensive to treat diseases (live long enough and you'll get something :) ).

Plus if the tobacco taxes are high enough, you can get smokers to pay for other stuff as well[1]

As a nonsmoker, I think smoking is good economics. Drug money and all that :). All these smoking bans (in restaurants, pubs etc) seem rather stupid to me. Just tax places that allow smoking higher compared to those that don't, then you won't lose another revenue opportunity ;).

[1] I saw some stats in the UK where the smokers cost the UK healthcare system 3 to 5 billion every year. But the tobacco tax revenue is 10 billion a year!

http://news.bbc.co.uk/2/hi/health/8086142.stm

http://www.the-tma.org.uk/tobacco-tax-revenue.aspx

http://www.ecancermedicalscience.com/news-insider-news.asp?itemId=311

Re:This is good news.

[gad_zuki!]

>As someone who got hooked on ciggies about six years ago and actually enjoys the habit

Of course you enjoy it. You're addicted to a chemical that affects mood. Your brain is forced to enjoy it. Enjoy!

Re:This is good news.

[FiloEleven]

There is of course much truth to that. Yet I hear many smokers say "I don't even enjoy it anymore, I just feel shitty without it." That's not me. In fact I've gone on week-long trips where I could not smoke and had no problem doing so, no cravings or anything. Perhaps I'm just not to that point yet, or perhaps the nicotine affects different people differently.

Enjoy!

Thank you, I will. =)

Re:This is good news.

[sjames]

Nicotine does have cognitive enhancing effects and can also act as an anti-psychotic (in fact the only one that doesn't have potentially devastating side effects). Nicotine also helps considerably with irritable bowel syndrome. Smoking is a rough way to administer it though.

E-cigarettes are a much kinder and gentler route of administration, but sadly the FDA and the American Lung Association (of all things) seems determined to ban those so people go back to smoking cigarettes.

Proper snus might be good (I've never tried it) but as I understand, the Americanized version being introduced is much weaker.

Re:This is good news.

[Anonymous Coward]

lung cancer isn't the only health effect of smoking you know, stroke and cardiovascular are also high risk if you smoke. frankly i can't see the attraction of smoking, it's expensive risky and what does it give you? a high? choke yourself for 30 seconds it'll give you the same head rush.

Did you know that if you are actually having a stroke right now a cig may benefit you?

http://www.data-yard.net/10b/cm.htm

It also prevents Alzheimer's and Parkinson's disease.

The more you know... ;)

Re:This is good news.

[Inda]

I said the same thing 22 years ago...

Re:This is good news.

[sourcerror]

Nicotine does have cognitive enhancing effects and can also act as an anti-psychotic (in fact the only one that doesn't have potentially devastating side effects)

What about a taurine-magnesium mix? (And it's certainly healthier.)

Re:This is good news.

[silentcoder]

Nicotine is a serotonine inhibitor, people with above average levels of this hormone tend to react emotionally, have trouble coping etc. (it's a known cause of at least some types of ADD). Among such people Caffeine and Nicotine addiction is incredibly common because it's effectively self-medicating. Caffeine doesn't inhibit serotonine but counteracts it a bit and helps focus, nicotine reduces it again helping focus and concentration.
This effect of course is completely zeroed out if you don't HAVE a naturally high serotonine level but there's a reason so many geeks and artists smoke and have among the lowest rates of successfully quitting. People with high serotonine are also highly creative and individualistic and thus drawn to such professions. With these legal drugs, they can balance the pro's and cons without it, they have serious difficulty adjusting and operating well - to them the "withdrawel effects" is huge. I put it in quotes because it isn't, the withdrawel is no worse than for any other person quitting, but it's massively aggravated by the fact that (probably for the first time since they were teenagers) they aren't supressing their serotonine levels.

It's easy to judge and generalize.

Personally - I rate being able to get through the day without acting irrationally, excessively emotionally and being able to concentrate on my job for the next 40 years or so rather higher than the risk of living ten years less. It's genuinely a case of - as a smoker, my quality of life is so MUCH higher, that I'll accept the side-effects. Especially since those drugs that can have the same effect tend to have too much of it (thus removing the PRO'S of my serotonine level as well) and besides, generally have side effects not much better than those of ciggies (and frankly, they happen right NOW, not 30 years down the line).

