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Related: Have any “cures” been invented since the 1950's or so?

I ran across the movie Cut Poison Burn, who's abstract is as follows:

Cut Poison Burn is a controversial, eye opening, and sometimes heartbreaking documentary that puts the business of cancer treatment under the microscope. Follow the frustrating journeys of critically ill cancer patients as they try to navigate the confusing and dangerous maze of treatment and encounter formidable obstacles in the “cancer industrial complex.” A compelling critique of the influence of medical monopolies, the power of pharmaceutical companies and government agencies, Cut Poison Burn is essential viewing for anyone and everyone touched by cancer.

The movie may advocate (haven't watched the whole thing) some kind of new, pennies-per-session treatment a la Burzynski, or at least Dr. Mercola is using it to do so.

There are a myriad of claims in the movie, I'm sure (I only watched the first 10min), but I'd like to address one in particular that struck me (occurs starting at the 7min mark). It is made by Charles B. Simone, M.MS, M.D., founder of the Simone Protective Cancer Center (transcripted by me; may contain small errors):

From 1920 to the present time, we have made little or no progress in the treatment of adult cancers. So a person who gets prostate cancer or breast cancer today will live as long as a person who got it in 1920. No big change. With all the radiation therapy that began in the 10's and 20's, combination chemotherapy in the 60's, immunotherapy that began in the 70's, PET scans, MRI scans, you name it, billions and billions and billions of research dollar that we've thrown into this whole area of cancer research and treatment... little or no significant progress in the treatment of adult cancers.

Is this the case? Has no treatment since 1920 done anything to increase the chance of [long-term] survival of adults who have cancer?

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Hendy
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    The first example on the accepted answer of the question you linked regards bone marrow transplant for lymphoma. – nico Sep 19 '11 at 16:09
  • PZ Myers addressed this question on [Pharyngula](http://scienceblogs.com/pharyngula/2011/03/support_cancer_research_now.php) for CHILDHOOD cancers. He references meta-analysis that shows huge improvements. I would be surprised if many of the gains didn't also apply to adult cancers. – Oddthinking Sep 19 '11 at 16:40
  • @Oddthinking Could you please add this to your answer, or create a new answer? This data is gold. – Konrad Rudolph Sep 20 '11 at 11:39
  • @Konrad, I have added as addendum to my answer. – Oddthinking Sep 20 '11 at 11:59
  • The title says: "is it the same?", your final question states: "did it improve?". It is confusing, please fix it. When somebody answers "Yes", it might not be apparent what does it mean on the first sight. – Tom Pažourek Apr 01 '14 at 13:12
  • @tomp It's been a long time since I wrote this, but the final question, verbatim is, "Has no treatment since 1920 done anything to increase the chance of [long-term] survival of adults who have cancer?". Reading this now, I find the wording clunky, but technically it's still saying the same as the title: if nothing since 1920 has increased long-term survival, then the rates are the same (or worse). So "Yes" means "the same" per the title and "not improved" per the final question. – Hendy Apr 01 '14 at 15:40
  • Something to understand: When you're dealing with cancer a cure only happens when you get it early and nail every bit of it. Otherwise it's a question of how long do you live. Thus the question is looking at the wrong yardstick. – Loren Pechtel Mar 05 '17 at 02:56
  • @LorenPechtel well, if in 1920 what you said was true and today it wasn't... wouldn't that be precisely the yardstick to use (you can get diagnosed further along today and still live just as long)? – Hendy Mar 05 '17 at 21:41

1 Answers1

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Women patients with metastatic breast cancer (for example) lived much longer after diagnosis in 1995 compared to 1920.

This 1983 study describes an interesting aspect to this question:

Survival of women with metastatic breast cancer at Yale from 1920 to 1980. Todd M, Shoag M, Cadman E., J Clin Oncol. 1983 Jun;1(6):406-8.

