<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>spondylosaurus</author><text>Untreated bowel inflammation also increases your risk of cancer significantly. If cancer risk is on the table either way, might as well take the drugs that increase your quality of life in the meantime :)&lt;p&gt;Plus—you have a chance of beating cancer. But a colectomy is a one-way trip!&lt;p&gt;(Prednisone will absolutely fuck you up long-term though. No cancer risk afaik, but osteoporosis risk is through the roof. I&amp;#x27;ve heard of UC patients who needed joint replacements in their 30s from long-term steroid use...)</text><parent_chain><item><author>6177c40f</author><text>All of them increase risk of cancer (EDIT: upon further review, maybe not all of them? Or maybe just with combination therapy?) and severe infection. Many of the biologics are also quite new, and the long term effects of taking them are not well understood. Plus, in some cases they don&amp;#x27;t work well enough alone and so multiple drugs are required (a biologic in combination with something like methotrexate or azathioprine is typical), which further increases risks. Anecdotally, I know of a couple people who had bizarre and severe immune reactions to biologics that left doctors baffled, so that&amp;#x27;s something that can also occur, apparently.&lt;p&gt;Also some people are just prescribed steroids like prednisone for whatever reason, which has some pretty negative long term effects.</text></item><item><author>epgui</author><text>Which drugs are you talking about? Pretty much all the biologics for CD have amazingly positive safety profiles…</text></item><item><author>rgmerk</author><text>I have Crohn’s but am one of the lucky 20% who is in long-term remission without surgery and without the more problematic drug therapies - thus far!&lt;p&gt;But if this works as well as hoped it will bring a lot of peace of mind that if I do ever need surgery, I won’t be going back in for more every few years.&lt;p&gt;Medical research is awesome, for all its inefficiencies.</text></item></parent_chain></comment><story><title>First-in-human implantation of bionic device to halt Crohn&apos;s disease (2023)</title><url>https://florey.edu.au/news/2023/12/first-in-human-implantation-of-bionic-device-to-halt-crohns-disease/</url></story>
<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>jessriedel</author><text>At least for Ulcerative Colitis, there are safe drugs that are much less effective (mesalamine) but the strong effective drugs all come with long-term cancer risks (prednisone, remicaid, entyvio, etc), as you say. The newer drugs like entyvio are generally less risky than the older ones, mostly on account of being more targeted, but the risk is still significant. I imagine the situation is similar for CD.</text><parent_chain><item><author>6177c40f</author><text>All of them increase risk of cancer (EDIT: upon further review, maybe not all of them? Or maybe just with combination therapy?) and severe infection. Many of the biologics are also quite new, and the long term effects of taking them are not well understood. Plus, in some cases they don&amp;#x27;t work well enough alone and so multiple drugs are required (a biologic in combination with something like methotrexate or azathioprine is typical), which further increases risks. Anecdotally, I know of a couple people who had bizarre and severe immune reactions to biologics that left doctors baffled, so that&amp;#x27;s something that can also occur, apparently.&lt;p&gt;Also some people are just prescribed steroids like prednisone for whatever reason, which has some pretty negative long term effects.</text></item><item><author>epgui</author><text>Which drugs are you talking about? Pretty much all the biologics for CD have amazingly positive safety profiles…</text></item><item><author>rgmerk</author><text>I have Crohn’s but am one of the lucky 20% who is in long-term remission without surgery and without the more problematic drug therapies - thus far!&lt;p&gt;But if this works as well as hoped it will bring a lot of peace of mind that if I do ever need surgery, I won’t be going back in for more every few years.&lt;p&gt;Medical research is awesome, for all its inefficiencies.</text></item></parent_chain></comment><story><title>First-in-human implantation of bionic device to halt Crohn&apos;s disease (2023)</title><url>https://florey.edu.au/news/2023/12/first-in-human-implantation-of-bionic-device-to-halt-crohns-disease/</url></story>