Science, Technology & Health: June 2003 Archives

An 11-year longitudinal study sponsored by the National Cancer Institute has been halted 3 years early because its findings are particularly clear and striking: finasteride, a drug currently used primarily to fight baldness and enlarged prostates, reduces the chance that a man will develop prostate cancer by 25%.

Prostate cancer afflicts 221,000 American men each year, killing 29,000, and the only treatment is to remove part or all of the prostate which often leaves the patient impotent and incontinent. Finasteride drugs, such as Propecia and Proscar -- which are already approved for sale by the FDA -- could greatly reduce the number of men afflicted with this disease, saving thousands of lives per year and millions of dollars in medical costs.

Men with a history of prostate cancer in their family are particularly at risk for developing it themselves. There appear to be few side-effects to the treatment (except maybe growing more hair).

Update:
Allen Glosson posted a good deal more information in the comments section, go read it. He points out that there are several available treatments for prostate cancer other than surgical removal, but all of these generally lead to sterility and often to impotence and incontinence.

Lileks describes (tangentially) what I believe to the the future of computing: the computer as an appliance.

Buy this box, and you can record TV anytime. Buy this box to go with it, and you can watch anything on your TV on your computer, even if the TV’s in the basement and the computer’s upstairs. Buy this box, and all the music on your computer can be played on any stereo. Buy this box, and the music goes in your car. Buy all these boxes, turn them on; they find each other and they know what to do. Here, let me take your photo with this nice new white camera. Click: it’s in your computer. Okay, take this remote, point it at the TV, press “photo,” arrow-key down to the album we just made. They’re your photos on the big TV downstairs for the family reunion. Beats the old slide-projector, eh?

Eventually, computers will be fast enough that no one will think about processor speed. Storage will be so cheap as to be practically free, and no one will consider the size of a hard drive. &c. Computers will become black box appliances that operate in an expected and intuitive manner, and will function as desired without elaborate trouble-shooting.

The desktop computer is a vastly more complicated system than anything else a person is likely to own, and it's no surprise that it's taking decades to reach the level of simplicity and reliability that people expect from microwaves and televisions. Artificial intelligence, my field of expertise, is integral to making this vision a reality. We're still a long way off, but I doubt my grandchildren will ever have to upgrade a home computer system.

No one upgrades (or even repairs) a TV, you just throw out the old one and buy a new one. The technology continues to improve, but it's transparent to the consumer, and that's how computers will be in the not-too-distant future.

Bill Gates has an op-ed in the Wall Street Journal today in which he discusses email spam and the measures that Microsoft is taking to fight it. (As a side note: I wonder whether or not Gates wrote it himself, and if so, how many checkers did it pass through afterwards? I have no reason whatsoever to doubt he wrote it, but I'm truly curious.)

Before discussing technological issues, Gates says that Microsoft has filed "15 lawsuits in the U.S. and U.K. against companies and individuals alleged to have sent billions of spam messages in violation of state and federal laws." That's pretty interesting. Although I'm skeptical of Microsoft's motives in general, unless there's more to this story it sounds like a good thing all around. Microsoft surely incurs costs associated with spam that runs through its corporate systems, plus Hotmail, and the lawsuits will end up benefiting end-users as well.

Gates then briefly mentions some "machine learning" "smart" systems that Microsoft is developing to help blocking software recognize spam before passing it through the system. Extracting meaning from language is one of the most difficult things a human can do, and thus one of the holy grails of artificial intelligence. I'm sure this is fascinating research; say what you like about Microsoft, but they spend more money on research than many universities.

Gates then talks a little about how Microsoft is working together with some other major companies to fight spam at different levels, and I think that's great. The only part of the op-ed that mildly distersses me is where Gates begins talking about government regulation.

A key to eliminating spam is establishing clear guidelines for legitimate commercial e-mail. With industry and consumer groups, we are developing best-practice guidelines to help responsible companies understand how to reach their customers without spamming them. Congress could help by providing a strong incentive for businesses to adopt e-mail best practices. Our proposal is to create a regulatory "safe harbor" status for senders who comply with e-mail guidelines confirmed by an FTC-approved self-regulatory body. Senders who do not comply would have to insert an "ADV:" label--standing for advertisement--in the subject line of all unsolicited commercial e-mail. This would enable computer users either to accept ADV-labeled mail or to have it deleted automatically.

It would be very beneficial for companies and individuals to adopt voluntary standards, but I don't like the idea of Congress or the FTC enshrining those standards into law. Aside from free speech issues that might render such standards unconstitutional, the bureacracy is ponderous and technologically incompetent -- in the long run the internet would only be harmed by the inevitable heavy-handedness of the federal government.

Many ideas have been floated, and many people are speculating on the nature of the next big media revolution. The internet is an amazing tool, like the printing press, but most media websites are still built around the same paradigm as print newspapers. We've got a neat new tool, but the users haven't reached its full potential yet.

Anyway, I wrote all that to say that I was pleased to discover that each time I reload the Washington Post site, I am greeted with a different picture of Potter fans mobbing a bookstore.

