Clinical trials in hospital. Who gets the money?

2 years ago, I made it clear that I was particularly interested in a
specific common treatment, IL-2 for my stage 4 kidney cancer. My
oncologist told me it wasn't common in Europe, although it is a
treatment of choice in the USA. It wasn't something that he could
offer me. He suggested that I might be interested in a clinical trial
comparing IL2 + 5FU with interferon alone. I accepted that but
unfortunately got the interferon alone arm. After that had all been
set up, a couple of days before I was due to start, he told me that I
could have received the high dose IL2 treatment I wanted at their
nearbye sister hospital. But I thought it was too late to start
again.
I feel I was misled although it is possible he didn't know that IL2
might be available anywhere in the UK.

I wonder if it was to do with budgets and finance. When the hospital
recruits a patient to a clinical trial on behalf of some drug company,
what does the hospital get out of it?

Tony

wrote in alt.support.cancer:

> 2 years ago, I made it clear that I was particularly interested in a
> specific common treatment, IL-2 for my stage 4 kidney cancer. My
> oncologist told me it wasn't common in Europe, although it is a
> treatment of choice in the USA. It wasn't something that he could
> offer me. He suggested that I might be interested in a clinical trial
> comparing IL2 + 5FU with interferon alone. I accepted that but
> unfortunately got the interferon alone arm. After that had all been
> set up, a couple of days before I was due to start, he told me that I
> could have received the high dose IL2 treatment I wanted at their
> nearbye sister hospital. But I thought it was too late to start
> again.
> I feel I was misled although it is possible he didn't know that IL2
> might be available anywhere in the UK.
>
> I wonder if it was to do with budgets and finance. When the hospital
> recruits a patient to a clinical trial on behalf of some drug company,
> what does the hospital get out of it?
>
> Tony

You have to ask a lot of questions. You won't be offered anything if you
don't ask. If you are on the NHS then you need to view the health system
as a whole when it comes to financing. It's a similar situation in
Australia where I am. I have done four clinical trials. A lot of the
trials are done at teaching hospitals. If the particular hospital you
visit is not a big teaching hospital then it's likely you can miss out on
drugs because they're not being researched at your hospital. You have to
do a lot of research yourself and don't rely on your oncologist knowing
what is available and when. If he hasn't treated someone with your type
of cancer for a while it is likely he might not know what is available.
He'll tell you one thing then ask around and find out more. It's not
really a case of deliberately misleading you, it's more a case of
information coming up at certain times and trials being available at
certain times etc.

I wasn't offered IL-2 either even though it's a common treatment for
melanoma. I don't know whether the govt views it as marginal (ie. it
doesn't work) or it's just too expensive. For melanoma I think it's the
former, there is not enough proof that it works.

All the same I feel I have been misled a number of times. 3 months ago I
was told there was nothing available. I was referred to a doctor who told
me to come and see him in 3 months time. He said he would have two trials
available. In the intervening 3 months I rang his trials nurse and she
told me she had no idea why I was told there were trials available
because there weren't. Now he has sent me back to the doctor who referred
me to him 3 months ago. In those 3 months I've had no treatment
whatsoever.

This happens because I am a nice patient. I do what I'm told. My appts
are always short. I am softly spoken because I'm big and I don't want
people to feel intimidated. I think there is definitely something in me
being male too. I am in no doubt whatsoever that women get better
treatment. I've seen it so many times it can't be a coincidence. I talk
to women who get offered treatments I don't get offered. This probably
happens because we (males) are not good advocates for ourselves.

Ask questions. Be a good advocate for yourself. Do your own research and
don't rely on anyone telling you anything. Don't think you'll get the
best treatment if you just go with the flow and do what your told when
your told. I did, and it didn't work.

tonyjeffs2@googlemail.com wrote:

> 2 years ago, I made it clear that I was particularly interested in a
> specific common treatment, IL-2 for my stage 4 kidney cancer. My
> oncologist told me it wasn't common in Europe, although it is a
> treatment of choice in the USA. It wasn't something that he could
> offer me. He suggested that I might be interested in a clinical trial
> comparing IL2 + 5FU with interferon alone. I accepted that but
> unfortunately got the interferon alone arm. After that had all been
> set up, a couple of days before I was due to start, he told me that I
> could have received the high dose IL2 treatment I wanted at their
> nearbye sister hospital. But I thought it was too late to start
> again.
> I feel I was misled although it is possible he didn't know that IL2
> might be available anywhere in the UK.
>
> I wonder if it was to do with budgets and finance. When the hospital
> recruits a patient to a clinical trial on behalf of some drug company,
> what does the hospital get out of it?

Hello Tony,
Am I glad to see you! I was worried since we hadn't heard.
I would put another conjecture to you.
Are you alone in life or wife in ill health?
IL-2 side effects can be very severe.
I think I read that there's support staff lacking in UK.

