?? why?

[JohnW2]

Sometimes we get something and form an opinion but it still does us good - placebo effect - we think it makes us better so we do get better because we have convinced ourselves of it, and yes that can work because our mental abilities can be so strong.

What obviously matters to patients is that whatever 'treatment' they have has a beneficial effect on their symptoms, and that is true whether the beneficial effect is due to an understood pharmacological effect or, at the other extreme, is 'all in the mind'- which is why I have personally never knocked the idea of treatment with 'placebo'

However, it's all-but-impossible these days. For fairly obvious reasons, a placebo is likely to have little or no beneficial effect if the person receiving it knows that it is a placebo. In the past, it was possible to prescribe medicines which were only identified as "The tablets", "The Mixture" or whatever - but that is no longer acceptable for the recipients not to be told exactly what their medicine is (other than in clinical trials). I recall, for example, that 'back then', there were some rhubarb-based potions described as "The mixture" which were sometimes prescribed (as a 'placebo').

But then people start jumping on band wagons stirred up by the press, or by politicians or by cynics or even by our own selves then yes we can get it wrong or mislead ourselves.

Indeed so.

I have a pet theory - everyone will get cancer if they live long enough, it is inevitable. ... My theory might have some truth in it or I might be completely Bonkers, it might even be "a bit true" LOL.

Certainly not bonkers, closer to 'a truth' than a theory and probably an inevitability given our unavoidable exposure to cosmic 'radiation' etc. Some cells in our body are undergoing 'malignant change' (i.e. 'becoming cancerous') all the time but, particularly when we're younger, our immune systems get rid of those cells before they have a chance to proliferate and produce 'tumours'. However, the older we get, the less well do those defence mechanisms work - hence the fact that cancers becoming increasingly common with increasing age.

With some cancers, what you suggest is already essentially demonstrably true. For example, it's been known for a long time is that if one goes carefully looking for them at autopsy, one will nearly always find at least some 'cancerous cells' in the prostates of elderly men, even if there was nothing to suggest that they had prostate cancer during their lives. That could well mean that we will need to make sure that screening for prostate cancer does not get 'too sensitive', since that could result in many men being subjected to 'treatment' for a disease which was not going to do them any harm (before they died of something else).

I would have the tendency to accept the consensus of the medical profession to get it right (if you can get them to agree with each other), but even then we can not be 100% sure about a lot of things and humans do have some differences in their make up although not that many from Chimpanzees genetically either. Sobering thought?

Given that our knowledge is neither perfect nor complete, the reality is that you'll probably never get a "100% consensus" from doctors (or any other group of professionals/'experts') about anything ... but I suppose that is a fairly 'healthy' situation (unless/until we become 'omniscient' - but I wouldn't hold my breath in relation to that ).

Kind Regards, John

 

[ebee]

That could well mean that we will need to make sure that screening for prostate cancer does not get 'too sensitive', since that could result in many men being subjected to 'treatment' for a disease which was not going to do them any harm (before they died of something else).

Yes I was certainly aware of that one

 

[morqthana]

Certainly not bonkers, closer to 'a truth' than a theory and probably an inevitability given our unavoidable exposure to cosmic 'radiation' etc. Some cells in our body are undergoing 'malignant change' (i.e. 'becoming cancerous') all the time but, particularly when we're younger, our immune systems get rid of those cells before they have a chance to proliferate and produce 'tumours'. However, the older we get, the less well do those defence mechanisms work - hence the fact that cancers becoming increasingly common with increasing age.

I have definitely noticed that in the fundraising adverts on telly (for Cancer Research or McMillan - can't remember which), the X in "1 in X of us will get cancer in our lifetimes" getting smaller and smaller.

 

[JohnW2]

I have definitely noticed that in the fundraising adverts on telly (for Cancer Research or McMillan - can't remember which), the X in "1 in X of us will get cancer in our lifetimes" getting smaller and smaller.

Quite so. Quite apart from 'more of the cancers getting diagnosed', since the risk of cancer increases fairly dramatically in the increasingly elderly, even small increases in average life expectancy have a marked effect on that X.

I think that in those adverts, X is now usually 2 (i.e. a 50% risk of cancer) - but the risk is only 'that low' because most of the other 50% die of heart disease or strokes before they get old enough to develop cancer. If (as probably will eventually happen) we find a way of preventing vascular disease (hence eliminate most of the cardiac and stroke deaths a few decades down the road), then almost everyone will probably end up with cancer at some point...

... and, of course, if, as well as eliminate cardiac and stroke deaths, we eventually also find a way of preventing and/or curing all cancer (far from impossible), then we would be faced with an almost unmanageable sociological catastrophe, since nearly everyone would end up having go die of 'old age', in many cases after a substantial period with dementia.

 

[morqthana]

Don't forget the old man's friend, though.

 

[JohnW2]

Don't forget the old man's friend, though.

In practice, much the same as "old age" ...

...in the great majority of people who die of what we would probably regard as "old age" or "dementia" (as well as many others) the actual pathological mechanism and recorded 'cause' of death is bronchopneumonia.