Re:This is good news.

[Anonymous Coward]

The 1950s called. They want their bad habit back.

Re:This is good news.

[Anonymous Coward]

That argument doesn't make much sense. Why not just get nicotine via gum or patch? Nicotine by itself is actually not much worse than caffeine. It's the smoke and other crap that causes lung cancer. If you can get the nicotine without the smoke, why wouldn't you do that if your goal is just to self medicate?

Re:This is good news.

[sjames]

I am not aware of any credible studies that show that combination to have any effects whatsoever beyond inducing people to buy energy drinks.

Nicotine, on the other hand has been shown to have the effects I mentioned in controlled clinical studies. In addition, there is no evidence whatsoever that nicotine by itself is any more harmful than caffeine. It's the smoking and nitrosamines that have the negative health effects.

Re:This is good news.

[Belial6]

Because it is a just a way to rationalize a vice.

Re:This is good news.

[sourcerror]

Sorry, but that's total BS.

Wikipedia:

The LD50 of nicotine is 50 mg/kg for rats and 3 mg/kg for mice. 40–60 mg (0.5-1.0 mg/kg) can be a lethal dosage for adult humans.[41][42] Nicotine therefore has a high toxicity in comparison to many other alkaloids such as cocaine, which has an LD50 of 95.1 mg/kg when administered to mice.

According to animal studies, taurine produces anxiolytic effect and may act as a modulator or anti-anxiety agent in the central nervous system.[44][45][46]

Re:This is good news.

[sjames]

I didn't say that nicotine can't possibly kill you (caffeine can kill you as well) just that it is no more harmful than caffeine when used recreationaly.

The interesting thing about the LD50 figures is that they are a guess for humans (since you can't just round up a bunch of humans, dose them, and see how many die) but nicotine has a very long history of use and death by nicotine poisoning is practically non-existent. While probably exaggerated, death from long term smoking is known, but that's not an effect of the nicotine itself.

Do let me know if/when the taurine studies are replicated in humans, that could be useful. The nicotine effects I mentioned are in humans.

I'm a bit mystified as to how you figure my post to be "total BS" since you refuted nothing that I said.

Re:This is good news.

[Anonymous Coward]

Dude, the vaccine is for PROSTATE cancer...how are you smoking those ciggies???

Re:This is good news.

[Abcd1234]

Weird that you were marked offtopic, given your post is exactly on topic (and, as it happens, exactly what I was thinking).

Come on, you smoke because your brain is broken? Really? Please. If that's really the case, get a prescription for an SRI and throw away the coffin nails.

Re:This is good news.

[TheLink]

A high risk factor is the polonium. Seems phosphate fertilizers tend to have a higher concentration of polonium, which get concentrated further in tobacco plant leaves.

So tobacco grown without such fertilizers might be significantly healthier.

Re:This is good news.

[sourcerror]

If you have a look at the Wikipedia page of taurin, only positive effects are listed, and they're all sourced.

It helps with brain function, is antioxidant, helps protein digestion and muscle development etc.

I'm a bit mystified as to how you figure my post to be "total BS" since you refuted nothing that I said.

You said
1, taurine doesn't have anti-psychotic effect
2, nicotine isn't toxic
I refuted these.

Re:This is good news.

[sjames]

I said that *I* wasn't aware of any studies showing a significant effect from supplemental taurine. You have only hand waved that there exists an animal study suggesting anxiolytic effects. I still see no evidence or even suggestion anywhere at all (other than you) that it has an antipsychotic effect.

There is some evidence that taurine may have an anti-convulsive property, so if I were epileptic that might be useful, but most people aren't epileptic.

None of this to say that taurine plays no role in the body, it does. But since we are talking about deliberate ingestion rather than incidental (as part of a normal diet), that's beside the point.

I made no claim that nicotine isn't toxic, just that there is no evidence that it is any more harmful than caffeine (also toxic). You didn't say anything to refute that. Practically everything becomes toxic if you take enough, including water and oxygen.

