then i remembered a month or so ago seeing this, and not knowing what to make of it.
As far as I can tell, they did a wholesale deal with quest diagnostics, and run your results through ChatGPT and give you supplement / diet recs via a pretty web portal 2x a year for $499.
Claim is it’s 100 biomarkers and would cost avg person $15k retail.
I’m a member and love it.
Ageless also provides many other longevity therapies.
Curious to see how these hold up over the long term.
I get it every year. So far, so good!
Question for you, what do you do when it shows you may have cancer? Do you speak to your physician? Surely, this will change your life even if it doesn't need treatment for next 6 years? Does the treatment change? Can the treatment be done based on those results?
So many questions.
I'm hoping we find more stuff for Alzheimer's. My aunt and now mother have it. I fear that I am next and I am too scared of doing the DNA test to check for genes.
what about Europe?
In my field, we all think that CfDNA testing will eventually become a standard thing that will go along with your annual physical's blood test, because it has predictive/preventative abilities.
EDIT:
Adding these caveats:
1. There is a ton of nuance in the diagnosis, since most people have a small amount of cancer in their blood at all times
2. The screenings are 5-10k + follow up appointments to actually see if its real cancer
3. All in cost then could be much higher per person
4. These tests arent something that are currently produced to be used at mass scale
The usual story is that you’re just better off not knowing because you’ll end up doing more harm than good chasing every little suspicious diagnosis. Cancer happens all the time, but many times doesn’t lead to anything.
It's the same reason they pay for annual physicals in the first place.
This is not to downplay the potential benefit of early cancer detection... which is huge. And in the US/UK anyway, there are ongoing large trials to try to figure some of this stuff out in the space of blood-based cancer screening, as part of the path to convincing regulatory bodies and eventual reimbursement for certain tests. As mentioned, you can currently at least get the Galleri test out of pocket (<$1k, not cheap, but not exorbitant either), as well as whole body MRIs (a bit more expensive, ~$2-5k).
We do a lot of CT imaging in the emergency department and it sucks if we incidentally find an abnormal growth in a young patient's CT head. These are usually benign and often not worth performing brain surgery to get a biopsy.
People talk about the “immune system” but they are really referring to a number of systems the body uses to regulate itself, more or less successfully, around environmental pressures. The body is a system under tension, sometimes extreme tension leads to extreme success (success here being growth of power), sometimes it breaks the body, and sometimes the systems have been slowly failing for a while, and most treatments will not help. Medicine is only useful in the specific case where the power of the body would be promoted if not for one thing, that the body would be healthy, at least manageably so, without that issue.
Incorrect.
There are tons of cancers that hide and mask with symptoms common to other symptoms. Kidney cancer, for example, presents pretty similarly to both kidney stones and UTIs. Even blood in the urine isn't proof positive that anything is wrong beyond either of those conditions. And, by the time blood is in the urine, it's often too late.
Liver cancer is even worse. The first symptoms you get can be thought of as a simple pulled muscle, just a little ache in the back. By the time you have appreciable problems, like turning yellow, it's quite advanced and too late to really do much.
There are common cancers like colon, skin, breast, and prostate that more fit your description of being mostly harmless so long as you get regular screenings and eat healthy. But, for every part of the body, a cancer can form and the symptoms are very often invisible.
I'm unfortunately all too familiar with how cancer looks. My wife currently has stage 4 cancer that started as kidney cancer. She does not drink or smoke, gets enough rest, and is very active.
Annual MRI?
I do wonder if a 5 year whole body MRI or CT would be generally beneficial for the population. I don't think it needs to be Annual to have benefits.
The problem is it really isn't uncommon for your body to create random puss fill sacks all over the place. It's one thing our cancer doctor warned us about. My wife is now on a 6 month CT regimen and ultimately, they'll just ignore new lumps.
GP wasn't asking what they should personally do. They were asking how the doctor would screen for it. (The truth is, the doctor can't/won't-- an annual MRI on every otherwise healthy person, for example, would be prohibitively expensive with how MRIs are currently set up-- and as another commenter pointed out, findings from those can be just as easily ignored or put off until it's too late.)
Being beside that hypochondric point is statistically a much healthier place to be.
The current state of medicine is the current state of medicine in the actual world.
Many prostate cancers, for instance, are slow growing and won't kill you before something else does. If you try to take that kind of cancer out surgically or zap it with radiation or chemo the side effects could be severe.
Is it moral for a doctor to give a test they think is going to increase someone's chance of death.
thanks for adding the caveats; they suggest that there are good reasons why it isn't clear cut that health care companies should pay.
- Sure, cancer can develop years before diagnosis. Pre-cancerous clones harboring somatic mutations can exist for decades before transformation into malignant disease.
- The eternal challenge in ctDNA is achieving a "useful" sensitivity and specificity. For example, imagine you take some of your blood, extract the DNA floating in the plasma, hybrid-capture enrich for DNA in cancer driver genes, sequence super deep, call variants, do some filtering to remove noise and whatnot, and then you find some low allelic fraction mutations in TP53. What can you do about this? I don't know. Many of us have background somatic mutations speckled throughout our body as we age. Over age ~50, most of us are liable to have some kind of pre-cancerous clones in the esophagus, prostate, or blood (due to CHIP). Many of the popular MCED tests (e.g. Grail's Galleri) use signals other than mutations (e.g. methylation status) to improve this sensitivity / specificity profile, but I'm not convinced its actually good enough to be useful at the population level.