A man from Russia was on it, at first he was able to continue his daily
walks, but as time went by, he was mostly bedridden and had his son and
wife to care for him. I think that Steve Dunn spent the better part of a
year in hospital.
So I offer the theory that Americans with good insurance plans can afford
to, but those who don't have home health care, are better off not trying
it, because they don't have enough staff and beds for long-term hospital.
He was younger than you and i think came close to dying, trying and as
best I can tell from others who've tried, gained very little in extra
time.

Sorry, I don't have the answer to your questions, but again, am glad to
hear from you.
Watch for possible replies from Steph or others.
J

jacques wrote:

> wrote in alt.support.cancer:
>
> > 2 years ago, I made it clear that I was particularly interested in a
> > specific common treatment, IL-2 for my stage 4 kidney cancer. My
> > oncologist told me it wasn't common in Europe, although it is a
> > treatment of choice in the USA. It wasn't something that he could
> > offer me. He suggested that I might be interested in a clinical trial
> > comparing IL2 + 5FU with interferon alone. I accepted that but
> > unfortunately got the interferon alone arm. After that had all been
> > set up, a couple of days before I was due to start, he told me that I
> > could have received the high dose IL2 treatment I wanted at their
> > nearbye sister hospital. But I thought it was too late to start
> > again.
> > I feel I was misled although it is possible he didn't know that IL2
> > might be available anywhere in the UK.
> >
> > I wonder if it was to do with budgets and finance. When the hospital
> > recruits a patient to a clinical trial on behalf of some drug company,
> > what does the hospital get out of it?
> >
> > Tony
>
> You have to ask a lot of questions. You won't be offered anything if you
> don't ask. If you are on the NHS then you need to view the health system
> as a whole when it comes to financing. It's a similar situation in
> Australia where I am. I have done four clinical trials. A lot of the
> trials are done at teaching hospitals. If the particular hospital you
> visit is not a big teaching hospital then it's likely you can miss out on
> drugs because they're not being researched at your hospital. You have to
> do a lot of research yourself and don't rely on your oncologist knowing
> what is available and when. If he hasn't treated someone with your type
> of cancer for a while it is likely he might not know what is available.
> He'll tell you one thing then ask around and find out more. It's not
> really a case of deliberately misleading you, it's more a case of
> information coming up at certain times and trials being available at
> certain times etc.

I suppose he could search clinical trials.
I just did using kidney OR solid OR renal | Open Studies | Interventional
Studies | cancer | United Kingdom | Adult
Found 48 studies.
Here's one.
http://clinicaltrials.gov/ct2/show/NCT00420888
Drug: ABR-217620, naptumomab estafenatox
Drug: IFN-alpha
Phase II
Phase III
3 UK locations, 2 recruiting.

The 48 unfortunately pick up "kidney" under the conditions (ruled in or out),
so he has to print a copy of the search results. Then cross off the obvious
"does not apply". Then look at each of the others and see which apply that he
could get to. I picked out age 18-65. There's a selection for older persons.
I did not specify Phase, so it picked them all up.
Before refining the search I got 501 studies and 3601 studies.
The 48 I got do not include "Expanded Access" and those that might be in
there, but "not yet recruiting".
He could refine it further by picking the phases, for instance, excluding
Phase I and IV, so checking off II and III
And adding age "Senior" That gets me 27
That was standard, detailled search.
There's also an "expert" (at databases) search.


This one's Sutent http://clinicaltrials.gov/ct2/show/NCT00130897

J wrote:

> I suppose he could search clinical trials.
> I just did using kidney OR solid OR renal | Open Studies | Interventional
> Studies | cancer | United Kingdom | Adult
> Found 48 studies.
> Here's one.
> http://clinicaltrials.gov/ct2/show/NCT00420888
> Drug: ABR-217620, naptumomab estafenatox
> Drug: IFN-alpha
> Phase II
> Phase III
> 3 UK locations, 2 recruiting.
>
> The 48 unfortunately pick up "kidney" under the conditions (ruled in or out),
> so he has to print a copy of the search results. Then cross off the obvious
> "does not apply". Then look at each of the others and see which apply that he
> could get to. I picked out age 18-65. There's a selection for older persons.
> I did not specify Phase, so it picked them all up.
> Before refining the search I got 501 studies and 3601 studies.
> The 48 I got do not include "Expanded Access" and those that might be in
> there, but "not yet recruiting".
> He could refine it further by picking the phases, for instance, excluding
> Phase I and IV, so checking off II and III
> And adding age "Senior" That gets me 27
> That was standard, detailled search.
> There's also an "expert" (at databases) search.
>
> This one's Sutent http://clinicaltrials.gov/ct2/show/NCT00130897

Whoops I wasn't finished.
http://clinicaltrials.gov/ct2/show/NCT00523159
This one's in 3 UK locations and 1 Glasgow, but not yet recruiting.
There might be a few more.
J

Hi J,
I've been kinda well, hence absence :-)
I think IL-2 is the only treatment I'd consider. It does have a track
record of success, even if the percentage is small. I know people
who've had their tumors vanish with it. Even though it is possibly,
like Jaques mentions, not enough to be statistically significant, I
think I can tell the difference between a mass placebo effect, and
actual successes. So for me it's IL-2 or nothing. I'm trying to
talk myself into taking the plunge. I can actually imagine how
horrible it'll be, based on my experience of interferon-A, but it is
all part of life's rich tapestry of experiences.

