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Rapamycin extends mouse lifespan 9–14%
NAD+ precursors reverse aging in humans
Blue-light glasses improve sleep quality
Walking 10 min after meals blunts glucose
Verdict change — caffeine half-life downgraded

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#121 – Azra Raza, M.D.: Why we’re losing the war on cancer — Whalespan

Content›Video›#121 – Azra Raza, M.D.: Why …

#121 – Azra Raza, M.D.: Why we’re losing the war on cancer

Peter Attia1h 55m · 2020-07-28

Claims Made

162

Claims Supported

67

Support Rate

41%

Support rate

67 of 162 claims supported

67 supported95 partial / not

Claims from this content

78

✕Not SupportedThe addition of a few months of survival for metastatic cancer patients represents a minimal and potentially insignificant improvement.✓Well SupportedCatching cancer earlier, when there are fewer cells, leads to better treatment outcomes.◐Partially SupportedThe NHS declined to fund Avastin because its cost exceeded the $100,000 per QALY threshold, given it provided less than 12 months of benefit.✓Well SupportedTests like 4K and other nuanced assays, in addition to PSA velocity and volume, clarify the importance of early cancer detection.Well Supported

More from Peter Attia

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Attia walks back the clinic protocol: too aggressive for healthy adults

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A. Volkovreader

4h

Bookmarking — the dossier-vs-overview split is the right call. Most of the time I want overview; sometimes I want receipts.

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Would love a "what would change this verdict" RSS feed. Sign me up if it exists.

✓

A significant portion of scientific literature in top journals is irreproducible.

✓Well SupportedThe observed 30-year decline in cancer mortality is primarily due to the decline in smoking rates, not advances in cancer treatment.

◐Partially Supported95% of experimental cancer agents fail completely, and the 5% that succeed only prolong survival by a few months for 20-30% of patients.

✓Well SupportedModern lifestyles significantly increase cancer rates, severity, and frequency.

◐Partially SupportedCheckpoint inhibitors can benefit patients with pancreatic adenocarcinoma who have checkpoint mutations, even if they also have Lynch syndrome.

◐Partially SupportedCAR T-cell therapy is an immune therapy where the body's own immune cells are engineered to selectively kill cancer cells.

◐Partially SupportedLiquid biopsies are expected to become significantly more valuable for screening and cancer detection in the next 10 years.

✕Not SupportedCAR T-cells cannot distinguish between normal and cancer cells, a fact not widely mentioned by scientists.

✕Not SupportedCTLA-4 antibody therapy can cause life-threatening gut inflammation, perforation, and death.

◐Partially SupportedPhase one clinical trials can cost tens of millions of dollars.

◐Partially SupportedA new, encapsulated form of the 'seven and three' AML treatment costs $45,000 per cycle, compared to $5,000 for the standard version.

✓Well SupportedFor non-smokers, obese, or heavy drinkers, exercise is the next most impactful lifestyle intervention for reducing cancer risk.

◐Partially SupportedCancer-related resources and effort should be shifted to prioritize prevention and early detection.

◐Partially SupportedTargeted therapies like Gleevec can transform previously fatal diseases into manageable ones.

✓Well SupportedThe core cancer treatment modalities of surgery, chemotherapy, and radiation have remained fundamentally unchanged for 2500 years.

◐Partially SupportedEarly detection is the only successful strategy in cancer treatment to date.

◐Partially Supported68% of newly diagnosed cancers are cured using surgery, radiation, and chemotherapy.

◐Partially SupportedChemical weapons inspired the use of chemotherapy for cancer by observing their effect on blood counts.

◐Partially SupportedCheckpoint inhibitors work by unmasking signals on cancer cells that prevent immune cells from recognizing and eliminating them.

◐Partially SupportedGleevac is effective for early-stage chronic myeloid leukemia but less so when the disease accelerates.

◐Partially SupportedCancer treatment focus has shifted from survival to progression-free survival due to difficulties in improving actual survival.

◐Partially SupportedPeter Attia believes cancer biology, not tumor burden, is the primary determinant of cancer outcome.

◐Partially SupportedCancer is a ubiquitous disease that will touch anyone, either directly or through someone they know.

◐Partially SupportedThe majority of oncology research funding historically came from the NIH/NCI, exceeding half of total global oncology research dollars around 1971-1972.

◐Partially SupportedKilling cancer cells without harming healthy cells is a challenge.

◐Partially SupportedOncologists have limited options when a solid tumor is not completely resected or if cancer cells have entered blood vessels.

◐Partially SupportedOtto Warburg first observed anaerobic metabolism in 1921, and ketogenic diets were used in the 1980s, indicating research into metabolic pathways related to cancer is not new.

◐Partially SupportedA young woman with acute myeloid leukemia presented with a precursor condition, making liquid tumors easier to study than solid tumors.

✕Not SupportedStandard treatments for AML and most common cancers have not significantly advanced in 43 years.

◐Partially SupportedPSA volume and PSA velocity are better indicators of prostate cancer risk than PSA alone.

◐Partially SupportedIt is difficult to study the longitudinal and prospective impact of lifestyle factors like running or using a trampoline on cancer risk due to small effect sizes and insufficient participation.