I really have no idea why you are so big on taurine and so against nicotine. I'm beginning to wonder if it's actually my posts you're responding to since while your posts are related, they seem to indicate that you're reading things I haven't written. Of course, they also seem to indicate that you've written something that I didn't read.

Re:This is good news.

[sjames]

But I'm not talking about tobacco, I'm talking about nicotine. While consuming tobacco is one way to get nicotine, it's not the only way. In the case of the e-cig, the nicotine is purified (probably extracted from tobacco) and then diluted considerably in water, vegetable glycerin and/or propylene glycol.

Snus is, of course tobacco but danger from polonium would depend on whether or not it goes into the saliva (if it stays in the snus, it will be spit out harmlessly at some point). If it does get into the saliva, the extent of the danger depends on how well it clears the digestive tract.

But certainly, polonium should be avoided.

Re:This is good news.

[silentcoder]

I've tried all the above... simple truth - they are all too weak to do anything usefull.

Re:This is good news.

[silentcoder]

Just because it's a rationalization doesn't mean it's not true. After all - you can't rationalize without thinking rationaly. The problem with rationalization is that it's an after the fact attempt to find a rational explanation for something done for irrational reasons.
Drug addiction (including nicotine) is most certainly an irrational action in general.

So... to make up pretend-reasons why it's okay, would be rationlization, and a bad variety too.
But what it, having gotten addicted, you genuinely found that you function better on the drug than off it ? What if you've been at times off it for over a year ?

Where do you draw the line between "I made a rational choice to accept the side effects because I want the benefits" and "I'm just rationalizing so I don't have to deal with addiction"?

Who the hell are you to draw that line for anybody except yourself ?

Nicotine use has benefits as well as side effects. So does heroine. Heroine's side effects are far worse - yet it remains legal to prescribe in certain limit cases (notably care of terminally ill patients) - where the benefits genuinely outweigh the side effects.

I believe that for me, cigarette's benefits outweigh their side effects. As long as we live in anything remotely approacing a free world - I believe it should be my legal right to make such a decision, just as I can legally choose to do so with any other substance - even one prescribed by a doctor. The state only gains the right to force me to take a drug when the results of my not doing so would cause a genuine danger to OTHER PEOPLE.

So as long as I am not smoking in the non-smoking section of the restaurant, it's my choice - not yours. You may disagree with my choice, that's your right. You can't force me to change it - that's MY right.

Ironically, statements like yours REDUCE the chances of people like me ever quitting. Because it just dismisses our genuine reasons why we make this choice, because it ignores that when I don't smoke I go through something significantly worse than the average quitter - and quite frankly if I try to quit when I'm not on holiday - chances are I'd get myself fired that same day... by ignoring these realities, you instantly dismiss giving any of us the kind of ABOVE AVERAGE support we would need to quit and adjust to life after ward.
The fact that not smoking pobably means I'd end up back on ritalin... I've BEEN on ritalin, I know what absolute HELL it was... seriously, there is no way in hell that cancer can be that bad... nothing can be that bad and I will NEVER subject myself to it again. I really WOULD rather die.
When that's the choice you face... there is nothing irrational about choosing to smoke.

Re:This is good news.

[silentcoder]

Everyone's brains are broken. More accurately - our brains aren't evolved for the kind of world in which we live. That's pretty much the one thing all of psychiatry since Freud has agreed on - and that discrepency affects us all in different ways, because the evolution of the human race didn't give us just "one kind of mind".
We now know there people whose sleep rhythms are naturally out of sync with the rest of us, that are actually nocturnel - an evolutionary development to ensure not everybody was asleep at the same time (making the tribe less vulnerable).
I personally put down the vast majority of mental conditions to just that - a discrepency between individual mental development in a brain evolved for certain tasks, living in a world that subverts it to other tasks.
Most people, most of the time can deal with it well enough to cope. Some people more easilly than others. Since the dawn of civilization however all of us have used natural and less natural chemical supplements to help us deal with this discrepency.