What i'd ideally like is cryo on my big tumors beforehand, and IL-2
to finish the job, if it works on me. But I don't think they'll agree
to that.

Jaques,
Thanks for your ideas. I am going to tell my original oncologist that
I think he should have told me sooner about the other hospital
providing IL-2. I'll find a way to do it without yelling at him or
embarrassing him. I just want him to know. I suspect he is under
constant pressure from above to manage the budgets.

I think that if you have reason to believe IL-2 will help you, you
should use your muscle, or rather, say calmly. "Can you offer me this
treatment; if not where can I get it?" which is what I should have
done in the first place.

Regards
Tony.

tonyjeffs2@googlemail.com wrote:

> Hi J,
> I've been kinda well, hence absence :-)
> I think IL-2 is the only treatment I'd consider. It does have a track
> record of success, even if the percentage is small. I know people
> who've had their tumors vanish with it. Even though it is possibly,
> like Jaques mentions, not enough to be statistically significant, I
> think I can tell the difference between a mass placebo effect, and
> actual successes. So for me it's IL-2 or nothing. I'm trying to
> talk myself into taking the plunge. I can actually imagine how
> horrible it'll be, based on my experience of interferon-A, but it is
> all part of life's rich tapestry of experiences.
>
> What i'd ideally like is cryo on my big tumors beforehand, and IL-2
> to finish the job, if it works on me. But I don't think they'll agree
> to that.
>
> Jaques,
> Thanks for your ideas. I am going to tell my original oncologist that
> I think he should have told me sooner about the other hospital
> providing IL-2. I'll find a way to do it without yelling at him or
> embarrassing him. I just want him to know. I suspect he is under
> constant pressure from above to manage the budgets.
>
> I think that if you have reason to believe IL-2 will help you, you
> should use your muscle, or rather, say calmly. "Can you offer me this
> treatment; if not where can I get it?" which is what I should have
> done in the first place.

Hello Tony and Jacques,
How are you each making out with your seeking treatments / clinical
trials?
J

J wrote:
> tonyjeffs2@googlemail.com wrote:
>
>> Hi J,
>> I've been kinda well, hence absence :-)
>> I think IL-2 is the only treatment I'd consider. It does have a track
>> record of success, even if the percentage is small. I know people
>> who've had their tumors vanish with it. Even though it is possibly,
>> like Jaques mentions, not enough to be statistically significant, I
>> think I can tell the difference between a mass placebo effect, and
>> actual successes. So for me it's IL-2 or nothing. I'm trying to
>> talk myself into taking the plunge. I can actually imagine how
>> horrible it'll be, based on my experience of interferon-A, but it is
>> all part of life's rich tapestry of experiences.
>>
>> What i'd ideally like is cryo on my big tumors beforehand, and IL-2
>> to finish the job, if it works on me. But I don't think they'll agree
>> to that.
>>
>> Jaques,
>> Thanks for your ideas. I am going to tell my original oncologist that
>> I think he should have told me sooner about the other hospital
>> providing IL-2. I'll find a way to do it without yelling at him or
>> embarrassing him. I just want him to know. I suspect he is under
>> constant pressure from above to manage the budgets.
>>
>> I think that if you have reason to believe IL-2 will help you, you
>> should use your muscle, or rather, say calmly. "Can you offer me this
>> treatment; if not where can I get it?" which is what I should have
>> done in the first place.
>
> Hello Tony and Jacques,
> How are you each making out with your seeking treatments / clinical
> trials?
> J
>

Scans yesterday. Three times as many mets since September (when they
decided to stop the last treatment) and they are 3 times as big, some
even bigger. That is down to the almost 4 months with no treatment, and
treatment is still at least two weeks away.

jacques wrote:

> > Hello Tony and Jacques,
> > How are you each making out with your seeking treatments / clinical
> > trials?
>
> >
>
> Scans yesterday. Three times as many mets since September (when they
> decided to stop the last treatment) and they are 3 times as big, some
> even bigger. That is down to the almost 4 months with no treatment, and
> treatment is still at least two weeks away.

Hello Jacques,

I suppose one way of looking at it, is if you feel and see an impressive
response, after 2 or 3 treatments, it'll be worth continuing and if you
don't, you'll know when to quit or switch to something else.
Thanks for the info - I saw your other post.
Best of luck.
Keep in touch
J

Jacques wrote : "Scans yesterday. Three times as many mets since September
(when they
decided to stop the last treatment) and they are 3 times as big, some
even bigger. That is down to the almost 4 months with no treatment, and
treatment is still at least two weeks away."

