Novartis also produces Glivec, which turned my dad's GIST stomach cancer(which normally has <1 year survival prediction) to living for over 8 years cancer free now.
Good thing we live in a country which pays for the treatment,as my dad has to take two boxes a month, and they are ~$3000 each.
"Gleevec became a breakthrough, helping almost every patient with a particular rare blood cancer, chronic myelogenous leukemia. Patients stay on it for years, and it is so valuable that Novartis has quadrupled its annual price from $24,000 per year in 2001 to more than $90,000 today. Even the stingiest insurers pay, though some patients get it free."
I am also in a country where you don't have to choose between pay or die, and I'm thankful for that. Seeing this kind of thing in print certainly makes you look twice and appreciate what you have.
Unfortunately I'm in the U.S. and if I had to pay $3,000 per box of that medicine (at 2 boxes a month) I would have to die because I simply do not make that much money. It's literally more than 100% of my entire income. I'm jealous, lol.
Under Obamacare, your annual out-of-pocket maximum would be $6,350. You still have to pay the Obamacare premium on top of that. But the end result is that you would only have to pay about 10% of the $92,000 annual list price of Gleevec.
Note that grandfathered plans are not subject to the out-of-pocket maximum until 2015.
P.S. Remember to vote in the 2014 and 2016 general elections if you live in a swing state.
This is toxic to democracy. People should vote no matter the state where they live otherwise it is only a tiny sliver of the swings that decided who rules the country and this allows for the money influx because you only have to buy/brainwash that sliver.
If a modern democracy manages to have 80% voter turnout you will be surprise how many safe seats will be not so safe.
So just vote - no matter where you live. It is your civil duty.
> If a modern democracy manages to have 80% voter turnout you will be surprise how many safe seats will be not so safe.
Are you suggesting that "people who decide to vote" is not a representative sample of the whole population? I am not sure of that, and a quick Google search shows mixed results.
> So just vote - no matter where you live. It is your civil duty.
I feel no loyalty to my country. I don't give a crap about civil duty. Most people I interact with feel the same way.
Or in a fully developed country where you don't have insurance, or if it doesn't cover it.
In my country(Poland) it's fully covered by the national insurance,which is not very expensive,and if you are poor you don't have to pay anyway - and are still fully covered.
Another interesting fact that Gleevec turned novartis around. but that patent expires soon. There was a patent battle they lost in India w.r.t. "evergreening" gleevec i.e. a small change in the drug that would help them repatent it.
Shockingly they wanted to keep the price tag of ~3000$ you quoted which is > 95% of the population's gross annual income.
Including the US, for now. Under Obamacare, there is a $6,350 annual out-of-pocket maximum. There is also cost-sharing for people with low incomes.
However, Obamacare is guaranteed to remain in effect only so long as the Democrats retain control of the Senate and the Presidency. If the Democrats lose one of them, then it will depend on whether certain vacancies open up on the Supreme Court. If they lose both, then that's the end of Obamacare.
It's in Poland. There is no out-of-pocket maximum - my dad pays literally nothing for the drug. He also had to have two operations to remove parts of his stomach,and then stay at hospital for a month at a time - also paid nothing. He also doesn't have to pay national insurance because due to his illness he qualifies for an exemption. Even if he didn't, he would pay less than $1000 a year for national insurance.
I didn't say that your father lived in the US. I was pointing out that "pays for the treatment" does not exclude the US, as Florin_Andrei seems to think.
I understand you're having a visceral reaction to the out-of-pocket maximum. But for the patient who has to take Gleevec for the rest of his life, it does not matter if he pays $1 for the premium and $10,000 for the medication, or $10,000 for the premium and $1 for the medication. It's the same $10,001 either way. It's just a matter of what you call it.
I think it's great that Poland reduced the premium to $0 for your father. But patients in many other countries still have to pay the premium even after they get sick. And nobody would say that their insurance refused to "pay for the treatment" just because it did not waive the premium. It becomes a matter of degree, not of principles.
The US still has the most expensive healthcare even after Obamacare. But at least it is now on the extreme end of the spectrum of universal health insurance. It is no longer off the charts.
