Author Topic: Episode 705  (Read 3904 times)

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Offline Steven Novella

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Episode 705
« on: January 12, 2019, 11:41:56 AM »
Forgotten Superheroes of Science: Nancy Grace Roman; News Items: Face Scanning for Disease, Cancer Stats and Crowdfunding Quackery, Cleaning Up Ocean Trash, Butterfly Decline, When Galaxies Collide; Who’s That Noisy; Your Questions and E-mails: Alpha Go Correction, CIA Follow Up; Science or Fiction
Steven Novella
Host, The Skeptics Guide
snovella@theness.com

Offline 2397

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Re: Episode 705
« Reply #1 on: January 12, 2019, 01:52:18 PM »
Sometimes it sucks to have the same name as more well-known people.

Online bachfiend

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Re: Episode 705
« Reply #2 on: January 12, 2019, 06:06:14 PM »
I have nothing but admiration for a person who managed to reach early adult life without knowing about ‘Spider-Man.’  I think it’s a sign of good use of time.  I saw the 2002 film.  I wish I hadn’t.  I hated it.
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Offline Friendly Angel

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Re: Episode 705
« Reply #3 on: January 12, 2019, 08:11:09 PM »
Steve said there have been fewer colon cancers because of more colonoscopies.  Was this a slip?  Or do colonoscopies prevent cancer?  By removal of precancerous polyps or something.
Amend and resubmit.

Online bachfiend

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Re: Episode 705
« Reply #4 on: January 12, 2019, 08:25:23 PM »
Steve said there have been fewer colon cancers because of more colonoscopies.  Was this a slip?  Or do colonoscopies prevent cancer?  By removal of precancerous polyps or something.

Yes, by removing precancerous and even cancerous polyps.  I used to be an anatomical pathologist before I retired.  It wasn’t unusual to see an early invasive cancer at the tip of submitted polyps just invading the submucosa (which is the earliest time at which there’s the possibility of metastasis (spread) elsewhere (cancer confined to the mucosa without invasion doesn’t spread).  Many endoscopists diathermy small polyps without submitting them for histology, so it’s possible that they may also be treating early cancers without knowing it.

The earlier you can treat a cancer, the less chance that it will spread and kill, which should improve life expectancy.  Unless the treatment has significant morbidity and mortality.  Colonoscopy for polyps and very early cancers is generally a benign procedure (you might have second thoughts in a very elderly frail person).  Prostatectomy for early cancers ‘detected’ by PSA ‘screening’ is another matter.
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Offline Friendly Angel

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Re: Episode 705
« Reply #5 on: January 12, 2019, 08:41:15 PM »
Steve said there have been fewer colon cancers because of more colonoscopies.  Was this a slip?  Or do colonoscopies prevent cancer?  By removal of precancerous polyps or something.

Yes, by removing precancerous and even cancerous polyps.  I used to be an anatomical pathologist before I retired.  It wasn’t unusual to see an early invasive cancer at the tip of submitted polyps just invading the submucosa (which is the earliest time at which there’s the possibility of metastasis (spread) elsewhere (cancer confined to the mucosa without invasion doesn’t spread).  Many endoscopists diathermy small polyps without submitting them for histology, so it’s possible that they may also be treating early cancers without knowing it.

The earlier you can treat a cancer, the less chance that it will spread and kill, which should improve life expectancy.  Unless the treatment has significant morbidity and mortality.  Colonoscopy for polyps and very early cancers is generally a benign procedure (you might have second thoughts in a very elderly frail person).  Prostatectomy for early cancers ‘detected’ by PSA ‘screening’ is another matter.


OK, but the statement was not about morbidity or life expectancy, it was about preventing cancer, which I took to mean fewer diagnoses of cancer (fewer lung cancers from less smoking, fewer colon cancers from more colonoscopies).   If they remove a cancerous polyp, the person had cancer and it wasn't prevented, even if it was completely cured or prevented from metastasizing.  Unless you're saying that a cancerous polyp in the submucosa is not sufficient for a diagnosis of cancer.
Amend and resubmit.

Offline stands2reason

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Re: Episode 705
« Reply #6 on: January 12, 2019, 09:02:05 PM »
Welcome to L.A., where you can see the whole city burning 'cause the podcasters got Uzis and the alt-meds keep serving.


Offline Soldier of FORTRAN

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Re: Episode 705
« Reply #7 on: January 12, 2019, 09:21:03 PM »
If I owned, I would plant a butterfly garden.
If global warming is real then how come I just felt this chill down my spine?

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Re: Episode 705
« Reply #8 on: January 12, 2019, 09:23:20 PM »
Steve said there have been fewer colon cancers because of more colonoscopies.  Was this a slip?  Or do colonoscopies prevent cancer?  By removal of precancerous polyps or something.