Hi Jacques,

Of course your news is disturbing, and I wish it were in my power to say
something un-disturbing, or as useful as J.'s thoughtfully researched
responses to you. But I'll have to just say "hello" and send you my best
wishes. Your courage is obvious in your posts, a quality I admire greatly.

best, Uncle Sally

On 27 Nov, 08:45, J <nswex@nalid;non> wrote:

> Hello Tony and Jacques,
> How are you each making out with your seeking treatments / clinical
> trials?
> J- Hide quoted text -
>
> - Show quoted text -

Hi J
Well, I'm not going to consider any more clinical trials. I may do
IL-2, which if it works will shrink my lung tumors to nothingness, but
wont get rid of my larger tumors. If that happens, it'll be hard
psychologically to draw a line at partial success. I might not do it
at all because I know how unpleasant it will be, and because I think
it might make my tinnitus worse.
I originally did interferon, but stopped after 3 months because I
didn't believe in it, and because it was so unpleasant.
So I haven't done any treatment for 20 months. My tumors are very
slow growing.

Currently, I'm rather well so it seems a shame to plunge myself into
an abyss of chemicals.


Here's a quiz for you - it is a trick question for fun. Suppose I have
a spherical tumor, 10cm diamater. Suppose it grows by 1 cm to 11 cm
diameter. By what percentage has it grown. Your answer must be one
positive number with no words of explanation at all. What answer would
you give?

Tony

<tonyjeffs2@googlemail.com> wrote in message
news:5fd94013-1567-4045-9628-f32cb1a16ca7@e6g2000prf.googlegroups.com...
> On 27 Nov, 08:45, J <nswex@nalid;non> wrote:
>
>> Hello Tony and Jacques,
>> How are you each making out with your seeking treatments / clinical
>> trials?
>> J- Hide quoted text -
>>
>> - Show quoted text -
>
> Hi J
> Well, I'm not going to consider any more clinical trials. I may do
> IL-2, which if it works will shrink my lung tumors to nothingness, but
> wont get rid of my larger tumors. If that happens, it'll be hard
> psychologically to draw a line at partial success. I might not do it
> at all because I know how unpleasant it will be, and because I think
> it might make my tinnitus worse.
> I originally did interferon, but stopped after 3 months because I
> didn't believe in it, and because it was so unpleasant.
> So I haven't done any treatment for 20 months. My tumors are very
> slow growing.
>
> Currently, I'm rather well so it seems a shame to plunge myself into
> an abyss of chemicals.
>
>
> Here's a quiz for you - it is a trick question for fun. Suppose I have
> a spherical tumor, 10cm diamater. Suppose it grows by 1 cm to 11 cm
> diameter. By what percentage has it grown. Your answer must be one
> positive number with no words of explanation at all. What answer would
> you give?
>
> Tony
>
>
>
>
>

10%

On Nov 28, 3:19 pm, "betsyb" <betsy...@TRASHoptonline.net> wrote:
> <tonyjef...@googlemail.com> wrote in message
>
> news:5fd94013-1567-4045-9628-f32cb1a16ca7@e6g2000prf.googlegroups.com...
>
>
>
> > On 27 Nov, 08:45, J <nswex@nalid;non> wrote:
>
> >> Hello Tony and Jacques,
> >> How are you each making out with your seeking treatments / clinical
> >> trials?
> >> J- Hide quoted text -
>
> >> - Show quoted text -
>
> > Hi J
> > Well, I'm not going to consider any more clinical trials. I may do
> > IL-2, which if it works will shrink my lung tumors to nothingness, but
> > wont get rid of my larger tumors. If that happens, it'll be hard
> > psychologically to draw a line at partial success. I might not do it
> > at all because I know how unpleasant it will be, and because I think
> > it might make my tinnitus worse.
> > I originally did interferon, but stopped after 3 months because I
> > didn't believe in it, and because it was so unpleasant.
> > So I haven't done any treatment for 20 months. My tumors are very
> > slow growing.
>
> > Currently, I'm rather well so it seems a shame to plunge myself into
> > an abyss of chemicals.
>
> > Here's a quiz for you - it is a trick question for fun. Suppose I have
> > a spherical tumor, 10cm diamater. Suppose it grows by 1 cm to 11 cm
> > diameter. By what percentage has it grown. Your answer must be one
> > positive number with no words of explanation at all. What answer would
> > you give?
>
> > Tony
>
> 10%

33%
The answer isn't as meaningful without qualification/explanation, but
there it is.

---
CSM

csm7532@hotmail.com wrote:
> 33%
> The answer isn't as meaningful without qualification/explanation, but
> there it is.

It is surprising to most people how little change in diameter
is required to displace a lot more volume.

tonyjeffs2@googlemail.com wrote:
> Here's a quiz for you - it is a trick question for fun. Suppose I have
> a spherical tumor, 10cm diamater. Suppose it grows by 1 cm to 11 cm
> diameter. By what percentage has it grown. Your answer must be one
> positive number with no words of explanation at all. What answer would
> you give?

