The business of cancer

The business of cancer

As advancements in DNA sequencing technology lead to personalised treatments, we examine the cost of the war on cancer.

It has been more than 40 years since Richard Nixon signed the National Cancer Act of 1971, beginning the 'war on cancer'. There have been notable successes since, particularly with childhood cancers. Childhood leukemia, once a death sentence, now has survival rates approaching 90 per cent. The American Cancer Society estimates that 767,000 cancer deaths were prevented over the last 20 years.

One cause for optimism is the rapid advance of DNA sequencing technology. The Human Genome Project took a decade and cost $2.7bn. Companies are now racing to sequence human genomes in a day for $1,000. This is particularly important for cancer research as genetic mutations cause the disease.

The ability to sequence patient DNA and that of their tumours is leading to "personalised medicine"; treatment regimes tailored to genetic quirks in people and their cancers. We talk to Dr Joel Malek and Dr Arash Tabrizi, two researchers doing exactly that right here in Qatar.

Producing these treatments is a business; the cost of cancer drugs can be shocking. A single treatment of the advanced cancer drug Yervoy can cost $30,000, or $120,000 for a four dose course. That is too expensive for NICE (the National Institute for Health and Clinical Excellence), the cost effectiveness watchdog for England's National Health Service, but producing such drugs does not come cheap.

It takes an average of 10 to 15 years and $1.3bn to bring a drug to market, but the real cost is in attrition; only five per cent of agents that show anti-cancer properties make it through the approval process. This high failure rate and associated costs make such investment risky; small companies have trouble finding financing and large pharmaceutical companies have slashed research spending. We speak to Dr. Ronald DePinho, the president of the MD Andersen Cancer Institute, and Dr. Paolo Paoletti, the president of Oncology at GlaxoSmithKline, about the business and future of cancer research.

Cancer is a disease that comes at great cost, financially, as well as personally, so what is being done to bring that cost down?

Personalised medicine and advanced therapies are unavailable to many in developing countries. Traditional chemotherapy kills cancer cells, but takes healthy cells with it. Those treatments require the sort of supportive care that is unavailable in many countries. There are fewer cases of cancer in developing nations, primarily because people do not live as long. Sixty per cent or more of new cancers occur in those aged 65 and older.

Those that do get cancer in developing nations have a poor outlook. In 2008, the International Agency for Research on Cancer found 118.7 incidences of cancer per 100,000 people and 93.7 deaths in Africa. Compare that to the UK which had 504 incidences and 181.3 deaths per 100,000.

As part of this episode of Counting the Cost, we take a look at the effort to provide good cancer care in Pakistan. In a country where 150,000 cancer cases are reported every year the Shaukat Khanum Memorial Hospital is for many the only hope.

Yousaf Khan, the father of a patient, says: "My son was suffering from blood cancer, even I was not able to afford its cost...but one day I visited Shaukat Khanum and found it a blessing for my son who is under treatment here from the last two years free of charge and he has recovered a lot."