Regarding a chemo drug or other intervention, when an oncologist uses the phrase 'response rate' you are confident he is gaslighting. He means a scan or LFT is temporarily a little better, with no reference to the patient. PFS is a related sales trick meant to trick the patient into agreeing with a useless (or worse) therapy.
You cannot be too skeptical of what passes for research these days.
Wonderful article with widely applicable general principles.
One of my mentors once taught me: we do things to patients for 2 objectives only - for them to live longer, or to feel better.
“To make their CT scan look better” decidedly was NOT on that list. Especially when that tradeoff further includes “and for them to feel worse and have more side effects”.
The specifics of this topic are well beyond my grasp. The corollary in cardiology would be our 3-point MACE which (often) includes non-fatal MI and stroke as morbidity endpoints. But at least in those scenarios, avoiding an MI or stroke at least fulfills the “feel better” (by avoiding a bad thing) aspects of what we should be trying to achieve. And for that, additional cost and more side effects may well be a justifiable tradeoff.
Here, the “benefits” and tradeoffs seem far less persuasive. Now, no doubt the sponsor (and their paid talking heads) will say “shared decision making” (a term and concept made more and more ludicrous by Pharma with every passing day, or so it would seem). But just as Dr. JMM has shown with the recent Champion AF laugher, why would a non-conflicted physician even bother to offer an option that represents no gain and all downside?
Here's where I'm at after Covid response by the gov't and the medical establishment. I won't bother going into how MSM treated it. I'm at a point where if I get cancer, I'd rather take Fenbendazole and Ivermectin than chemo treatment. Meaning, I'd rather take advice from YT'ers and rando strangers on the Internet than from a doctor who can't think for him or herself and toes the line.
Now, you'd think I'm some kind of a tin foil conspiracy nut job living in a dank dark basement. I'm not. I was an Infantry officer, I was an engineering student, I had jobs in financial and tech companies for the last 40 years. I'm about as logical, straight laced man as you can get. And I *adored* doctors because so many of my friends went through the crucible of medical school and residency. We'd commiserate, me with my 96 hour patrols, the miserable ruck marches and my friends with med/residency horrors.
Then Covid hit. I was gas lighted. I was told lies. I was called every name in the book just for thinking logically. TO THIS DAY, no one *really* wants to talk about the damage the vax has done to people. For almost 3 years after taking the vax, I was hit with heart, lung, and brain issues. Healthy as a horse then I was forced to take the vax and all hell broke loose. And, of course, you would say it's anecdotal- because it is. I agree. But there are more of us "anectotals" in my immediate circle than you can possibly imagine.
When my IRA grows large enough, I'm going to make it my mission to sue the hell out of schools that mandated the vax on my kids. I either had to disenroll them or roll the dice. But back in 2021, I couldn't comprehend that big pharma handed me a loaded dice as doctors and researchers stayed silent.
Regarding a chemo drug or other intervention, when an oncologist uses the phrase 'response rate' you are confident he is gaslighting. He means a scan or LFT is temporarily a little better, with no reference to the patient. PFS is a related sales trick meant to trick the patient into agreeing with a useless (or worse) therapy.
You cannot be too skeptical of what passes for research these days.
Wonderful article with widely applicable general principles.
One of my mentors once taught me: we do things to patients for 2 objectives only - for them to live longer, or to feel better.
“To make their CT scan look better” decidedly was NOT on that list. Especially when that tradeoff further includes “and for them to feel worse and have more side effects”.
The specifics of this topic are well beyond my grasp. The corollary in cardiology would be our 3-point MACE which (often) includes non-fatal MI and stroke as morbidity endpoints. But at least in those scenarios, avoiding an MI or stroke at least fulfills the “feel better” (by avoiding a bad thing) aspects of what we should be trying to achieve. And for that, additional cost and more side effects may well be a justifiable tradeoff.
Here, the “benefits” and tradeoffs seem far less persuasive. Now, no doubt the sponsor (and their paid talking heads) will say “shared decision making” (a term and concept made more and more ludicrous by Pharma with every passing day, or so it would seem). But just as Dr. JMM has shown with the recent Champion AF laugher, why would a non-conflicted physician even bother to offer an option that represents no gain and all downside?
Here's where I'm at after Covid response by the gov't and the medical establishment. I won't bother going into how MSM treated it. I'm at a point where if I get cancer, I'd rather take Fenbendazole and Ivermectin than chemo treatment. Meaning, I'd rather take advice from YT'ers and rando strangers on the Internet than from a doctor who can't think for him or herself and toes the line.
Now, you'd think I'm some kind of a tin foil conspiracy nut job living in a dank dark basement. I'm not. I was an Infantry officer, I was an engineering student, I had jobs in financial and tech companies for the last 40 years. I'm about as logical, straight laced man as you can get. And I *adored* doctors because so many of my friends went through the crucible of medical school and residency. We'd commiserate, me with my 96 hour patrols, the miserable ruck marches and my friends with med/residency horrors.
Then Covid hit. I was gas lighted. I was told lies. I was called every name in the book just for thinking logically. TO THIS DAY, no one *really* wants to talk about the damage the vax has done to people. For almost 3 years after taking the vax, I was hit with heart, lung, and brain issues. Healthy as a horse then I was forced to take the vax and all hell broke loose. And, of course, you would say it's anecdotal- because it is. I agree. But there are more of us "anectotals" in my immediate circle than you can possibly imagine.
When my IRA grows large enough, I'm going to make it my mission to sue the hell out of schools that mandated the vax on my kids. I either had to disenroll them or roll the dice. But back in 2021, I couldn't comprehend that big pharma handed me a loaded dice as doctors and researchers stayed silent.
Such an important perspective. Thank you for sharing