33%

Mark Jones wrote in alt.support.cancer:

> tonyjeffs2@googlemail.com wrote:
>> Here's a quiz for you - it is a trick question for fun. Suppose I have
>> a spherical tumor, 10cm diamater. Suppose it grows by 1 cm to 11 cm
>> diameter. By what percentage has it grown. Your answer must be one
>> positive number with no words of explanation at all. What answer would
>> you give?
>
> 33%

I had one jump from 25x21 to 70x55, you don't have to be a genius to work
out that even in two dimensions that is a 700%+ increase.

On Nov 28, 4:40 pm, jacques <n...@anywhere.atall.org> wrote:
> Mark Jones wrote in alt.support.cancer:
>
> > tonyjef...@googlemail.com wrote:
> >> Here's a quiz for you - it is a trick question for fun. Suppose I have
> >> a spherical tumor, 10cm diamater. Suppose it grows by 1 cm to 11 cm
> >> diameter. By what percentage has it grown. Your answer must be one
> >> positive number with no words of explanation at all. What answer would
> >> you give?
>
> > 33%
>
> I had one jump from 25x21 to 70x55, you don't have to be a genius to work
> out that even in two dimensions that is a 700%+ increase.

Or, to be pedantic, about a 633% increase. Given the linear
increases, it would most likely be about 20x its earlier volume and
mass. Yikes! May you never repeat *that* kind of achievement.
Mark's right, most people are surprised by how a small linear increase
makes for a large area increase, and even larger volume increase.
While we're on arithmetic, consider how a a tumor would be affected if
it kept going through cycles of growth & shrinkage, by the same
percentage each time.

wrote in alt.support.cancer:

> On Nov 28, 4:40 pm, jacques <n...@anywhere.atall.org> wrote:
>> Mark Jones wrote in alt.support.cancer:
>>
>> > tonyjef...@googlemail.com wrote:
>> >> Here's a quiz for you - it is a trick question for fun. Suppose I
>> >> have a spherical tumor, 10cm diamater. Suppose it grows by 1 cm
>> >> to 11 cm diameter. By what percentage has it grown. Your answer
>> >> must be one positive number with no words of explanation at all.
>> >> What answer would you give?
>>
>> > 33%
>>
>> I had one jump from 25x21 to 70x55, you don't have to be a genius to
>> work out that even in two dimensions that is a 700%+ increase.
>
> Or, to be pedantic, about a 633% increase.

OK, we've safely established that I'm not a genius :-)

> Given the linear
> increases, it would most likely be about 20x its earlier volume and
> mass. Yikes! May you never repeat *that* kind of achievement.

Comes from no treatment for 4 months I hope. I suspect I'll get some
treatment over christmas, maybe 3 or 4 cycles, then they'll refer me to
palliative care. Don't take that to mean I have given up. Just looking at
it from a real;istic perspective. I could have given up 4 months ago when
they told me to. Never.

> Mark's right, most people are surprised by how a small linear increase
> makes for a large area increase, and even larger volume increase.
> While we're on arithmetic, consider how a a tumor would be affected if
> it kept going through cycles of growth & shrinkage, by the same
> percentage each time.

Happens. I've been on 4 (or5???) clinical trials. There has always been
an initial level of shrink then regrowth, except for the last time. That
stuff didn't work at all.

<tonyjeffs2@googlemail.com> wrote in message
news:5fd94013-1567-4045-9628-f32cb1a16ca7@e6g2000prf.googlegroups.com...
> On 27 Nov, 08:45, J <nswex@nalid;non> wrote:
>
>> Hello Tony and Jacques,
>> How are you each making out with your seeking treatments / clinical
>> trials?
>> J- Hide quoted text -
>>
>> - Show quoted text -
>
> Hi J
> Well, I'm not going to consider any more clinical trials. I may do
> IL-2, which if it works will shrink my lung tumors to nothingness, but
> wont get rid of my larger tumors. If that happens, it'll be hard
> psychologically to draw a line at partial success. I might not do it
> at all because I know how unpleasant it will be, and because I think
> it might make my tinnitus worse.
> I originally did interferon, but stopped after 3 months because I
> didn't believe in it, and because it was so unpleasant.
> So I haven't done any treatment for 20 months. My tumors are very
> slow growing.
>
> Currently, I'm rather well so it seems a shame to plunge myself into
> an abyss of chemicals.
>
>
> Here's a quiz for you - it is a trick question for fun. Suppose I have
> a spherical tumor, 10cm diamater. Suppose it grows by 1 cm to 11 cm
> diameter. By what percentage has it grown. Your answer must be one
> positive number with no words of explanation at all. What answer would
> you give?
>
> Tony
>
>
>
>
>

33%

tonyjeffs2@googlemail.com wrote:

> Hi J
> Well, I'm not going to consider any more clinical trials. I may do
> IL-2, which if it works will shrink my lung tumors to nothingness, but
> wont get rid of my larger tumors. If that happens, it'll be hard
> psychologically to draw a line at partial success. I might not do it
> at all because I know how unpleasant it will be, and because I think
> it might make my tinnitus worse.
> I originally did interferon, but stopped after 3 months because I
> didn't believe in it, and because it was so unpleasant.
> So I haven't done any treatment for 20 months. My tumors are very
> slow growing.
>
> Currently, I'm rather well so it seems a shame to plunge myself into
> an abyss of chemicals.

