Is Disease Revolutionary?

[Marat]

If you ask the typical layperson, he or she will say that medicine is doing wonders today. But the FDA published a 'panic bulletin' in 2008 noting that the number of new drug approval requests had declined for the first time since the approval process was established, and the typical patent attorney will tell you that the drug patenting laws are now inappropriate because they were designed to protect major therapeutic breakthroughs which are no longer happening. The death rates for many forms of cancer have not improved significantly for decades, the unsolved problems in diabetes and renal failure remain what they were a half century ago, and the last disease removed as a public health problem was polio nearly 60 years ago. In short, medicine is stagnating, but the public is being told the opposite.

 

If you look at any websites where doctors, hospitals, public health officers, drug companies, and the government 'inform' patients and the public about various diseases, you will find that the fatuously over-optimistic information about the disease and its prognosis provided bears no resemblance whatsoever to the negative picture presented of the disease in any medical book. The same misleading optimism characterizes all the patient forum websites, where anyone posting honest, medically accurate, but negative information is instantly banned. So why does society feel compelled to hide the truth about the failures of modern medicine and the unmet challenges of disease?

 

Perhaps because if the public knew how bad the reality of disease was, this would have a revolutionary impact. People would refuse passively to keep paying the outrageous prices demanded by Big Pharma for its products; they would demand that their legislators stop providing such generous patent protection to Big Pharma's drugs; they would decline to support the inflated salaries of doctors; and they would rebel against regulatory agencies like the FDA and the AMA. In short, a lot of powerful interests would feel the heat from the public if the news got out that their social power, prestige, and wealth were based on inadequate performance.

[DJBruce]

I do not believe that the current state of medicine is really as grim as you make it seem. We have many many medications, which are able to fight many different diseases. Heck, we have the technology to identify diseases now, that 50-60 years ago would have gone unnoticed.

 

As for why the prognosis of many diseases is falsely represented to the public, I am not sure if this is entirely the case. Look at the H1N1 outbreak last year for weeks on end all you could hear on any news network was how this disease was deadly and could become the next black death. I as highly highly doubt that there is some grand consipracy between medical officials, the government, and pharmaceutical companies to keep the people in the for fear of revolution.

 

Do you have any proof that there is such a consipracy? Saying thinks like if you check this you'll see is not proper validation of a claim.

[Moontanman]

Compared to 200 years ago modern medicine is miraculous beyond belief, what are they conspiring to do? Keep us all healthy?

[CharonY]

Why is it surprising that approval requests are declining? During the biotech boom there were in fact an overabundance diagnostic markers that were submitted, and none of them survived the clinical trials. Was it a conspiracy? Nope, just the new methodologies simply did not work. We have gained massive knowledge and at some point it is clear that unless the next big thing pops up, rates will slow down a bit.

Are people dying left and right from diseases? Nope. Is it likely to assume that there are miracle cures that the pharma and/or government are trying to hide? Nope either. One has to keep in mind that pharma rarely is doing basic research. They just mostly buy up stuff and develop it into a marketable medicine.

Novel stuff are often initially introduced by startups rather than by big pharma. But the latter bring it to the market.

 

Cure cancer? Well, there is massive government investment into that (just look at the study section of the NIH). Is anyone hiding the cancer cure? Nope. The problem is that cancer (or, to be precise the various cancer variants) are in fact a part of how our body works and alters over time. For certain variants, that are often triggered by viruses, there are actually vaccines available or under development. But for the others it is actually doubtful whether a cure is technically feasible.

Medicine hast its limitation. Or rather, our bodies have. Biological systems are easily the most complicated system that we have to deal with and while the advancement of overall technology is astonishing, it is naive to think that we can as easily deal with our biology.

[Marat]

I am not saying that there is anything like an organized conspiracy which causes all the public information you hear about medical progress and disease prognosis to be so profoundly optimistic, while all the technical information you read in medical textbooks is so profoundly pessimistic. I am merely suggesting that the same general social and economic forces operate to produce this enormous disconnect between public and professional disease information, and that these probably are the need for Big Pharma and the Medical Establishment to induce the public to tolerate their social power and insistence on enormous remuneration for their inadequate performance.

