Ever since modern medicine started recording cancer, it has taken millions of lives every year. It is the second biggest cause of death in the US (the first being heart disease) that took more than 600,000 lives, with at least 1.9 million more people diagnosed in 2022. The numbers are even more alarming in the global landscape, where an estimated one in six people die of cancer.
This disease has existed for as long as medical sciences has existed. In fact, the earliest traces of cancer were found in a 1.7 million-year-old bone. Even the word “cancer” has been used to describe the disease since as early as 3000 BC when the Egyptians coined this term on papyrus. Surprisingly, among other ancient Egyptian records on the disease, there was also plenty of data on how cancer is a disease without a cure.
After all these years and miraculous strides in the world of medicine, the Egyptian conclusion still holds true; cancer is still an incurable disease.
While underfunded cancer research may be to blame for this, we’d be remiss if we didn’t take cancer treatment into account. The cure may not exist, but today, cancer is not the death sentence it once was.
That is not to say that the research process for cancer is free of faults, bureaucracies, and agendas. In fact, we are probably still far from accomplishing what we could have in a perfect world where profits come second to humanity.
In this blog, I will explore the various aspects of cancer research, its limitations, and all the recent newsworthy developments in this domain.
Why Pharmaceuticals Don’t Invest in Cancer Prevention Research
In an ideal scenario, we should be able to prevent cancer from happening rather than treating it after it has developed. And yet, cancer research focuses more on treatment than prevention. The simple answer to that is the economic incentive to treat cancer is much higher than the incentive to prevent it. To put it in simpler words, a medical establishment (including pharmaceuticals) can make more money out of cancer treatment than prevention.
Since private firms work on the profit-first principle, they can’t be expected to choose a lesser profitable option. But why is this happening in the first place? Let’s explore the situation.
The problem of skewed profitability happens because of the way the FDA approves drugs. Once a drug gets patented, the company has to quickly show that it is both safe and effective for use so they can get FDA approval. The quicker they are in completing the required testing stages, the more time they’ll have left on their patent, and they can quickly send the drug to market to earn high-profit margins from it.
The duration between the patent and sending the drug to market is called the commercialization lag, and companies are always trying to reduce this lag. The simple reason why that happens is that when a pharmaceutical has a patent, they can charge a much higher profit on their product than when the patent runs out.
So when companies develop drugs for late-stage cancer, they can reduce the commercialization lag to a great extent. This is because they can get desirable results from clinical trials much faster as the disease has already progressed significantly by then, and the results of the drug are much more obvious. Even small results are enough to prove the efficacy of the drug and secure FDA approval.
How to Shift the Focus to Cancer Prevention
With the pharmaceuticals working to increase their profits, the entire onus of cancer prevention research is on the government, which is already dealing with one too many things. That said, there are a few ways to shift the focus of research from cancer treatment to prevention. Here’s how it can be done:
Government-Run Programs: If the government has the funds, it should simply begin government-run research programs that work towards cancer prevention. President Biden’s Cancer Moonshot is a case in point where the government is actively involved in cancer research. This way, the research objectives can be set to benefit the population rather than earning profits.
Increase Drug-Market Exclusivity Time: Another way to shift the focus of cancer research is to incentivize drug companies. It can be done by increasing the patent time for companies that are involved in research for cancer prevention. This way, the companies will have a longer time period of exclusivity in the market to compensate for the extra research time.
Overhauling FDA Approval Process: The FDA approval process can be made quicker with specific markers of efficacy rather than using survival as the only measure. Like in the case of leukemia, the reduced count of white blood cells should be an indication of success. Essentially, any measure that has a high correlation with survival should be enough to speed up the approval of the drug. This is called using a surrogate endpoint to approve the drug rather than using survival rate to decide the drug’s effectiveness.
Limitations in Cancer Research
There’s no doubt that research has significantly improved the cancer survival rate, but this disease still remains fairly mysterious. While the profit-first outlook of private pharmaceutical and research companies is a major deterrent to cancer research, there are still many other limitations to the process. The fact is, cancer is a complex, mutating disease, and we may never be able to find a singular cure for it. Here’s why.
Cancer is an Umbrella Term
According to recent estimates, there are more than 200 different types of cancers. To put this number into perspective, think of all the different symptoms of every different kind of cancer and all the possible permutations of all the symptoms observed in cancer patients.
Every broad category of cancer is further divided into sub-categories, and all of them are different from each other at a molecular level. This creates an overwhelming amount of data and variables that researchers have to consider. It’s also why researchers tend to focus on one type of cancer at a time, and the more common types of cancers get more attention.
Cancer Cell Mutation is Erratic
The biggest issue with researching cancer cells is that even in a single tumor, there are many different types of cells. On top of dealing with the already existing genetic mutation that starts cancer, researchers have to account for more mutations as the tumor grows. So if a treatment works on a particular type of cell, it may not work on another type of cell. One way to deal with this is to focus on particular mutations and how they increase the likelihood of some types of cancers.
Treatments Can Lose Efficacy over Time
As cancer grows, many new types of cell mutations start emerging. This means that a treatment may work for a cancer patient for some time before it loses its efficacy on newly mutated cells. On top of this, cancer cells don’t die easily like normal cells. Instead, they have ways to not only avoid getting killed but to grow and multiply as well.
This is one of the many reasons why researchers base their research on ways to overcome the resistance shown by cancer cells.
Recent Developments in Cancer Research
In the past century, the world has collectively managed to make some major strides toward cancer treatment and some tiny steps toward cancer prevention. In the past couple of years, some of these major breakthroughs happened in the cancer domain that should definitely be mentioned here.
CAR-T-cell therapy has shown particular success in leukemia patients as it boosts the function of immune cells and helps hunt down cancerous cells. This therapy involves removing, altering, and reinserting the T-cells that go on to kill cancer. This research was started by the University of Pennsylvania, and the two people who got treatment have been in remission for the past 12 years.
Using AI to Fight Cancer
This India-based cancer research uses artificial intelligence (AI) and machine learning to fight cancer. One of their research programs focus on using AI for risk profiling to screen for common types of cancer. This can lead to preventative measures (such as mastectomy for people with the BRCA1 gene) and early treatment. Additionally, artificial intelligence is also being used to read x-rays of cancer patients for accurate diagnosis in hospitals where imaging experts aren’t available.
Breast Cancer Vaccine
Most recently, Cleveland Clinic announced that its vaccine for triple-negative breast cancer had passed the initial testing phases. Despite affecting only 12% to 15% of breast cancer patients, this type of cancer is one of the deadliest types of breast cancer. This vaccine is currently in its last phase of trials, which are set to conclude at the end of 2023, and will likely be one of the biggest breakthroughs for breast cancer research.
In addition to these, many other kinds of research and new treatments have also popped up in recent years. Most notably, research related to precision oncology, liquid & synthetic biopsy, and pancreatic cancer diagnosis has been fairly successful.
Needless to say, we’re still far from finding 100% effective treatment for cancer, let alone a complete cure for it. We’re even farther behind in working out how to prevent this deadly disease altogether.
Are you interested in learning more about developments in the cancer domain? Start by checking out and buy Health care reform book.
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