The survival of metastatic breast cancer patients initially increased dramatically:

The median survival of these patients increased steadily from 21 months in 1920 to 41 months in the decade from 1970 to 1980. The percentage of women actually surviving 5 years increased from 5% in the 1920s to approximately 25% in the 1960s.

However, over the next twenty years, improvements were more limited:

Despite the use of combination drug programs in the 1970s, the percentage of these patients remaining alive at 5 years remained near 25%. Firm conclusions cannot be made from a retrospective study spanning 60 years, although the trends depicted and lack of continued improvement indicate that our current therapeutic approach to metastatic breast cancer may not result in dramatic improvement in overall survival.

Taking over from there was another study:

Survival of patients with metastatic breast cancer: twenty-year data from two SEER registries, Patricia Tai , Edward Yu, Vincent Vinh-Hung, Gábor Cserni and Georges Vlastos. BMC Cancer 2004, 4:60 doi:10.1186/1471-2407-4-60

It compared cause-specific survival from metastatic breast cancer for two periods: 1981-1985 and 1991-1995. It looked at the results from two areas: Connecticut and San Francisco-Oakland. It found that back in 1981-1985, both regions has similar results, but there was an improvement in survival for the San Francisco-Oakland registry patients a decade later and no improvement in Connecticut.

To summarise: Improvements from 1920-1960, static from 1960-1980, and then mixed results from 1981-1995.

Beware of the confounding effects of earlier/better detection of disease.

Addendum

Noted skeptic PZ Myers addressed a similar issue on his Pharyngula blog. He shows how the survival rates for childhood cancers have increased dramatically.

It doesn't directly answer the question, because it deals with childhood cancers (the original quote was about cancer in adults), and because it is poorly referenced. However, the graphs are quite dramatic, and one could expect to see similar results in adults.

Survival Rates in Children

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  • Thanks for the answer. So perplexing that breast cancer appears to be a clear winner while Simone used breast cancer as one of his specifically named varieties of no improvement in treatment. – Hendy Sep 19 '11 at 17:42
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    “Beware of the confounding effects of earlier/better detection of disease.” – I’m not sure they can be (dis)counted as confounding effects. They are *effects*. Improved diagnosis and early detection are probably *the* most important factors that contribute to cancer survival. – Konrad Rudolph Sep 20 '11 at 11:36
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    @Konrad, if they lead to earlier treatment, which leads to a better prognosis, then yes, they are important factors. But if there is no effective treatment and patients continue to die at the same age, but are just aware of their cancer for longer, it will improve the 5-year-survival rate statistics (the "stopwatch" starts at diagnosis) without contributing to an improved life-expectancy, and may actually reduce quality of life. – Oddthinking Sep 20 '11 at 11:50
  • @Oddthinking Ah. Thanks for the explanation, very true. – Konrad Rudolph Sep 20 '11 at 11:56
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    @Hendy - One thing that should be noted is that Breast cancer is believed to be related to prostate cancer in men (at least that with a genetic link). Another cancer that used to kill people regularly was skin cancer, something that is well controlled and handled today. – Chad Sep 20 '11 at 16:15
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    "After diagnosis" is misleading. Longer "survival after diagnosis" is often attributed to earlier diagnosis, and not better or more effective treatment. A better metric needs to be used if we are to determine if cancer patients actually live longer now. – Flimzy Sep 20 '11 at 19:52
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    @Flimzy: very difficult, unless you have a way to "retro-diagnose" people in the '20s... – nico Sep 20 '11 at 21:55
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    @nico: I'm not suggesting that it's simple (or even possible). I'm only saying that this metric, while it may have its uses, is _not_ useful for answering this particular question. – Flimzy Sep 20 '11 at 21:58
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    @Flimzy: sure, and I agree with you, I was just saying that probably we'll have to do with that... – nico Sep 20 '11 at 22:00
  • @Flimzy, I agree. You'll see I included a warning about it, but I don't have anything better available. The (unreferenced, wrong age group) chart via Myers helps here with longer term projections. – Oddthinking Sep 20 '11 at 23:58