 

I am not saying that there hasn't been any medical progress since 1800. But compare the progress in other areas of science with medical progress and you will notice that medicine is lagging badly. In 1944 the first military jet plane was developed and now we are more than 30 years past having sent men to the Moon and back. In 1944 the first renal dialysis machine was developed but it was found to produce a hideous lifestyle for patients and to provide them only with a very short lifespan. Today, 66 years later, although the dialysis machines and treatments are better, the same basic problems of hideous patient lifestyle and extremely shortened lifespan remain. In 1922 Banting and Best discovered insulin injections as a way to correct the metabolic abnormalities of diabetes, but the inability of insulin injections to imitate the natural functions of the pancreas meant that patients often suffered poor quality of life and died early. Today, 88 years laster, those same problems with insulin therapy of diabetes remain, though life expectancies have improved. But contrast the situation in 1922 in diabetology and aeronautics with that today: Insulin was discovered 5 years before Lindberg made history by flying over the Atlantic, and now we can send space probes to Jupiter. Or compare the advances in computer technology: the fastest way to calculate in 1922 was with an adding machine, but now a pocket calculator can solve quadratic equations; there is nothing in medicine that can compare with this degree of progress.

[CharonY]

As I said, the problem is that biology is much harder than rocket science. Seriously.

[ccdan]

Perhaps because if the public knew how bad the reality of disease was, this would have a revolutionary impact.

I don't think so... people live a lot more nowadays than in the past and more diseases are treatable or manageable

 

rebel against regulatory agencies like the FDA

I don't think many would like buy medical products that weren't properly tested

 

But compare the progress in other areas of science with medical progress and you will notice that medicine is lagging badly. In 1944 the first military jet plane was developed and now we are more than 30 years past having sent men to the Moon and back.

I'm afraid your analogy is not very good... the space technology hasn't evolved almost at all in the last 50 years... the rockets we use today to carry people to the ISS or to send space probes to other plantes are similar to those that put the first satellite in orbit more than 50 years ago and everything related to space exploration still is outrageously expensive and it is likely to remain so if we don't manage to develop other, more efficient propulsion systems... and btw., back in the 50s and 60s many people hoped that we would colonize the moon and perhaps mars and other regions further in space by the year 2000... now it's 2010 and apart from sending a few small and limited space probes and building the ISS, nothing really happened...

[Marat]

You could even say that rocket technology is just the applied science version of Newton's discoveries in mechanics 350 years ago, but other areas of technology, such as computers, show much more important advances over the past 50 to 80 years than medicine has achieved.

 

The great advances in human life expectancy were achieved through improvements in public health, not medical science. Cleaner living conditions, better water purification, and improved diet are the main reasons that the average life expectancy in developed countries today is entering the eighties. If you look at the odds of a 60 year old in 1900 living to 80, you will find very little difference from what they are today, which speaks against medicine as the motive force behind these gains. What really made the difference was the high infant mortality rate in earlier historical periods. People always make the mistake of thinking that because average life expectancy was 40 in a certain historical period that means that people in their late 30s then were old because medicine was not as good. But in fact, it was just that babies under 5 were dying like flies from inadequate nutrition and infectious disease, and that new mothers were dying from mineral loss and puerperal fever, which can be avoided by simple cleanliness. The Old Testament, written about 1300 B.C., speaks of people naturally living for 'three score and ten,' or 70 years, so what has 2300 years of medicine achieved since then -- an additional 8 years?! Recently life expectancy among males has actually leveled off or is declining slightly in some areas of the developed world -- for the first time ever, because medicine cannot make any progress against cancer, diabetes, autoimmune disease, athero- and arteriosclerosis, etc. And what benefit is it to most people to live past 75? The typical person is functionally dead at that age, since the intellect is going or gone, and another decade of existence spent in mounting confusion, incontinence, and crippling arthritis is hardly 'life.'

