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Cancer treatment measurably accelerates several markers of biological ageing. No trial has ever asked whether moving one of those markers makes any difference to a person, and an entire retail industry rests on the assumption that it would.
The frontier facet of this round documented the acceleration and then documented the hole underneath it. Epigenetic clocks run fast in survivors; p16INK4a, a marker of cellular senescence, rises after chemotherapy; physiological frailty appears decades early in childhood cancer survivors. Those are measurements, and they are reasonably well made.
What does not exist is the next step. No clock is validated as a clinical test, none is used to make a treatment decision, and no trial has shown that moving a clock changes what happens to a person. The same applies one marker down: no trial has shown that lowering p16INK4a changes a person's health, and no intervention has been shown to lengthen telomeres in people in a way that changes health. No trial has shown that an intervention reverses established frailty in survivors.
Meanwhile the market has not waited. Senolytics have no completed randomised trial in cancer survivors and the one properly randomised trial of adequate design in another disease missed its primary endpoint. The trial designed to test metformin as a geroprotector has been proposed for a decade and has not started. A 48-week randomised trial of intermittent rapamycin in healthy ageing adults left its primary endpoint unchanged. There is no randomised trial of an NAD+ precursor in cancer survivors for recovery, fatigue or biological age, and a Europe PMC search for randomised trials of intravenous NAD+ in cancer survivors returns none. Clocks sold direct to consumers are not the clocks in this literature and are not interpretable against it.
The design problem is real and is worth stating rather than treating the absence as negligence. A trial with a clock as its primary endpoint proves nothing a person would notice. A trial with a clinical endpoint in survivors needs years and hundreds of participants. The way through is a trial with a function endpoint and the clock as a prespecified secondary, so that the two can be compared in the same people; one such trial is recruiting now, and it is the reason the fisetin trial record exists on this front.
Shares Telomere length after treatment, Epigenetic age after cancer treatment, Frailty and late effects in survivors, What actually works after treatment and the tags rejuvenation, survivorship, biological-ageing.
Shares Telomere length after treatment, Epigenetic age after cancer treatment, Frailty and late effects in survivors, What actually works after treatment and the tags rejuvenation, survivorship, biological-ageing.
Shares NAD+ precursors taken by mouth, What actually works after treatment, Recovery and rejuvenation roadmap: cure is not enough → survivorship gets a name → the cohorts that measured the cost → exercise proven as treatment → biological ageing measured and sold → repair, if anyone funds it and the tags rejuvenation, survivorship.
Shares Recovery and rejuvenation roadmap: cure is not enough → survivorship gets a name → the cohorts that measured the cost → exercise proven as treatment → biological ageing measured and sold → repair, if anyone funds it and the tags rejuvenation, survivorship, open-problem.
Shares Recovery and rejuvenation roadmap: cure is not enough → survivorship gets a name → the cohorts that measured the cost → exercise proven as treatment → biological ageing measured and sold → repair, if anyone funds it and the tags rejuvenation, survivorship, open-problem.
Shares Recovery and rejuvenation roadmap: cure is not enough → survivorship gets a name → the cohorts that measured the cost → exercise proven as treatment → biological ageing measured and sold → repair, if anyone funds it and the tags rejuvenation, survivorship, open-problem.
Shares Recovery and rejuvenation roadmap: cure is not enough → survivorship gets a name → the cohorts that measured the cost → exercise proven as treatment → biological ageing measured and sold → repair, if anyone funds it and the tags rejuvenation, survivorship, open-problem.
Shares Recovery and rejuvenation roadmap: cure is not enough → survivorship gets a name → the cohorts that measured the cost → exercise proven as treatment → biological ageing measured and sold → repair, if anyone funds it and the tags rejuvenation, survivorship, open-problem.