True, Tony.

Did I ever post this for you? http://www.kcuk.org/
It's got a petition there. Also a forum where they've got treatment
topics.

I hope you don't go away from here - it just seems to be a good place for
you to keep in touch with what's happening in UK for kidney cancer. Some
of them probably also keep abreast of what's happening in new medicines in
other countries. So Keep an eye on things.
Best
J

On Wed, 28 Nov 2007 17:26:57 -0600, "Mark Jones"
<noemail@mindspring.com> wrote:

>tonyjeffs2@googlemail.com wrote:
>> Here's a quiz for you - it is a trick question for fun. Suppose I have
>> a spherical tumor, 10cm diamater. Suppose it grows by 1 cm to 11 cm
>> diameter. By what percentage has it grown. Your answer must be one
>> positive number with no words of explanation at all. What answer would
>> you give?
>
>33%
>
Try 72.8%. The volume of a sphere is 4/3 pi r^3
radius or r is half diameter.

r goes from 5 to 6 so the ratio is 6 x 6 x 6/5x5x5 of or 216/125
72.8%

matt weber wrote:
> On Wed, 28 Nov 2007 17:26:57 -0600, "Mark Jones"
> <noemail@mindspring.com> wrote:
>
>> tonyjeffs2@googlemail.com wrote:
>>> Here's a quiz for you - it is a trick question for fun. Suppose I
>>> have a spherical tumor, 10cm diamater. Suppose it grows by 1 cm to
>>> 11 cm diameter. By what percentage has it grown. Your answer must
>>> be one positive number with no words of explanation at all. What
>>> answer would you give?
>>
>> 33%
>>
> Try 72.8%. The volume of a sphere is 4/3 pi r^3
> radius or r is half diameter.
>
> r goes from 5 to 6 so the ratio is 6 x 6 x 6/5x5x5 of or 216/125
> 72.8%

Guess again. Radius goes from 5 to 5.5

Correct answer is still 33%.

On Nov 28, 10:07 pm, jacques <n...@anywhere.atall.org> wrote:
> wrote in alt.support.cancer:
>
>
>
> > On Nov 28, 4:40 pm, jacques <n...@anywhere.atall.org> wrote:
> >> Mark Jones wrote in alt.support.cancer:
>
> >> > tonyjef...@googlemail.com wrote:
> >> >> Here's a quiz for you - it is a trick question for fun. Suppose I
> >> >> have a spherical tumor, 10cm diamater. Suppose it grows by 1 cm
> >> >> to 11 cm diameter. By what percentage has it grown. Your answer
> >> >> must be one positive number with no words of explanation at all.
> >> >> What answer would you give?
>
> >> > 33%
>
> >> I had one jump from 25x21 to 70x55, you don't have to be a genius to
> >> work out that even in two dimensions that is a 700%+ increase.
>
> > Or, to be pedantic, about a 633% increase.
>
> OK, we've safely established that I'm not a genius :-)

Nor I. Welcome to another club.

> > Given the linear
> > increases, it would most likely be about 20x its earlier volume and
> > mass. Yikes! May you never repeat *that* kind of achievement.
>
> Comes from no treatment for 4 months I hope. I suspect I'll get some
> treatment over christmas, maybe 3 or 4 cycles, then they'll refer me to
> palliative care. Don't take that to mean I have given up. Just looking at
> it from a real;istic perspective. I could have given up 4 months ago when
> they told me to. Never.

Good for you. I like to say any day above ground is a good day. We
get no guarantees.

> > Mark's right, most people are surprised by how a small linear increase
> > makes for a large area increase, and even larger volume increase.
> > While we're on arithmetic, consider how a a tumor would be affected if
> > it kept going through cycles of growth & shrinkage, by the same
> > percentage each time.
>
> Happens. I've been on 4 (or5???) clinical trials. There has always been
> an initial level of shrink then regrowth, except for the last time. That
> stuff didn't work at all.