- The cost-effectiveness of most follow on screening is not viable for the given sensitivity-specificity profile of MCED assays (Grail would disagree). To achieve this, we would need things like downstream screening to be drastically cheaper, or possibly a tiered non-invasive screening strategy with increasing specificity to be viable (e.g. Harbinger Health).
I lost my wife to melanoma that metastasized to her brain after cancerous mole and margin was removed 4 years earlier. They did due diligence and by all signs there was no evidence of recurrence, until there was. They think that the tumor appeared 2-3 months before symptoms (headaches) appeared, so it was unlikely that you’d discover it otherwise.
With something like this, maybe you could get lower dose immunotherapy that would help your body eradicate the cancer?
Literally anything that reduces cancer deaths is a win. I'm certainly not campaigning against early detection tests like this! Just talking about a challenge that comes up operationalizing them.
Like if we had some kind of prophylactic cancer treatment that was easy/cheap/safe enough to recommend to people even on mild suspicion of cancer with false positives, we could offer it to positive tests. Maybe even just lifestyle interventions if those are proven to work. That's probably very difficult though, just dreaming out loud.
What is CHIP?
It’s when bone marrow cells acquire mutations and expand to take up a noticeable proportion of all your bone marrow cells, but they’re not fully malignant, expanding out of control.
There are a lot of companies right now trying to apply AI to health, but what they are ignoring is that there are orders of magnitude less health data per person than there are cat pictures. (My phone probably contains 10^10 bits of cat pictures and my health record probably 10^3 bits, if that). But it's not wrong to try to apply AI, because we know that all processes leak information, including biological ones; and ML is a generic tool for extracting signal from noise, given sufficient data.
But our health information gathering systems are engineered to deal with individual very specific hypotheses generated by experts, which require high quality measurements of specific individual metrics that some expert, such as yourself, have figured may be relevant. So we get high quality data, in very small quantities -a few bits per measurement.
Suppose you invent a new cheap sensor for extracting large (10^7+ bits/day) quantities of information about human biochemistry, perhaps from excretions, or blood. You run a longitudinal study collecting this information from a cohort and start training a model to predict every health outcome.
What are the properties of the bits collected by such a sensor, that would make such a process likely to work out? The bits need to be "sufficiently heterogeneous" (but not necessarily independent) and their indexes need to be sufficiently stable (in some sense). What is not required if for specific individual data items to be measured with high quality. Because some information about the original that we're interested in (even though we don't know exactly what it is) will leak into the other measurements.
I predict that designs for such sensors, which cheaply perform large numbers of low quality measurements are would result in breakthroughs what in detection and treatment, by allowing ML to be applied to the problem effectively.
There are nevertheless privacy issues, which I did not address as my first comment was already very long, especially for a tangent. Most obviously, people would be consenting to the collection of data whose significance they cannot reasonably forsee.
I do agree that most current AI companies are unlikely to be a good steward of such data, and the current rush to give away health records needs to stop. In a way it's a good thing that health records are currently so limited, since the costs will so obviously outweigh the benefits.
I'd be really curious to see how longitudinal results of sequencing + data banking, plus other routine bloodwork, could lead to early detection and better health outcomes.
It's kind of why I'm favor of universal option to align financial incentives. Like given how sick the US population is, it probably makes sense to put a lot more people of GPL-1s and invest in improving their efficacy and permanence. Like nationalize-the-patent COVID-operational-warp-speed level urgency. There are over 100M Americans that are pre-diabetic, the cost of treating a diabetic is about 20k/yr. So $4 trillion in new costs, on top of the misery and human suffering.
Searching the web shows that Cigna forces some patients to use this program in order to receive coverage for certain conditions. They're likely saving all the info collected through it in order to use it to deny you coverage if they can at all make an argument that something was caused by your lifestyle, was pre-existing for a certain amount of time, etc-- at least, that's the vibe I got from researching it.
COVID was different because being a transmissible disease, there was a strong motivation to try to maximise the percent of the population immunised. With GLP-1 agonists, if you made them freely available, likely over >50% of eligible patients would take them voluntarily, which would result in massive long-term cost savings from lifestyle diseases, even considering the continued costs from the other 50% who will refuse. And insurers may even give discounts to those who take GLP-1s (if permitted by regulators)
GLP-1s are probably going to have the unintended side effect of increasing weight stigma - already obesity skews poor, once most of the well-off obese people cure their obesity with GLP-1s it is going to skew even more poor. I can foresee a cycle in which GLP-1s increase weight stigma which pushes more people into taking them which then increases weight stigma even more, which could drive up their adoption even further
Sounds like either there are complicating factors or an absence of standard protocol adherence.
US health insurance is a mess, but that doesn’t sound like the entire story. I suspect urologists see a fair amount of friction for routine procedures related to prostrate health.
https://aacrjournals.org/cancerdiscovery/article-abstract/do...
Full text is paywalled, and no mention in abstract of false positive rate in control group. Has this test actually been independently verified? No mention of that important fact in the press release.
They assumed their previous cancer had survived and metastasized. Doctors couldn't find the source. It turned into a waiting game, where they lived with a sword of Damocles over their head. They were retested every few months and monitored. Then after a year the tests the levels dropped off. And the end result was nothing came of it so far.
It's normal to have some amount of pre-cancerous cells get naturally removed by your immune system. And this catches those too.
bookofjoe•5h ago