Saturday, May 18, 2024

The business of cancer: a growing concern

When one digs deeply into the sweeping sphere of cancer there is an abundance of misinformation and an endless stream of puzzling dilemmas and unanswered questions.

We have a cure; “Big Pharma” is preventing that cure from making it to market.

Cannabis cures cancer.

There is no cure for cancer.

Can anybody truly say they are an expert on cancer if they can’t cure it? Can you really understand the cause if you cannot find the solution?

However, two things are certain: cancer incidence in the world’s population continues to rise and cancer is big business.

Almost 40% of us will get cancer in our lifetime.1 With over $120 billion spent on cancer research in the last 50 years, why is there no cure?2

What is cancer?

Cancer is the abnormal proliferation of cells within the body (i.e., cells multiply in a dangerous fashion within the body). This proliferation can create a tumour, of which there are two types, benign and malignant.3 Benign tumours are non-cancerous and are confined to their original location. Malignant tumours are cancerous and can spread through the critical systems of the body (“metastasis”).4 When a malignant tumour is removed, the cancerous cells often remain in the body, and further treatment may become necessary. The four most common cancers are breast, prostate, lung, and colon/rectum cancer. Lung cancer is the most lethal, accounting for almost 30% of all cancer related deaths.5

What causes cancer?

There is sufficient evidence to show that viruses can create circumstances within the human body that lead to cancer.6 It is estimated that 15% of all cancers are caused by viral infections.7 Further, excessive and chronic exposure to sunlight, tobacco, pharmaceuticals, hormones, alcohol, parasites, fungi, bacteria, salted fish, wood dust, and herbs, have also been identified as significant contributors. It seems that pretty much anything can cause cancer.8 There is also a genetic component to cancer in which carcinomas, sarcomas, or leukemias/lymphomas9can be passed down from generation to generation. The cells can be dormant and then activated by many factors, including all of the above.10

Treatment options and success rates

Diet manipulation

Changing not only what a cancer patient consumes in everyday diet, but when they consume it, has shown to be an effective part of both treatment regimen and prevention plan.1112 There is some evidence to suggest that plant-based diets rich in fibre and fruits and vegetables, and low in simple sugars and trans fats, may be effective in prevention and treatment. Cancerous cells, like the rest of the tissues in the body, need fuel to proliferate and tend to prefer energy sources that are high in monosaccharides.13  

Perhaps more impactful is the research surrounding short-term fasting (STF) as both a preventative measure and accompaniment to chemotherapy treatment. The theory behind STF is that restricting a cell’s nutrient supply reinforces its stress resistance, while tumour cells become even more sensitive to toxins through shortage of nutrients to satisfy the demands necessary for high proliferation rates.14 While research is in its early stages, there is evidence that shows an enhancement in the effects of chemotherapy while having a limiting factor on the unpleasant side effects.15 

Chemotherapy

Chemotherapy uses medicines called cytostatics, which consist of various chemicals designed to target and kill rapidly dividing cells in the body.16 The trouble is that along with attacking cancerous cells these chemicals also attack healthy cells. Because of this, cells that are responsible for producing blood, hair cells, and the mucous membrane cells in the mouth and throat area and in the digestive system, temporarily die, often producing significant short-term effects like hair loss, anemia, nausea, vomiting, diarrhea and infections in the mouth.17 

Radiotherapy (“Radiation Therapy”) 

Radiotherapy is a localized treatment method which employs the use of high energy rays or radioactive substances to bombard tumoral cells in an effort to halt their growth and  division.18 About half of cancer patients will receive radiotherapy, either on its own, or as part of a greater treatment plan.19

Alternatives

After an official diagnosis, more than 50% of cancer patients reported trying alternative cures, including special diets, adding extra vitamins and minerals to their current diet, adding biological products (e.g. cannabis, teas, mushrooms, turmeric), energy therapies (e.g. oxygen or ozone treatment), alternative medicine (e.g. acupuncture, aboriginal medicine), and spiritual therapies (e.g. yoga, Reiki, mental imagery).20 While alternative methods may help make the patient manage symptoms and feel better during treatments, the American Cancer Society has determined that these methods offer no statistically significant support towards curing the disease.21 

Survival rates

Oncological recommendations for chemotherapy as an initial treatment option have declined in recent years as it has become associated with a higher rate of mortality, and as other treatment methods are being developed.22 While it depends on the type of cancer and stage of growth and metastasis, chemotherapy and radiotherapy (often combined) have an average five-year survival rate of just more than 60% and a curative rate of just more than 2%. While these treatments are shown to help prolong life, curing a patient of illness is rare. 