I really meant from an mathematical standpoint. Pick a percentage,
say 10%. See what happens if the tumor grows by 10%, then shrinks by
10%, then grows by 10%, then shrinks by 10%, etc. Whatever the
initial size, and whatever the >0 percentage chosen, the pattern of
size changes will result in a reduction over time. Even with a modest
percentage, if the period is short, the cumulative effect is
substantial---it's like the "magic" of compound interest, using the
base (1-x)*(1+x), or (1 - x**2). For 10%, this is .99. The bad news
is that it will never reach 0, unless you choose at least 100 as your
percentage. Using 100, the first increase will double the size, first
decrease will eliminate the tumor! Unfortunately, real-world
treatments don't produce such results.
OK, so I'm a math nerd, and far enough separated from real math work
that I may err a bit.

---
CSM

On Nov 29, 12:48 pm, "Mark Jones" <noem...@mindspring.com> wrote:
> matt weber wrote:
> > On Wed, 28 Nov 2007 17:26:57 -0600, "Mark Jones"
> > <noem...@mindspring.com> wrote:
>
> >> tonyjef...@googlemail.com wrote:
> >>> Here's a quiz for you - it is a trick question for fun. Suppose I
> >>> have a spherical tumor, 10cm diamater. Suppose it grows by 1 cm to
> >>> 11 cm diameter. By what percentage has it grown. Your answer must
> >>> be one positive number with no words of explanation at all. What
> >>> answer would you give?
>
> >> 33%
>
> > Try 72.8%. The volume of a sphere is 4/3 pi r^3
> > radius or r is half diameter.
>
> > r goes from 5 to 6 so the ratio is 6 x 6 x 6/5x5x5 of or 216/125
> > 72.8%
>
> Guess again. Radius goes from 5 to 5.5
>
> Correct answer is still 33%.

Yep. In fact, you don't actually need to know the formula for volume
of a solid to get the right answer. As long as the resulting solid is
the same shape as the original solid, a linear change of X will result
in a volume change of X**3. Whether you have a sphere, a cube, a
pyramid, or whatever, you get the same result. In the original
example, X was 5.5/5, or 1.1, so X**3 is 1.331, a 33% increase. If
the '6' had been correct, then X would have been 1.2 and X**3 1.728
for a 72.8% increase. This is kind of fun! Should I be embarrassed
by that?

---
CSM

csm7532@hotmail.com wrote:
> Yep. In fact, you don't actually need to know the formula for volume
> of a solid to get the right answer. As long as the resulting solid is
> the same shape as the original solid, a linear change of X will result
> in a volume change of X**3. Whether you have a sphere, a cube, a
> pyramid, or whatever, you get the same result. In the original
> example, X was 5.5/5, or 1.1, so X**3 is 1.331, a 33% increase. If
> the '6' had been correct, then X would have been 1.2 and X**3 1.728
> for a 72.8% increase. This is kind of fun! Should I be embarrassed
> by that?

I didn't have to look up the volume formula for a sphere.
Lots of math formulas stored in my brain. At work they
are surprised when someone has a question like this
and I tell them the answer without looking anything up.
They may not even have a clue where to start looking
to come up with the answer themselves.

My favorite classes in college were analytic geometry and
calculas, followed by physics. I have a BS in Electronics
Engineering, so the nerd or geek tag isn't too far fetched.

On Nov 29, 3:01 pm, "Mark Jones" <noem...@mindspring.com> wrote:
> csm7...@hotmail.com wrote:
> > Yep. In fact, you don't actually need to know the formula for volume
> > of a solid to get the right answer. As long as the resulting solid is
> > the same shape as the original solid, a linear change of X will result
> > in a volume change of X**3. Whether you have a sphere, a cube, a
> > pyramid, or whatever, you get the same result. In the original
> > example, X was 5.5/5, or 1.1, so X**3 is 1.331, a 33% increase. If
> > the '6' had been correct, then X would have been 1.2 and X**3 1.728
> > for a 72.8% increase. This is kind of fun! Should I be embarrassed
> > by that?
>
> I didn't have to look up the volume formula for a sphere.
> Lots of math formulas stored in my brain. At work they
> are surprised when someone has a question like this
> and I tell them the answer without looking anything up.
> They may not even have a clue where to start looking
> to come up with the answer themselves.
>
> My favorite classes in college were analytic geometry and
> calculas, followed by physics. I have a BS in Electronics
> Engineering, so the nerd or geek tag isn't too far fetched.

I look up things more because I don't trust my memory than because I
don't remember. My favorite classes would include DE for my Math
minor, and Assembler (the class to build one, not use the results) for
my CSS major. College calc was boring, as it turned out to (nearly)
all repeat work from high school. I considered a EE major, but that
would have been at a different school, so I wouldn't have met my wife,
so my life would be empty and mirthless. Instead, I went with
computers, won the lottery so to speak, and lived happily mostly
after.

---
CSM

I'd go with 33%, and agree that the most meaningful increase is the
volume.
My doctors generally in conversation would say 10%. Perhaps if it was
a more formal question they'd go for 33.

My biggest tumor has grown over 23 months from 5cm to 5.5cm. Despite
the significant increase, it doesn't 'look' substantial in printm and
doesn't inspire me to want to start treatment now.
I kind of imagine that once I start treatment, I'll spend the rest of
my life, hopefully a good few years, being uncomfortable and feeling
ill, the alternative being to live a few less years and have decent
quality of life,
Hard to decide.