◐Partially SupportedGrail is developing multi-cancer detection technology and is in Phase 2 trials for nearly 30 cancers.

◐Partially SupportedThe M-Chip can measure biomarkers like PSA from a single drop of blood for frequent home monitoring.

◐Partially SupportedToshiba has announced a technology capable of detecting 13 different cancers from one drop of blood in four hours for $180.

◐Partially SupportedThe speaker is optimistic about the potential of liquid biopsies and has incorporated them into her practice.

✕Not SupportedThe treatment of cancer is currently paleolithic and comparable to beating a dog with a baseball bat to remove fleas, due to disfiguring and horrible side effects.

◐Partially SupportedThe five-year survival rate for AML using 'seven and three' treatment increased to approximately 26% by 2020 due to improvements in supportive care.

◐Partially SupportedChemotherapy cocktails are effective for lymphomas due to the disease's biology.

◐Partially SupportedAvastin was developed based on the concept that tumors require neovascularization to grow and metastasize.

◐Partially SupportedCheckpoint inhibitors have been a significant advancement in cancer treatment in the past five years.

◐Partially SupportedBiomarker 'barcodes' from a single drop of blood for various cancers could revolutionize early detection.

✕Not SupportedUsing artificial mouse models or cell lines for drug testing is an ineffective approach for complex diseases like cancer.

◐Partially SupportedSophisticated technology and intellectual resources should be employed to develop biomarkers for early cancer detection across various bodily fluids and the microbiome.

◐Partially SupportedCancer is most common with increasing age because cells accumulate DNA copying errors over more divisions.

◐Partially SupportedThe primary treatment for breast cancer today remains surgical removal (mastectomy).

◐Partially SupportedFor the vast majority of cancers, random mutations account for their development.

◐Partially SupportedUntreated cancer can cause one of the most painful deaths.

◐Partially SupportedThe FDA's Phase Zero trial system uses a small dose in humans to start drug development and bypasses animal testing.

◐Partially SupportedWhile some rare cancers have seen significant treatment improvements, they collectively account for less than 10% of all cancers.

◐Partially SupportedThe standard treatment for acute myeloid leukemia in 1977, a combination of cytarabine and daunorubicin, resulted in a 10% five-year survival rate.

◐Partially SupportedDrug development in animals does not reliably extrapolate to humans, although animal research is valuable for understanding biology.

◐Partially SupportedUnlike smoking, it is difficult to isolate the impact of most environmental contributors to cancer, with obesity being a potential exception.

◐Partially SupportedAvastin extended median survival by approximately four months in patients with metastatic colorectal cancer, at a cost of around $100,000.

◐Partially SupportedEarly detection is the only successful strategy in cancer.

✕Not SupportedAnimal models should not be used for drug safety testing because results in animals have little relevance to human outcomes.

✕Not SupportedCAR T-cell therapy and similar treatments have severe side effects and should be used only when tumor burden is low.

◐Partially SupportedThe most lethal cancers account for about two-thirds of cancer deaths, and catching them before metastasis is key.

◐Partially SupportedThe success of treatments for chronic myeloid leukemia (CML) is due to a single genetic change targeted by drugs like Gleevec.

◐Partially SupportedCompanies may choose to sell off-patent drugs at high prices or repurpose them, potentially increasing prices by nearly 10x.

◐Partially SupportedSpontaneous recovery from metastatic gastric cancer suggests the immune system can eradicate cancer.

◐Partially SupportedThe age-adjusted mortality rate for cancer in 2020 is the same as it was in 1930.

✕Not SupportedThe definition of a partial response (PR) in cancer clinical trials is arbitrary.

◐Partially SupportedTargeted therapies may be more effective for advanced cancers with specific mutations like FLT3 if administered earlier.

◐Partially SupportedCell therapies and checkpoint inhibitors are the two most popular kinds of immune therapies.

◐Partially SupportedLifestyle changes, such as not smoking, are common sense and reduce the likelihood of not only lung cancer but many other diseases.

◐Partially SupportedBiomarkers to identify early signs of pancreatic and ovarian cancer could lead to a multi-cancer detection system from a single blood drop.

◐Partially SupportedCurrent cancer treatment has not significantly improved life extension over the past 90 years.

◐Partially SupportedDietary interventions or supplementation alone cannot cure advanced cancer and aim to improve survival by a few months.

◐Partially SupportedImmortalized tissue culture cell lines like HeLa often mutate to express similar genes for survival in vitro, regardless of their tissue of origin.

◐Partially SupportedThe irreproducibility of scientific studies can be partly due to the use of different mouse models across labs.

✕Not SupportedEpidemiological studies on diet and mortality can be misleading due to confounding factors.

◐Partially SupportedUsing a rebounder trampoline for 20-30 minutes daily after running can stimulate the lymphatic system.

◐Partially SupportedDisturbed metabolism can lead to the production of reactive oxygen species or free radicals, which can cause mutations, with metabolic disturbance being the primary event in some advanced cancers.

◐Partially SupportedAcute promyelocytic leukemia (APL) can be cured with arsenic or vitamin A analogs (ATRA).