It may not be very politically correct but it is a fact. My brain isn't any more broken than anybody else's, it's just broken in a specific way - and since I recognize it, I consider myself to have a major edge over everybody who doesn't realize in what ways THEIR brains are suboptimal to the world they live in. I can utilize things like caffeine and nicotine to gain the maximum benefits from my brain chemistry while largely negating the downsides. Live out my particular talents without being excessively harmed by the talents I lack. Make no mistake, - that's all this really is, different individual natural talents. Just because we have a much better idea these days why talents differ, doesn't mean that all of a sudden a talent (or lack thereoff) becomes a disease.
Frankly, I still think the potential side effects of my little coctail of legal drugs is significantly less than those of the stuff I could "get a prescription for".

So... why would I overdose myself on stuff with an extreme and excessive effect that would kill of the benefits of my brain chemistry (my natural talent) to supress the downsides of it ? When I can spent a tiny amount of money (relative to that) on a pack of ciggies, and regulate the downsides while RETAINING the upsides ?

Re:It won't be allowed to be used.

[AK Marc]

They already ration care in the US. There are already lines for services in the US. People already flee the US for cheaper/better treatment. And that's *before* Obama was elected.

National debt - $128,000 per US household and still rising + 10,000 per year.

You are including promised payouts which will be covered by future pay-in. Conservatives may bitch about SS all the time, but they love to use it when it comes to doing the numbers. It's paying in more than it's taking out, but it is still called a drain on the budget. It's a net income, but will get ignored when it comes to the deficit, but included when it comes to the debt. If you take out the future payments (which are all statutory anyway, meaning a change in law and those obligations are freed, as they are not actually promised like a "real" debt) then the levels are much lower than you state.

But then, I agree that the economy is burdened by debt. I arranged for my leave of the US before the elections took place, so it wasn't because any one person got elected. I didn't care whether it was Kang or Kodos, they are the same. The US can't recover. The politicians won't let it happen. I blame the Republicans a little more than the Democrats (more time in the last 30 years in office and it's the last 30 years that have been the worst for the debt). But neither seem interested in cutting spending, and there can't be a viable 3rd party in the US. So the US will fail. And I didn't want to be there when it happened.

Does this vaccine cause Autism?

[Anonymous Coward]

Just sayin...

Since most research is done no the public dime

[Anonymous Coward]

and they drug companies are just doing the (relatively cheap) trials, I guess it all balances the fuck out.

Sorry, I've got family with cancer and the only research into the type they've got is being done in Universities and in Europe because it wasn't deemed profitable enough to bother here. I say screw the free market. I'm fed up with nitwits who don't realize that a book written 200+ years ago (The Wealth of Nations) doesn't apply anymore.

Re:Since most research is done no the public dime

[TheMeuge]

and they drug companies are just doing the (relatively cheap) trials, I guess it all balances the fuck out.

Relatively cheap?

It's at least $100 million to take a single drug to stage 3.

I'm very sorry about your family, but you're speaking nonsense.

Re:Since most research is done no the public dime

[sjames]

The Wealth of Nations might well still apply today, but we wouldn't know because we have thrown out all but the most dumbed down bare bones parody of what Smith recommended (essentially all of the inconvenient parts about keeping businesses small to medium sized and not having publicly traded companies are ignored). As a result, most markets are rather unhealthy and competition is sparse.

Re:Since most research is done no the public dime

[ShakaUVM]

>>I'm fed up with nitwits who don't realize that a book written 200+ years ago (The Wealth of Nations) doesn't apply anymore.

Do you thatch your own roof, too?

Re:Placebo Effect

[Anonymous Coward]

Only one word described your comments: retarded

$93,000 for the treatment

[ISoldat53]

Dendreon said Thursday the drug will cost $93,000 per patient. Their stock was up today.

Re:$93,000 for the treatment

[Anonymous Coward]

I read the cost on another site and seems like a lot of money for such a minimal life extension.

Re:$93,000 for the treatment

[TheLink]

The deciding factor to me would be how many of those 32% have a good quality of life vs the 23%?

If they are all still in a bad state - just clinging on to life rather than seemingly healthy, I'd rather spend the 93K on making the last few months/years of my life more pleasant.

Or give it to some loved ones to have a nice holiday, if I'm in already a too screwed up a state to enjoy it much. Or give it to some charity.

