Malignant: How Bad Policy and Bad Evidence Harm People with Cancer is a nonfiction book by Vinay Prasad, published in 2020 by Johns Hopkins University Press. [1]
Malignant: How Bad Policy and Bad Evidence Harm People with Cancer is a nonfiction book by Vinay Prasad, published in 2020 by Johns Hopkins University Press. [1]
The book delves into cancer policy, oncological drug regulation, and clinical trial design, examining how many marginal and unproven cancer therapies are pushed to market on the basis of hype and bias.[ citation needed ]
According to Benjamin Chin Yee, who wrote an in-depth review of Malignant, "Prasad does not shy away from controversy, and lays out his argument in lucid, readable prose." [2] Tahla Burki writes in the Lancet Haematology , "Prasad outlines how the US Food and Drug Administration (FDA) approves cancer therapies on the basis of arbitrarily assigned surrogate endpoints that typically have no bearing on overall survival or quality of life. He examines how a complex web of conflicts-of-interests pollutes policy debates and expert recommendations, and how studies ask irrelevant questions in unrepresentative patient populations." [3] Prasad has appeared on many podcasts to discuss Malignant, such as EconTalk with Russ Roberts [4] and Oncology Overdrive with Shikha Jain. [4] These discussions examine the current state of cancer policy and the ways in which physicians and patients can benefit from appropriate solutions.
Multiple myeloma (MM), also known as plasma cell myeloma and simply myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. Often, no symptoms are noticed initially. As it progresses, bone pain, anemia, kidney dysfunction, and infections may occur. Complications may include hypercalcemia and amyloidosis.
A biopsy is a medical test commonly performed by a surgeon, an interventional radiologist, or an interventional cardiologist. The process involves the extraction of sample cells or tissues for examination to determine the presence or extent of a disease. The tissue is then fixed, dehydrated, embedded, sectioned, stained and mounted before it is generally examined under a microscope by a pathologist; it may also be analyzed chemically. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. An incisional biopsy or core biopsy samples a portion of the abnormal tissue without attempting to remove the entire lesion or tumor. When a sample of tissue or fluid is removed with a needle in such a way that cells are removed without preserving the histological architecture of the tissue cells, the procedure is called a needle aspiration biopsy. Biopsies are most commonly performed for insight into possible cancerous or inflammatory conditions.
Malignancy is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer.
Melanoma is the most dangerous type of skin cancer; it develops from the melanin-producing cells known as melanocytes. It typically occurs in the skin, but may rarely occur in the mouth, intestines, or eye. In women, melanomas most commonly occur on the legs; while in men, on the back. Melanoma is frequently referred to as malignant melanoma. However, the medical community stresses that there is no such thing as a 'benign melanoma' and recommends that the term 'malignant melanoma' should be avoided as redundant.
Small-cell carcinoma is a type of highly malignant cancer that most commonly arises within the lung, although it can occasionally arise in other body sites, such as the cervix, prostate, and gastrointestinal tract. Compared to non-small cell carcinoma, small cell carcinoma is more aggressive, with a shorter doubling time, higher growth fraction, and earlier development of metastases.
Glioblastoma, previously known as glioblastoma multiforme (GBM), is the most aggressive and most common type of cancer that originates in the brain, and has very poor prognosis for survival. Initial signs and symptoms of glioblastoma are nonspecific. They may include headaches, personality changes, nausea, and symptoms similar to those of a stroke. Symptoms often worsen rapidly and may progress to unconsciousness.
Pemetrexed, sold under the brand name Alimta among others, is a chemotherapy medication for the treatment of pleural mesothelioma and non-small cell lung cancer (NSCLC)..
Myeloproliferative neoplasms (MPNs) are a group of rare blood cancers in which excess red blood cells, white blood cells or platelets are produced in the bone marrow. Myelo refers to the bone marrow, proliferative describes the rapid growth of blood cells and neoplasm describes that growth as abnormal and uncontrolled.
A leiomyosarcoma, also known as LMS, is a rare malignant (cancerous) smooth muscle tumor. The origin of the word is from leio- + myo- + sarcoma which means malignant smooth muscle tumor. The stomach, bladder, uterus, blood vessels, and intestines are examples of hollow organs made up of smooth muscles where LMS can be located; however, the uterus or abdomen are the most common sites.
Ramucirumab is a fully human monoclonal antibody (IgG1) developed for the treatment of solid tumors. This drug was developed by ImClone Systems Inc. It was isolated from a native phage display library from Dyax.
Oncology is a branch of medicine that deals with the study, treatment, diagnosis, and prevention of cancer. A medical professional who practices oncology is an oncologist. The name's etymological origin is the Greek word ὄγκος (ónkos), meaning "tumor", "volume" or "mass". Oncology is concerned with:
Treatment of lung cancer refers to the use of medical therapies, such as surgery, radiation, chemotherapy, immunotherapy, percutaneous ablation, and palliative care, alone or in combination, in an attempt to cure or lessen the adverse impact of malignant neoplasms originating in lung tissue.
A cancer biomarker refers to a substance or process that is indicative of the presence of cancer in the body. A biomarker may be a molecule secreted by a tumor or a specific response of the body to the presence of cancer. Genetic, epigenetic, proteomic, glycomic, and imaging biomarkers can be used for cancer diagnosis, prognosis, and epidemiology. Ideally, such biomarkers can be assayed in non-invasively collected biofluids like blood or serum.
An osteolytic lesion is a softened section of a patient's bone formed as a symptom of specific diseases, including breast cancer and multiple myeloma. This softened area appears as a hole on X-ray scans due to decreased bone density, although many other diseases are associated with this symptom. Osteolytic lesions can cause pain, increased risk of bone fracture, and spinal cord compression. These lesions can be treated using biophosphonates or radiation, though new solutions are being tested in clinical trials.
Vinayak K. Prasad is an American hematologist-oncologist and health researcher. He is a professor of Epidemiology and Biostatistics at the University of California, San Francisco (UCSF). He is the author of the books Ending Medical Reversal (2015) and Malignant (2020).
Selinexor sold under the brand name Xpovio among others, is a selective inhibitor of nuclear export used as an anti-cancer medication. It works by blocking the action of exportin 1 and thus blocking the transport of several proteins involved in cancer-cell growth from the cell nucleus to the cytoplasm, which ultimately arrests the cell cycle and leads to apoptosis. It is the first drug with this mechanism of action.
Cancer is one of the underlying diseases that increases the risk of COVID-19 developing to a serious illness.
Justin Stebbing is Editor-in-Chief of Nature’s cancer journal Oncogene, a visiting Professor of Cancer Medicine and Oncology at Imperial College, London and a Professor of Biomedical Sciences at ARU, Cambridge. He works at the Phoenix Hospital Group in London to provide medical services to patients for the management of cancer, in person and remotely. He specialises in a range of solid malignancies including difficult cases with few conventional options and has published over 700 papers, the majority regarding new therapeutic and translational approaches including use of immunotherapies in clinical trials, many in the world's best journals.
Voxtalisib is a drug which acts as a dual inhibitor of the kinase enzymes phosphatidylinositol 3-kinase (PI3K) and mechanistic target of rapamycin (mTOR). It is in clinical trials for the treatment of various types of cancer.
Bisantrene is an anthracenyl bishydrazone with anthracycline-like antineoplastic activity and an antimetabolite. Bisantrene intercalates with and disrupts the configuration of DNA, resulting in DNA single-strand breaks, DNA-protein crosslinking, and inhibition of DNA replication. This agent is similar to doxorubicin in chemotherapeutic activity, but unlike anthracyclines like doxorubicin, it exhibits little cardiotoxicity.