Yes, by removing precancerous and even cancerous polyps.  I used to be an anatomical pathologist before I retired.  It wasn’t unusual to see an early invasive cancer at the tip of submitted polyps just invading the submucosa (which is the earliest time at which there’s the possibility of metastasis (spread) elsewhere (cancer confined to the mucosa without invasion doesn’t spread).  Many endoscopists diathermy small polyps without submitting them for histology, so it’s possible that they may also be treating early cancers without knowing it.

The earlier you can treat a cancer, the less chance that it will spread and kill, which should improve life expectancy.  Unless the treatment has significant morbidity and mortality.  Colonoscopy for polyps and very early cancers is generally a benign procedure (you might have second thoughts in a very elderly frail person).  Prostatectomy for early cancers ‘detected’ by PSA ‘screening’ is another matter.


OK, but the statement was not about morbidity or life expectancy, it was about preventing cancer, which I took to mean fewer diagnoses of cancer (fewer lung cancers from less smoking, fewer colon cancers from more colonoscopies).   If they remove a cancerous polyp, the person had cancer and it wasn't prevented, even if it was completely cured or prevented from metastasizing.  Unless you're saying that a cancerous polyp in the submucosa is not sufficient for a diagnosis of cancer.

Polyps (actually adenomatous polyps) are precancerous, so if you remove the precancerous polyps, you’re reducing the later incidence of cancer.  And some early cancers are inadvertently removed without realising it, even if they’re examined histologically.  A small 5 millimetre polyp would require 1000 sections to examine the entire polyp.  It’s always possible that in small polyps there might already be early invasive cancer present which was missed (not a bad result, since early invasive cancers have a good outlook).
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Online bachfiend

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Re: Episode 705
« Reply #9 on: January 12, 2019, 09:33:50 PM »
If I owned, I would plant a butterfly garden.

You’d be in good company.  I recently read Andrew Roberts’ biography of Winston Churchill ‘Walking with Destiny.’  Churchill was a keen butterfly cultivator.  It’s reported that in the region surrounding Chartwell, his country home, there was an unusual increase in butterflies.  Churchill loved butterflies (and painting.  And bricklaying.  And writing.  He was a pretty incredible character).

One of the amusing comments in the book was the result of a survey of 15 year old British school children carried out recently, which showed that 20% thought that Winston Churchill was a fictional character.  And around 50% thought Sherlock Holmes and Eleanor Rigby were historical characters.  Sigh...
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Offline Soldier of FORTRAN

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Re: Episode 705
« Reply #10 on: January 12, 2019, 09:37:34 PM »
Just got to the CIA commentary.  Intelligence Analysis is its own thing.  The rhetorical focus should be on analysis. 

The CIA has a complicated reputation and a long, storied history of unfortunate, bizarre chicanery.  Not sure how much overemphasizing their brand would help 'Analysis Chat'

One of the amusing comments in the book was the result of a survey of 15 year old British school children carried out recently, which showed that 20% thought that Winston Churchill was a fictional character.  And around 50% thought Sherlock Holmes and Eleanor Rigby were historical characters.

Ha, I'll forgive them this bit of wishful thinking
« Last Edit: January 12, 2019, 09:39:52 PM by Soldier of FORTRAN »
If global warming is real then how come I just felt this chill down my spine?

Online brilligtove

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Re: Episode 705
« Reply #11 on: January 12, 2019, 11:31:16 PM »
The patreon version has the ad in it.
evidence trumps experience | performance over perfection | responsibility – authority = scapegoat | emotions motivate; data doesn't

Offline fuzzyMarmot

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Re: Episode 705
« Reply #12 on: January 13, 2019, 12:59:28 AM »

One of the amusing comments in the book was the result of a survey of 15 year old British school children carried out recently, which showed that 20% thought that Winston Churchill was a fictional character.  And around 50% thought Sherlock Holmes and Eleanor Rigby were historical characters.  Sigh...

Given the level of hagiography surrounding Churchill, those 20% might have a point.

Online bachfiend

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Re: Episode 705
« Reply #13 on: January 13, 2019, 03:00:27 AM »

One of the amusing comments in the book was the result of a survey of 15 year old British school children carried out recently, which showed that 20% thought that Winston Churchill was a fictional character.  And around 50% thought Sherlock Holmes and Eleanor Rigby were historical characters.  Sigh...

Given the level of hagiography surrounding Churchill, those 20% might have a point.

Winston Churchill was wrong many times.  He was right once when he recognised that Hitler was truly evil in the mid ‘30s, and that one correct judgement outweighed all the mistakes he made.  It’s also been said that all politicians make mistakes many times.  Successful politicians make each mistake just once.
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Offline 2397

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Re: Episode 705
« Reply #14 on: January 13, 2019, 03:57:59 AM »
Maybe it outweighed his mistakes, but Churchill's deliberate actions and sanctioning of crimes against humanity don't become acceptable because someone else was doing worse.

 

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