[DJBruce]

The great advances in human life expectancy were achieved through improvements in public health, not medical science. Cleaner living conditions, better water purification, and improved diet are the main reasons that the average life expectancy in developed countries today is entering the eighties. If you look at the odds of a 60 year old in 1900 living to 80, you will find very little difference from what they are today, which speaks against medicine as the motive force behind these gains.

 

Can I get some proof of your claims here?

[Marat]

You can confirm these data from any good medical history book, such as Singer's famous text. Now you can probably also confirm this information from internet sources.

[CharonY]

If you look at the odds of a 60 year old in 1900 living to 80, you will find very little difference from what they are today, which speaks against medicine as the motive force behind these gains.

 

Marat, you are cherry-picking data here. The majority of the gain is due to reduced infant mortality and treatment of infectious diseases. It is not unexpected that at older age medicine cannot prolong life much more. In with the ancient Greeks, if people lived to a certain age, they could well reach their eighties (and quite some famous ones did). Only their chance to reach it was lower.

 

At some point biology kicks in. Few people, regardless of medicine, will, for instance, reach an age of 100 and over.

Medicine has shifted the causes of death, though. For instance, in countries with bad medical health care more people will die from infectious diseases than cancer or Alzheimer's, diseases that typically have an onset late in ones life.

Ow and hygiene is a sub-discipline of medicine, btw.

[Marat]

Although you can technically say that hygiene is part of medicine, in fact huge gains in health and life expectancy can be achieved with improvements in hygiene which are utterly primitive and nearly totally pre-scientific, like hand-washing, defecating in water only downstream from where you wash your hands, getting enough sunlight, not eating out of the same pot that you urinate in, etc. So while you might count those commonsense, primitive public health measures as still part of 'medicine,' they make no positive comment on the state of modern medical science as a progressive discipline.

 

The fact that the Old Testament speaks of the allotted lifespan of man as three score and ten suggests that this was a typical life expectancy at the time. If so, then the average life expectancy of 78 now -- a gain of only 8 years after 3300 years of work and who knows how many trillions of dollars of research efforts -- represents a pitiful degree of progress among those making it past the huge infant mortality cull in primitive societies.

[DJBruce]

The fact that the Old Testament speaks of the allotted lifespan of man as three score and ten suggests that this was a typical life expectancy at the time. If so, then the average life expectancy of 78 now -- a gain of only 8 years after 3300 years of work and who knows how many trillions of dollars of research efforts -- represents a pitiful degree of progress among those making it past the huge infant mortality cull in primitive societies.

 

The old testament also discussed people living to be very very old. An example of this being Moses who was said to be 120 years.

 

5 So Moses, the servant of the Lord, died there in the land of Moab, just as the Lord had said. 6 The Lord buried him[a] in a valley near Beth-peor in Moab, but to this day no one knows the exact place. 7 Moses was 120 years old when he died, yet his eyesight was clear, and he was as strong as ever.

 

So I am not really sure if you can cite the Bible as a reliable source for age statistics.

[Cap'n Refsmmat]

So I am not really sure if you can cite the Bible as a reliable source for age statistics.

 

²⁶ And after he became the father of Lamech, Methuselah lived 782 years and had other sons and daughters.

http://www.biblegateway.com/passage/?search=Genesis+5:26&version=NIV

 

Indeed.

 

Let's look at some actual data:

 

http://www.wolframalpha.com/input/?i=life+expectancy

 

Look at the disparity between Swaziland, where 60% of the population lives on $1.25 or less daily, and Macau, with the 18th-highest per-capita GDP in the world, where infrastructure and medicine are affordable.

 

What Marat also forgets is that hygiene is not "pre-scientific"; it took significant advances in medicine for the germ theory of disease to ever be proven, and advancing the idea of hand-washing took significant amounts of work by Joseph Lister. Defecating in water you don't drink requires understanding that diseases like cholera are spread through contaminated drinking water -- and anyone in a pre-scientific time had no idea what a germ even was, let alone how it was spread.

 

One must also take into account quality of life instead of just life expectancy. Modern medicine also works on non-fatal illnesses -- treatments for cold symptoms, surgeries to fix damaged joints, and so on. The problems wouldn't cause death, but the treatment makes life easier for the patient.

