[niekmaas]

There is no way for us to know if the drug is a "revulotionary cancer drug" if we don't test it in a double blinded randomized controlled trial (RCT). Indeed it would be disappointing the later find out you were treated with the placebo, but so many drugs or other interventions have to potential to be revolutionary but fail to really change the clinical decision making later on.

[littlestymaar]

I don't disagree with you and I'm not saying it's not necessary or RCT are evil or anything, but being given the placebo just sucks.

[amcoastal]

I guess I never understood placebo trials in a lot of medical situations. Like what we are discussing here, a "revolutionary cancer drug", why even bother letting people die giving them placebos? Its cancer. Its not like you can placebo effect the cancer away. You don't need a double blind trial to see if the drug stops the cancer, you just give people the drug and observe the cancer! I feel like our medical system is pretty wack. Or maybe I'm entirely wrong and you can placebo cancer away.

[daedalus_f]

That is not how randomised controlled trials in conditions like cancer work. They are almost always a riff on new drug + current best treatment regime vs current best regime. Sometimes a drug within a regime is swapped with the new agent and the two compared in terms of survival and toxicity.

Progress in cancer treatment is almost always achieved by incremental tweaking of how we treat it. There are a few revolutionary agents based on specific disease mechanisms in certain cancers (e.g. imatinib [1]) but these are in the minority - cancer is protean.

[1] https://en.m.wikipedia.org/wiki/Imatinib

[setr]

A common medical joke:

A cold takes 7 days to resolve on its own. With modern medicine, it will take merely a week !

The placebo is not to eliminate the cancer, it’s to guarantee that we know the “normal” path without the drug, and gives a comparison point between the control and the target. The fundamental problem is that cancer can just resolve/improve on its own, or rather without intervention… so just poking and watching isn’t sufficient proof of the drug’s efficacy