Health care costs

Healthcare costs in general account for almost 20% of the United States’ GDP – twice that of Canada.23 Expenditures on care for cancer patients in the U.S. topped $150 billion in 2018 alone (in Canada it was projected at $12 billion), with projections for future care continuing to rise due to an aging population and the increasing cost of treatment.24 

The cost of one complete treatment cycle for a cancer patient varies based on the type of cancer, which phase the patient is in, and the geographical location of the treatment. In Ontario, Canada (universal healthcare system), an individual in the initial phase of care for breast cancer can expect out-of-pocket expenses of about $14,000.25 In the U.S., where health care consists of a mix of personal coverage and publicly funded programs. treatment costs for a patient with the same affliction can be more than $100,000. How much of that is covered by insurance and how much is paid out-of-pocket depends on the level and depth of coverage. Those with private coverage incurred an out-of-pocket expense averaging $7,500 to $10,000.26 Those without coverage have to foot the entire bill. While 68% of Americans have private health insurance, only 34.1% are covered by public funding. Medicaid will cover roughly the same percentage of costs as private coverage, but the state must participate in the program and the patient must earn an income of less that $17,236 per year to be eligible.27 The percentage of Americans have no insurance coverage at al is 9.2%.28 

The markup on cancer medications is significant. On average, pharmaceutical companies profit $14.50 for every $1 spent on research and development.29 This number does not include a hospital or treatment centre’s markup. Consequently, treatments such as chemotherapy and radiotherapy often pail in comparison to the cost of cancer medications, which often cost as much as $6,000-$10,000 per month.30 It is a disputed number on the political front, but some research claims that 62% of personal bankruptcies in the U.S. were due to medical costs, and 78% of those bankruptcies involved patients who had health insurance at the beginning of their illness.31 In Canada, 11% of personal bankruptcies were attributed to medical costs.32

Health has always been a business. Until about 1990, however, it was not big business. Around that time, consultants began approaching hospitals about changing their billing structure from a per item use method (e.g. $5 for a roll of gauze) to be focused on those treatments that were covered by health care providers.33 

It would seem that the best treatment is prevention, but Canada only spends 5% of its healthcare costs on prevention and promotion while the United States is around half that. Some research shows that the savings from increased preventative and promotional spending would be $6 for every $1 allocated.343536 

With cancer incidence projected to continue to grow and desperate patients looking for any cure, often in unconventional methods, is there incentive for governments and corporations to keep us sick? Are increased cancer treatment costs simply a product of a larger population that lives longer? We leave the opinions to you. 

 

Footnotes

  1. https://www.cancer.gov/about-cancer/understanding/statistics
  2. https://www.cancer.gov/about-nci/budget
  3. https://www.ncbi.nlm.nih.gov/books/NBK9963/
  4. https://www.ncbi.nlm.nih.gov/books/NBK9963/
  5. https://www.ncbi.nlm.nih.gov/books/NBK9963/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734938/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994798/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734938/
  9. https://www.ncbi.nlm.nih.gov/books/NBK9963/
  10. https://www.cancerresearch.org/blog/april-2019/what-causes-cancer-risk-factors
  11.  https://jeccr.biomedcentral.com/articles/10.1186/s13046-019-1189-9
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312721/
  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312721/
  14.  https://jeccr.biomedcentral.com/articles/10.1186/s13046-019-1189-9
  15.  https://jeccr.biomedcentral.com/articles/10.1186/s13046-019-1189-9
  16. https://www.ncbi.nlm.nih.gov/books/NBK279427/
  17. https://www.ncbi.nlm.nih.gov/books/NBK279427/
  18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634375/
  19.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298009/
  20.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092049/
  21. https://www.cancer.org/latest-news/the-truth-about-alternative-medical-treatments.htm
  22. https://academic.oup.com/jnci/article/110/5/493/4718501
  23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375405/
  24. https://www.cancer.gov/about-cancer/understanding/statistics#:~:text=Approximately%2039.5%25%20of%20men%20and,will%20die%20of%20the%20disease
  25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5344366/
  26. https://milliman-cdn.azureedge.net/-/media/Milliman/importedfiles/uploadedFiles/insight/2017/cost-burden-cancer-care.ashx
  27. https://www.fightcancer.org/policy-resources/medicaid-ensuring-access-affordable-health-care-coverage-lower-income-cancer
  28.  https://www.census.gov/library/publications/2020/demo/p60-271.html
  29.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324319/
  30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538397/
  31.  https://pubmed.ncbi.nlm.nih.gov/19501347/
  32. https://www.researchgate.net/publication/261253211_Health_Issues_and_Health_Care_Expenses_in_Canadian_Bankruptcies_and_Insolvencies
  33.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139860/
  34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695931/
  35. https://www.cpha.ca/making-economic-case-investing-public-health-and-sdh
  36. https://www.cpha.ca/making-economic-case-investing-public-health-and-sdh
Brendan Rolfe
Brendan Rolfe
Brendan Rolfe is a Chartered Professional in Human Resources and business consultant for firms across Canada. He holds a degree in human psychology from UBC and a diploma from Kwantlen Polytechnic University. Brendan is a firm believer in credible data sources and spin-free news.
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