Re:$93,000 for the treatment

[ntimid8]

You should keep in mind this is compared to $60,000 for Taxotere, the only treatment currently available to patients this sick. In virtually all cases treatment with Taxotere will add another $30K+ in support care expense (hospitalization, follow-up care, medication, etc.) to treat the added sickness caused by chemotherapy. The only side effect or additional care patients using Provenge will have to endure will be slight fever, rash, or a regular oncology visit. In the end it costs the same and patients live longer, and with dignity. I work for Dendreon and today has been one of the greatest of my life - I am proud to work for a company that truly puts patients first. It gives me hope to see science and logic prevail in our increasingly skeptical and cynical world. Like all things demand for the science will improve process and reduce price, but we should focus on the breakthrough, both bureaucratic and scientific, that Provenge represents.

Re:It won't be allowed to be used.

[h4rr4r]

We already ration healthcare here, we ration everything already we used money for this.

Re:It won't be allowed to be used.

[Anonymous Coward]

Saying that life expectancy is exclusively tied to a health care system is short sighted (but I won't claim there is no effect). For all you know, it could be that longer working hours, higher rate of obesity, more guns, etc would otherwise halve an American's life expectancy - but their superior health care system makes up for much (but not all) of the loss!

Again...

[menkhaura]

Again fucking statistics used as proof. No knowledge of how chemicals interact within the body, how and why the reactions that cause cancer occur, no fucking nothing. Just the damn statistics.

Re:Again...

[Daniel Dvorkin]

Again fucking statistics used as proof. No knowledge of how chemicals interact within the body, how and why the reactions that cause cancer occur, no fucking nothing. Just the damn statistics.

Again someone who has no idea how drug development and clinical trials work shooting his mouth off.

Re:Again...

[timmarhy]

excuse me, but at you retarded?

Re:Again...

[mini me]

someone who has no idea how drug development and clinical trials work

Is that not his point? He wants to know more about how the drugs were developed and why they work they way they do. Instead he is given a brief line about the success rate in clinical trials and not much else.

Re:Again...

[Daniel Dvorkin]

Is that not his point? He wants to know more about how the drugs were developed and why they work they way they do.

No, I don't think he does. His contempt for the single most important item to be reported in any clinical trial says he doesn't really give a damn, but just wants to indulge in an ill-informed rant.

Re:Again...

[Eivind]

Just because the article doesn't contain it, doesn't mean there's no theory behind the function of the drug, it's not as if it's created by randomly pouring stuff in a jar and shaking it about.

In any case, knowing statistically -that- something has an effect, and search for the reason why, is a hell of a lot better than what the alternative world typically does; which is have a lot of explanations (bullshit ones: water has memory etc) for how something is supposed to work, but not the tiniest hint of evidence that it -does- infact work.

Re:Again...

[Anonymous Coward]

Saying that's how it's done in the industry, doesn't justify the practice.

The man was right. Statistics without any background explanation of the product and how it works opens the door to lies and a misleading use of statistics.

Re:Again...

[nedlohs]

It's a clinical trial, so it doesn't matter why it works. It's a study to determine if it works.

They could have designed it based on deep knowledge of the workings of body chemistry, or they could have noticed that people on a treatment for something else don't seem to die from prostate cancer as often as you would expect and decided to try and confirm that with absolutely zero knowledge of mechanism.

It doesn't fucking matter, because explaining the workings isn't the aim of the trial.

But in this particular case the article does explain the workings*, so you are not only retarded but also illiterate.

* Extract the immune cells from the patient. Grow them while exposing them to a protein specific to the cancer cells. Put them back into the patient. So the mechanism is obvious - convincing the patients immune system (well the bit you grew in a dish anyway) that the cancer cells are bad and hence using the normal immune response of the body to attack them. Of course that convincing part is likely tricky to actually do, but irrelevant to the mechanism in the body.

Re:Again...

[Anonymous Coward]

Description of how the drug works:
http://en.wikipedia.org/wiki/Dendreon

How clinical trials work:
http://en.wikipedia.org/wiki/Clinical_trial

Prostate cancer epidemiology:
http://en.wikipedia.org/wiki/Prostate_cancer#Causes

Re:Again...

