- Cancer burden is ever increasing!
- Number of cancer chemotherapy drugs are ever increasing!
- Cancer treatment costs are ever increasing！
- But are cancer patients, families and the society as a whole really benefiting from the ever increasing cancer care costs?
- The following data will show that the cancer patients, families and the society do not receive significant benefits. Then,
- Who are really benefiting from these ever increasing cancer care costs?
Cancer is a top chronic disease, with 1.9 million new cancer diagnoses and killing more than 600,000 Americans in 2021 (1). Globally, there were 23.6 million new cancer cases and 10 million cancer deaths in 2019, “global burden of cancer is substantial and growing” (2).
Chemotherapy has been the standard treatment for cancer over the past decades. The chemo drug market is $USD 141 billion in 2021 and is expected to double in the next few years to reach ~$USD 290 billion in 2028 (3).
With that much money spent on chemo drugs, are these chemo drugs helping cancer patients? Let’s look at some large scale epidemiology studies.
Nearly 20 years ago, a group of Australian scholars studied the impact of cytotoxic chemo drugs on cancer patients 5-year survival rate, a standard measure of chemo drugs in the USA and Australia. They concluded disappointingly in their paper (4):
- “As the 5-year relative survival rate for cancer in Australia is now over 60%, it is clear that cytotoxic chemotherapy only makes a minor contribution to cancer survival. “
Another group of scientists studied the impact of chemo drugs on cancer patients in the United Kingdom (5).
“The NHS Cancer Drugs Fund (CDF) was established in 2010 to reduce delays and improve access to cancer drugs, including those that had been previously appraised but not approved by NICE (National Institute for Health and Care Excellence). After 1.3 billion GBP expenditure, a UK parliamentary review in 2016 rationalized the CDF back into NICE.”
The authors concluded: We conclude the CDF has not delivered meaningful value to patients or society.
A 2017 study published on Nature looked at the global impact of chemo drugs worldwide. They concluded (6):
- Of the 277 cancer chemo drugs in clinical trials from 2011 to 2015, 85% had no clinical effect;
- The more expensive the cancer chemo drug, the less the clinical effect;
- In the low- and middle-income countries, high-tech cancer treatments do more harm than good to patients.
A 2020 JAMA paper studied the 90 FDA approved new cancer drugs between 2000 and 2016. They authors concluded (7):
“In this study, data available at the time of FDA drug approval indicated that novel cancer therapies were associated with substantial tumor responses but with prolonging median overall survival by only 2.40 months. Approval data from 17 years of clinical trials suggested that patients and clinicians typically had limited information available regarding the benefits of novel cancer treatments at market entry.”
The above large scale data from the USA, The United Kingdom, Australia and the whole world spanning the past ~20 years, clearly show lack of evidence of beneficial impact of these very toxic cancer drugs to cancer patients, their families and the society as a whole.
How did they ever become the standard cancer therapy?
Don’t these substantial data indicate the significant flaws in the oncology industry from drug approval process, marketing and all the way down to individual cancer patient management?
- Global Burden of Disease 2019 Cancer Collaboration, Kocarnik et al. Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. JAMA Oncol. 2021 Dec 30. PMID: 34967848.
- Morgan G, Ward R, Barton M. The contribution of cytotoxic chemotherapy to 5-year survival in adult malignancies. Clin Oncol (R Coll Radiol). 2004 Dec;16(8). PMID: 15630849.
- Aggarwal et al. Do patient access schemes for high-cost cancer drugs deliver value to society?-lessons from the NHS Cancer Drugs Fund. Ann Oncol. 2017 Aug 1. PMID: 28453615;
- Sullivan R, Pramesh CS, Booth CM. Cancer patients need better care, not just more technology. Nature. 2017 Sep 19. PMID: 28933447.
- Ladanie et al. Clinical Trial Evidence Supporting US Food and Drug Administration Approval of Novel Cancer Therapies Between 2000 and 2016. JAMA 2020 Nov 2. PMID: 33170262;