[Marat]

Of course hygiene has some scientific elements, but the progress in hygiene, and its life-saving effect, is heavily concentrated at the very bottom of the 'scientific' spectrum, whereas what we usually mean by 'medical progress' is heavily concentrated at the very top of the scientific spectrum, involving reliance on high-tech innovations to cure disease and extend the lifespan. It seems counterintuitive to classify hand-washing as a breakthrough in medical science rather than just the attainment of a higher degree of social organization.

 

In using ancient source materials as an indication of the average span of life long ago, it would be foolish to count the extreme examples, such as that of the 800-year-old Methuselah or the miraculously long-lived Moses, since this is just superstition to enliven the tale and says nothing about nomral life expectancy at the time. These long lives were supposed to impress contemporaries as astonishing, so they say nothing about what was normal at the time.

 

But it is quite different with the phrase in Psalms 90:10, where the Bible says "The days of our years are three score and ten," for this is stating what is regarded as the normal time allotted for human life. It would only discredit the tale in the eyes of its contemporary audience if 70 years were known to them as a life expectancy which was not ordinary.

[nec209]

Rocket science has not made much prograss from the 60's.to now .And airliners trying to go very fast died with the concorde jet.There is no incentive to invest money in a new concorde or a new concorde that can go 2 or 3 times faster.

 

Has for virus that can mutate or virus with different strains there is no incentive to invest money for a drug that works for 5 or 10 years than you have to come up with a new drug do to the virus mutated or you have so many strains.

 

Look at antibiotics and bacteria resistant.It is a losing battle where the pharmaceutical companies are not making money.Do to new strains of bacteria resistant the superbug and flesh eating bacteria.

 

Has for computers say thanks to the invention of the transistor and IC or there would be no computers in people home or laptops only computers running on big vacuum tubes and a computer 2 or 3 times bigger than your car.

 

Has for drugs that can tell cells what to do that does not exit.Cancer and organs going bad is a cellular problem.No drug exit or the know how to manipulate anything at a cellular level.

[DJBruce]

In using ancient source materials as an indication of the average span of life long ago, it would be foolish to count the extreme examples, such as that of the 800-year-old Methuselah or the miraculously long-lived Moses, since this is just superstition to enliven the tale and says nothing about nomral life expectancy at the time. These long lives were supposed to impress contemporaries as astonishing, so they say nothing about what was normal at the time.

 

But it is quite different with the phrase in Psalms 90:10, where the Bible says "The days of our years are three score and ten," for this is stating what is regarded as the normal time allotted for human life. It would only discredit the tale in the eyes of its contemporary audience if 70 years were known to them as a life expectancy which was not ordinary.

 

Sorry, but I still do not think you can cite the Bible as a reliable source of life expectancy data.

[Marat]

There are two ways to use the Bible as a source of information. One is as the revealed truth of God about the world, which is not how I am using it here. The other is as an archaeological record of what people at the time believed was normal about human physiology -- here, with respect to life expectancy. Assuming that the authors of the book would not want to fill their document with statements about what was natural for humans with obvious inaccuracies, since this would undermine the credibility of the whole tale, I take what they say about the natural lifespan as more or less accurate for the time, since the authors could gain nothing by lying. Thus I am reading the Bible here much as archaeologists look at a piece of pottery in an ancient granary marked with the word for 'corn' and take that as evidence that the granary once stored corn.

[Mr Skeptic]

It's true that medicine has not been able to do much/anything to raise maximum life expectancy. For now the best we have for that is to live at near starvation, preferably in a sterile environment (see the Metusaleh mouse project). However, we have done wonders at increasing average life expectancy. Childbirth was a major killer of women back in the day. Infant mortality was rampant. This despite their living a much healthier lifestyle (other than hygiene).

[Cap'n Refsmmat]

Also, the Biblical life expectancy claims do not coincide with archaeological evidence.

 

http://www.utexas.edu/depts/classics/documents/Life.html

 

http://www.reshafim.org.il/ad/egypt/people/index.html

 

http://anthro.palomar.edu/homo2/mod_homo_3.htm

 

All of these support the idea that the average life expectancy in ancient times was perhaps 20 or 30. A larger proportion of deaths at the time were due to violent causes as well.