[Anonymous Coward]

Maybe I'm not reading it right, but the stats in the prescribing information look like there is little to no statistical difference between the drug and placebo.

Grade 3 reactions Provenge=23.6% placebo=25.1%
Grade 4 reactions Provenge=4% placebo=3.3%
Fatal reactions Provenge=3.3% placebo=3.6%

Survival in months

Study 1 Provenge 22.8-27.7
Study 1 placebo 17.7-23.8
(THEY OVERLAP! Many people live just as long on placebo as on the drug.)

Study 2 Provenge 20.0-32.4
Study 2 placebo 12.3-25.8
(THEY OVERLAP! Many people live just as long on placebo as on the drug.)

Look at the graph in the report from the manufacture. AT 60 MONTHS THE PLACEBO GROUP HAS A HIGHER SURVIVABILITY RATE. Anyone who has done research on prostate cancer knows that 60 months is one of the standard mile markers for gauging survival rates of treatments. By this measure placebo did better in clinical trials.

Re:Again...

[mini me]

I still feel that he does have a point, even if it was, perhaps, not presented in the best manner.

If this was about a "cure" for a computer virus we would get long winded explanations about how the virus was able to attack the system, which systems are vulnerable, and exactly how the fix is able to remove the virus.

Instead we are told that researchers were able to successfully remove the virus from 32% of the computers in the lab. Encouraging, perhaps. But it does not help anyone better understand the hows and whys.

Re:Again...

[Anonymous Coward]

Ranter's motives aside. I too criticize the idea of using statistics to make claims. For example, a person who has angioplasty needs it because angioplasty removes a heart blockage which would cause death. After that, you get put on a bunch of medicines because doing so has a certain statistical effect. But modern medicine doesn't really know if those prescriptions will correct the causes of the infarction. It's just a really good guess, based on statistics.

That is where the ranter's criticisms are valid. We must always get down to the cause and effect of things.

Re:Again...

[fishexe]

Again fucking statistics used as proof. No knowledge of how chemicals interact within the body, how and why the reactions that cause cancer occur, no fucking nothing. Just the damn statistics.

Why do you need to know how chemicals interact in order to know that it empirically works?

If we can measure the circles the planets move in well enough to figure the Sun and not the Earth is at the center, do we need to wait around 2 more centuries for the theory of gravity before we agree on heliocentrism?

Re:It won't be allowed to be used.

[Anonymous Coward]

The laws of nature will be repealed and we will sit around the campfire and sign kumbaya while we force some people to work for free in order to pay for health care for the rest of us. The nature of freedom at its best. Not.

sex

[mikey177]

well research shows that the more you have sex and masturbate when you are young increases your chance of prostate canacer, and with teens having sex at a younger and younger age i think this company will be making some good money from this later down the road. http://www.sciencedaily.com/releases/2009/01/090126082343.htm

Re:It won't be allowed to be used.

[jjohnson]

That's sort of damning with faint praise, isn't it?

FYI, in Canada, we have a province with a quarter of the country's population (Quebec) that thinks a good meal is a plate of fries covered in cheese curds and drowned in gravy. We also have five times the number of doughnut shops per capita that you have in the U.S. I'm jes sayin'...

Re:It won't be allowed to be used.

[jjohnson]

And yet, even with all that rationing and those death panels working overtime, all of those countries have average life expectancies greater than the U.S., measured in years, while paying about 55% per capita of what Americans pay.

Re:It won't be allowed to be used.

[Anonymous Coward]

I wonder if there could be anything else that accounts for the difference in life expectancy? For example, Sweden didn't implement universal insurance until the '50s, and the life expectancy delta between Swedes and Americans at the time was approximately what it is today. Japanese-Americans have the same life expectancies as Japanese living in Japan.

Re:It won't be allowed to be used.