Regards
Tony

On 29 Nov, 22:01, "Mark Jones" <noem...@mindspring.com> wrote:
> csm7...@hotmail.com wrote:
> > Yep. In fact, you don't actually need to know the formula for volume
> > of a solid to get the right answer. As long as the resulting solid is
> > the same shape as the original solid, a linear change of X will result
> > in a volume change of X**3. Whether you have a sphere, a cube, a
> > pyramid, or whatever, you get the same result. In the original
> > example, X was 5.5/5, or 1.1, so X**3 is 1.331, a 33% increase. If
> > the '6' had been correct, then X would have been 1.2 and X**3 1.728
> > for a 72.8% increase. This is kind of fun! Should I be embarrassed
> > by that?
>
> I didn't have to look up the volume formula for a sphere.
> Lots of math formulas stored in my brain. At work they
> are surprised when someone has a question like this
> and I tell them the answer without looking anything up.
> They may not even have a clue where to start looking
> to come up with the answer themselves.
>
> My favorite classes in college were analytic geometry and
> calculas, followed by physics. I have a BS in Electronics
> Engineering, so the nerd or geek tag isn't too far fetched.


Hi Mark, & Csm7 in particular, and everyone else....
I'm turning into a maths nerd myself...
I wish I'd gone further with maths at school. I've recently became
interested in prime numbers. It seems odd that something so
systematic- the way prime numbers come about - can result in a series
that is so unpredictable.
So I'm going to buy myself a book on primes and the Reimann
hypothesis. I hope I can understand it!
I just read a captivating entertaining easy to follow book; Fermat's
last theorem, by Singh.

To

On Dec 1, 12:03 pm, tonyjef...@googlemail.com wrote:
> I'd go with 33%, and agree that the most meaningful increase is the
> volume.
> My doctors generally in conversation would say 10%. Perhaps if it was
> a more formal question they'd go for 33.

That was my point about the number being less meaningful without
qualification. It *is* a 10% increase, in one sense. That number is
just as *true* as 33%, though I would say less important.

> My biggest tumor has grown over 23 months from 5cm to 5.5cm. Despite
> the significant increase, it doesn't 'look' substantial in printm and
> doesn't inspire me to want to start treatment now.
> I kind of imagine that once I start treatment, I'll spend the rest of
> my life, hopefully a good few years, being uncomfortable and feeling
> ill, the alternative being to live a few less years and have decent
> quality of life,
> Hard to decide.

I don't know what to say to that. Quality of life is important, but
then so is quantity. I chose to feel bad for a while, with the hope
of a lot more time feeling good. That was a much easier decision. I
wish you luck with yours.

---
CSM

On Dec 2, 4:24 am, tonyjef...@googlemail.com wrote:
> On 29 Nov, 22:01, "Mark Jones" <noem...@mindspring.com> wrote:
>
>
>
> > csm7...@hotmail.com wrote:
> > > Yep. In fact, you don't actually need to know the formula for volume
> > > of a solid to get the right answer. As long as the resulting solid is
> > > the same shape as the original solid, a linear change of X will result
> > > in a volume change of X**3. Whether you have a sphere, a cube, a
> > > pyramid, or whatever, you get the same result. In the original
> > > example, X was 5.5/5, or 1.1, so X**3 is 1.331, a 33% increase. If
> > > the '6' had been correct, then X would have been 1.2 and X**3 1.728
> > > for a 72.8% increase. This is kind of fun! Should I be embarrassed
> > > by that?
>
> > I didn't have to look up the volume formula for a sphere.
> > Lots of math formulas stored in my brain. At work they
> > are surprised when someone has a question like this
> > and I tell them the answer without looking anything up.
> > They may not even have a clue where to start looking
> > to come up with the answer themselves.
>
> > My favorite classes in college were analytic geometry and
> > calculas, followed by physics. I have a BS in Electronics
> > Engineering, so the nerd or geek tag isn't too far fetched.
>
> Hi Mark, & Csm7 in particular, and everyone else....
> I'm turning into a maths nerd myself...
> I wish I'd gone further with maths at school. I've recently became
> interested in prime numbers. It seems odd that something so
> systematic- the way prime numbers come about - can result in a series
> that is so unpredictable.
> So I'm going to buy myself a book on primes and the Reimann
> hypothesis. I hope I can understand it!
> I just read a captivating entertaining easy to follow book; Fermat's
> last theorem, by Singh.

Primes are indeed fascinating. Like many other math nerd computer
geeks, I've spent some time playing with writing programs to deal with
primes. I often do prime factorization in my head---a sort of mental
exercise. While in chemo, I started reading _The Music of the Primes_
(a sort of history of prime investigation), but it was too hard to
focus. I may restart that one, when I have time again.

---
CSM