[nec209]

Wrong alot of people could not live past age 35. The medine in the medieval time was worse than being crude it was superstition and religious .Well science and medical knowledge was surprised by the church.And anyone trying to do science or medical research was a taboo.If the church did not get in the way and people where not so superstition we would be more advance today.

 

 

That may say it again there is no cure for cancer or organs going bad because it is a cellular problem.No drug exit or the know how to manipulate anything at a cellular level.

 

Well infectious disease are not profitable for the drug companies now.There is not going to be much prograss in the future to there is more of a understand of the cellular level and how to manipulate things at the cellular level or how to tell cells what to do.

[Marat]

I don't see anything in your data to make me change my views that the gains in life expectancy in the modern world were due to factors having nothing to do with advanced medical science. Improved hygiene, better nutrition, clearing of swamps and the decline of malaria, reduction in infant mortality and puerperal fever, were the truly significant causes of today's improved lifespans. The data you provide on the lifespan at various ages in the Roman Empire confirm rather than refute my hypothesis, since they show that in Ancient Rome people who made it to 70 were likely to live to be 75, those living to 65 were likely to make it to 73, those living to 60 were likely to survive to 70, and those making it to 55 were also likely to live to 70. This shows that once infant mortality, early infections, and childbirth-associated deaths were taken out of the equation, the life expectancies reached without any advanced medicine were close to those found today, suggesting that modern medicine has not achieved very much.

[nec209]

I don't see anything in your data to make me change my views that the gains in life expectancy in the modern world were due to factors having nothing to do with advanced medical science. Improved hygiene, better nutrition, clearing of swamps and the decline of malaria, reduction in infant mortality and puerperal fever, were the truly significant causes of today's improved lifespans. The data you provide on the lifespan at various ages in the Roman Empire confirm rather than refute my hypothesis, since they show that in Ancient Rome people who made it to 70 were likely to live to be 75, those living to 65 were likely to make it to 73, those living to 60 were likely to survive to 70, and those making it to 55 were also likely to live to 70. This shows that once infant mortality, early infections, and childbirth-associated deaths were taken out of the equation, the life expectancies reached without any advanced medicine were close to those found today, suggesting that modern medicine has not achieved very much.

 

 

Read my other thread why there is no cure for cancer and most likely will not be with today's technology. Well organs going bad is a problem at a cellular level and because it is a cellular problem.No drug exit or the know how to manipulate anything at a cellular level.And transplants are the only option.

 

In the future 100 or 150 years artificial organs may be a reality.It is too crude now and a very very very long ways off to a prototype.

 

I hear that some doctors think in 50 years we can use pig organs for transplant.

Edited August 11, 2010 by nec209

[Marat]

I agree with you that anticipated improvements in medicine, the media reports of which have misled many people into thinking we are on the verge of great progress, will only materialize in the distant future, if ever.

 

The whole field of organ transplantation is severely limited by two constraints: first, the percentage of humans dying in circumstances in which their organs can be harvested in time for their organs to be transplantable is extremely small, and second, the drugs which have to be used to suppress the immune system in order to make plansplants function are often more toxic than the diseases they are designed to treat.

 

Trying to compensate for the first problem with animal transplants faces the problem of hyperacute rejection, since the tissues of animals are so foreign to the human immune system that no drug regimen can effectively suppress the rejection process.

 

However, we already have one form of animal-to-human transplant available, which is the implantation of animal cells in humans after the cells have been immunologically isolated by being put in capsules which allow the desired hormones to escape from the cells but which keep out the immunologically active cells which could destroy them. This is now being done by the Living Cell Technolgies company, which is implanting porcine pancreatic islet cells encased in capsules into the abdomen of human diabetics to improve their blood sugar control without having to use immunosuppressive drugs.

[Mr Skeptic]

Another option for transplants is to take an animal organ, strip it of the cells while leaving the appropriately shaped extracellular matrix (made of collagen, which is perfectly compatible), seeding it with human cells, and growing your own organ.