[jjohnson]

The U.S. has comparable or lower rates of violent crime than Canada, England, or France, so that's not it. Lifestyle differences undoubtedly have an impact--Sweden is notoriously active, for example--but Canada has a province where a quarter of the country's population thinks a good meal is plate of fries covered in cheese curds and drowning in gravy, and also has more smokers, and fives time the number of doughnut shops per capita that the U.S. has (and England's not better). Rates of disease outbreak aren't worse in the U.S., and live expectancy as a measure of the country's health system is bolstered by comparable results (i.e., the UHC countries are significantly ahead of the U.S.) in other aggregate scores like time spent off work due to illness, or infant mortality rate.

Re:It won't be allowed to be used.

[commodore64_love]

>>>You are including promised payouts which will be covered by future pay-in

No. You're wrong. I'm taking the current national debt (12.8 trillion) and dividing by the number of households (100 million) and arriving at $128,000 per home. Simple.

As for rationing I'd rather see it happen naturally, through the free market, then via bribing politicians or administrators to gain "special favors". I'm also concerned about racism creeping-in, if those administrators don't like certain groups, like blacks or asians or Jews, and denying care to them.

Re:It won't be allowed to be used.

[commodore64_love]

One reason other countries life expectancies are higher is because they "massage" the numbers. Take infant mortality for example. Most countries don't include those deaths of individuals below age 1 in their life expectancy figures. The US does, and naturally that makes the overall number drop much, much lower.

Comparing stats is not enough. You have to make sure the stats were arrived at via the same methodology, and in this case, they were not. So no direct comparison can be made.

Re:Placebo Effect

[drinkypoo]

Somehow, this sounds like the opposite of "I'm just big boned." I'm sure it exists, but it's probably a lot rarer than what most people need to be concerned about.

With all the unmoving couch potatoes in modern society eating diet foods which don't nourish them I'm sure it's very common. If you have no muscle, you can have some fat and not look fat.

Re:It won't be allowed to be used.

[ShakaUVM]

>>They wouldn't let her go.

Hospitals are not allowed to hold patients against their will, generally speaking. The exceptions are:
-Mental illness (they can hold up to 72 hours without a court order)
-Public threat (you have ebola)
-You have diminished capacity (stroke victim, dementia, etc.)
-You're a criminal.

The way it came off, it probably seemed like the doctor wouldn't let her go, but if she wanted to walk out the door, they can't stop her, unless one of the above applies.

Re:It won't be allowed to be used.

[AK Marc]

No. You're wrong.

You're right. I stopped paying attention when I got permission to emigrate and didn't realize how bad the Bush bailouts hit his last fiscal year. $3 trillion in just over a year. I'm glad I got out. Though I'm still on the hook for taxes unless I renounce my citizenship.

As for rationing I'd rather see it happen naturally, through the free market, then via bribing politicians or administrators to gain "special favors".

I don't see how the "free market" being paying more for it getting you to the front of the line is inherently better than paying off someone else. Not to mention that most most places with such systems don't have the problems you mention. Are you saying that Americans are less honorable than everyone else?

I'm also concerned about racism creeping-in, if those administrators don't like certain groups, like blacks or asians or Jews, and denying care to them.

What makes you think that doesn't happen now? And if it doesn't happen now, and doesn't happen in, say, Canada or the UK, why would you think it would happen here?

Re:It won't be allowed to be used.

[jjohnson]

And you have some cite for this, or perhaps a ranking of countries by an adjusted method that evens out the methodological differences?

Your own CIA Factbook backs up what I'm saying, and I suspect they don't just call up the country's embassy and ask for the number.

Re:Placebo Effect

[stupid_is]

Somehow, this sounds like the opposite of "I'm just big boned." I'm sure it exists, but it's probably a lot rarer than what most people need to be concerned about.

I've never seen a fat skeleton

Re:It won't be allowed to be used.

[stupid_is]

In the US, they treat the test results, regardless of the condition of the patient. Outside the US, they treat the patient, using the test results as a tool to that end. That difference alone is a major factor as to why the US has the most expensive health care on the planet, yet a middle of the pack (for industrialized nations) life expectancy.

25% of US healthcare spend is on admin and associated paper pushing, according to these chaps, and this article puts the estimate at over 30%. For the UK, for example, I've seen estimates of between 5% and 15%, and everyone over here thinks the NHS overly bureaucratic.

Re:It won't be allowed to be used.