Lileks goes on a brief rant about fax machines, and I've got to agree wholeheartedly. Why is it that they're all different? In some you put the paper-to-be-faxed face up, and in some you put it face down -- which is which is anybody's guess.

At least "modern" fax machines use real paper instead of rolls of tissue paper. I use scare quotes because it's hard for me to see any fax machine as "modern".

I had to fax some documents to/from my car insurance agent a few days ago. Can't you just email them to me? Email? What's that? I'll just go to your website. Website? You can't get insurance over our website. I think we have a website....

I can buy GM and hog futures over the internet, I can make all the arrangements to travel to Japan for a year on the internet, I can auction off my used harware on the internet, I can write all this stupid nonsense on the internet, but to get car insurance I have to use a fax machine?

Following up on the post below, Allen Glosson writes in the comments:

For a somewhat more pointed view about reforming the FDA, you might also see http://www.stopfda.org, in particular the essay about "Consumer Rape".

The story I like the most about the FDA involves Beta Blockers. Back in 1984, Dr. Kessler proudly announced that the FDA had approved Beta Blockers to treat high blood pressure and that the approval would save 17000 lives each year. What he didn't tell us was that Beta Blockers had been approved in Europe in the mid 1970s and approval was sought with the FDA back in 1977. The FDA took 7 years to approve a drug which had already been shown effective in European markets. Thus, the FDA had willfully and deliberately allowed over 100K people to die needlessly while they dotted i's and crossed t's in the approval process.

Do we still believe that the FDA saves lives? I for one, do not.

Incredible, and damning.

Bill Hobbs has a post with a great letter from Allen Glosson of St. Louis, Missouri, who gives a good description of the difficulties drug companies face trying to recoup their R&D costs by selling their drugs under patent. Drug patents last 17 years and...

It takes about 15 years for the entire drug approval cycle to be completed, previously leaving only 2 years for the drug company to recover all of its R&D costs.

Bill suggests that the "patent clock" shouldn't start until FDA approval is granted, but a) 17 years seems like a very long time to go without generic substitutes, b) what about drugs that never get approved? Sounds like it would create a new disincentive construct that might change the dynamics of the whole industry in some unforseeable ways.

But on to the real issue at hand. Allan writes further:

Currently, the drug can't be sold to anybody until after the FDA finally approves it. If you've ever read the writing of cancer patients, slowly dying, desperate for that new drug begging with the drug company and the FDA to allow them one more shot at life, you'll know that the FDA process is deeply flawed.

The Food and Drug Administration essentially has veto power over all new medical drugs and devices, and is controlled by a lopsided set of incentives that tends to make it overcautious -- the repurcussions are far worse for the FDA if it mistakenly approves of a treatment that turns out to be dangerous than if it mistakenly delays or fails to approve a treatment that is actually beneficial, even if the number of lives lost in each case is equivalent. The fact that the FDA can prevent sick people from voluntarily assuming the risk of unproven (but potentially beneficial) drugs has undoubtedly claimed thousands or even millions of lives.

The best proposal I've read was put forward by the Competitive Enterprise Institute and suggests that the FDA's veto power be eliminated and that unapproved treatments be made available under medical supervision and with clear warnings of the potential risks involved. The FDA would continue to serve as a state-run evaluator of treatments, and drug companies could choose to seek FDA approval if that approval was sufficiently valued by the public. Competitive market forces would then take hold in the medical industry, bringing costs of production down and thereby lowering prices all around. Additionally, and even more importantly to some, a greater number of treatments for a greater number of diseases would become available for use, which could save an uncountable number of lives above and beyond those saved by the lower prices.

I don't get it. I get a spam email that tells me my secret admirer has sent me a message. Oh goody! Eager, trembling with anticipation, ecstatic at the prospect of having a secret admirer, I double-click and open the email...

ARGH MY EYES! Why, dear God, why must I be subjected to such a puketastic image!?

[deep breath]

What do these companies gain by trying to trick me into opening such things? If I wanted to see pictures of "cum soaked teens riding the pony" then I would probably be willing to open an email with that title. However, if I'm like the vast majority of people and would rather gouge my eyes out than even contemplate such a thing, I won't visit the website even if they trick me into opening their horrid visual regurgitant. I just can't imagine anyone getting taken in by the false subject, seeing the picture, and then thinking "hey that's pretty great, sign me up."

I HATE COMPUTERS: I know that I'm a computer science graduate student, but sometimes I hate computers. Like tonight. I have a picture of me standing on top of the stupid Palais de Justice in stupid Paris, and I said I'd scan it and post it, but my stupid printer/scanner dealie doesn't want to scan. It'll print all day long, it loves to print, but when I tell it to scan the stupid computer tells me the stupid scanner isn't connected. However, since I've now spent eight years studying computer science, I know this to be false -- if the stupid printer can print, then the stupid scanner can scan.

I reinstalled the stupid software. Same situation. Fan-stupid-tastic (imagine another word there besides "stupid"). So, no one gets to see the view from the roof of the Palais de Stupid except me.