[Anonymous Coward]

"No. You're wrong. I'm taking the current national debt (12.8 trillion) and dividing by the number of households (100 million) and arriving at $128,000 per home. Simple."

You're off by 15-18 million on the number of households. Debt per household is closer to $110,000. Big enough that there's no need to overstate it.

Re:It won't be allowed to be used.

[tburkhol]

In the US, they treat the test results, regardless of the condition of the patient. Outside the US, they treat the patient, using the test results as a tool to that end. That difference alone is a major factor as to why the US has the most expensive health care on the planet, yet a middle of the pack (for industrialized nations) life expectancy.

You may be forgetting that many of us Americans judge the quality of things by their cost. As long as US medical care costs more than European medical care, US must have (almost by definition) the best care.

Very Glad

[physburn]

My father did of prostrate cancer, it his last years has horrible. The figures show Immuotherapy helps a bit but clearly its a long way from a cure. I hope medicine but enhance Immuotherapy to make it much more effective and extend it to other cancers.

Re:Very Glad

[Anonymous Coward]

My father did of prostrate cancer, it his last years has horrible. The figures show Immuotherapy helps a bit but clearly its a long way from a cure. I hope medicine but enhance Immuotherapy to make it much more effective and extend it to other cancers.

Well, maybe with this vaccine, he could had an extra four horrible months. Sorry to joke, but it really annoys me when they focus on extending life and not quality of life. A huge fortune is spent keeping suffering people alive, while other people can't afford preventative care which saves society money in the long run. I have medical power of attorney for my father and so we had to discuss all these things and he was very clear about not extending his life after he can't enjoy it any more.

Re:Placebo Effect

[Anonymous Coward]

It truly is amazing. Girls who get Pregnant like symptoms when they really want to be pregnant.

Yes, but how is babby formed? How girl get pragnent?

I think the Mayo is on to a better solution...

[Anonymous Coward]

http://www.mayoclinic.org/news2009-rst/5318.html

nicely done.

[93,000]

and me with no mod points.

huh? I'm supposed to do what now?

[93,000]

Oh, sorry. Missed the dollar sign. As you were...

Unknown quirks?

[Futurepower(R)]

You are assuming a random distribution. You are assuming there are no unknown quirks or bias in the way the experiment was run. You are also assuming there was no dishonesty.

The difference between taking the drug and not taking it is tiny, according to the stated results of the experiment.

Quote: "The big story here is that this is the first proof of principle..." Translation: The big story is NOT that this drug works well.

Note that the U.S. government is very weak in regulating drug companies. For example, the fine in this case was trivial compared to the profits: Drug Makers to Pay Fine of $81 Million.

See - Internet Porn really can kill you!

[Anonymous Coward]

See - Internet Porn really can kill you!

I'm still not certain that I believe it. Is ScienceDaily a reputable source?

Fortunately, when I was in my 20s the internet wasn't available to most people and it took 2 hrs to download a single unknown photo from a BBS. I never saw any porn in my teens, just the Queen "bicycle" album art. Oh how far we've cum.

Re:It won't be allowed to be used.

[Beezlebub33]

See this Healy statement. The definitions of what counts as a live birth, and therefore what counts as infant mortality vary even in developed countries. the definitions are even more variable in developing countries.

Re:It won't be allowed to be used.

[jjohnson]

That article mentions differences in definitions of live births, but also cites real (and incompletely understood) factors in infant mortality (such as ethnicity) that are meant to question infant mortality as a proxy for the quality of the health care system. Fair enough. I'm not seeing how differences in infant mortality rate explain years of difference in life expectancy between the U.S. and Canada, England, France, or Switzerland (none of which are mentioned in Dr. Healy's article, so it's not clear that the comparison isn't apples-to-apples). It also doesn't address the fact that the CIA factbook, a U.S. publication from an organization that (presumably) makes some effort to normalize numbers across countries, shows the same differences across almost all aggregate measures of population health.

Life expectancy, infant mortality, lost productivity due to illness... none of these are perfect indicators of the quality of a country's health care. But when most or all of those approximate indicators are against you, and you're spending almost double what all those other countries are spending per capita, it seems pretty clear that you're paying more and getting less for health care in the U.S.