The out-of-pocket maximum is the maximum amount that the patient will pay before the insurer takes on the rest of the costs. Even if someone needs $100k/yr medication, he should only have to pay $6,350 per year for it.
From the article: "The current CARTs kill not just cancer cells but any B-cell, the type of white blood cell that goes wrong in leukemia."
So this really isn't an cancer cure at all; it is B-cell cure. I'm surprised this isn't a more significant detail in the article. It's really the cell-equivalent of cutting off a cancerous limb.
You're getting downvoted probably because people do not understand the raw truth that lies behind what you said.
I detest articles that use the word "cure" and "cancer" in the title. They are without fail so breathless about the clichéd achievement that they are exploiting in the headline that they either fail to acknowledge the real magnitude of the problem or gloss over it with practiced sleaze (not sure which happened to the writers here).
We've had a "cure" for cancer since the times when barbers also performed surgery on the side (Egyptian civilization, at least), and that is surgical excision. It's still the best treatment we have for many cancers, e.g. melanoma and lung cancer, both of which are much more common than the cancer in the article. It doesn't work for every cancer, but for some cancers it works good enough, and even better when combined with chemotherapy (which ham-handedly slows replication in every cell in your body). The point of any cure is to remove the cancer cells from your body and for some cancers they fortunately stay within one excisable area.
Like the GP comment pointed out, this is essentially a much more targeted version of the same thing. Obviously it would be better for the patient to retain B cells, without which they will have no adaptive immunity--just like a patient with melanoma would prefer to keep the hunk of their nose that the surgeon had to remove. This is an incremental, very fancy and very expensive improvement on the same old strategy of killing the organ to save the body. It will never work on non-blood cancers (which are the vast majority of cancers, BTW).
People do not understand that cancer is a disease that combines the trickiest parts of fighting aging with the trickiest parts of fighting infectious disease. Cell replication is one of the hardest things your body has to do, and it does it several trillions of times per day in your body, essentially copying about 1 billion TB worth of data while automatically detecting and fixing every dangerous error that could possibly result. It is natural that this process will screw up catastrophically at some point--on an infinite timescale, assuming we fix all other health issues, everybody will still get cancer just as surely as they age every year. And once they do, you have a cell that your immune system has carefully trained for decades not to engage, invading and hogging every resource it can, with mutations that allow it to adapt to selective pressures, including any drugs you might throw at it. Essentially, it's an infectious parasite, except it looks 99% like your own cells to your immune system, and is already perfectly suited to your body's style of metabolism.
Let's keep in mind that this can arise from any cell in your body that replicates, and just about every organ system has a good number of those to replenish malfunctioning or old cells and fix injuries. The possibilities are staggering and so are the number of known cancers.
There is no "magic bullet" that cures every single cancer, just like there is no "magic antibiotic" that kills every infectious bacterium. Even the smartest, most generalizable ideas right now, like cancer vaccines, depend on your immune system to make the final push, and the immune system is just as fallible as any other organ system. At the point where somebody can make the claim that all cancer is cured, we will as a matter of course have gained control over every replication event that occurs in our body (trillions upon trillions of nanoscale events per day). That will be a truly remarkable feat, but is in no way within reach of any foreseeable technology.
When we cure cancer, we will have by necessity cured aging and all infectious disease will have become a relatively trivial problem. That should put the claim of "curing cancer" into perspective.
> Even the smartest, most generalizable ideas right now, like cancer vaccines, depend on your immune system to make the final push, and the immune system is just as fallible as any other organ system.
I'm still waiting for the nanobots that we were promised two decades ago.
Imagine a billion nanobots swarming inside your body, networked [1] and analyzing every cell they come across. Over time, they build a gigantic database of your cells. Then they'll be able to use some heuristics to determine whether any given cell is a menace to your health. If it is, they either tag it for apoptosis or terminate it with a micro laser, depending on how reliable they think each method would be.
Movie material today, reality tomorrow. When this happens, I'll finally welcome the combination of "cure" and "cancer" in the same sentence.
> Imagine a billion nanobots swarming inside your body, networked [1] and analyzing every cell they come across. Over time, they build a gigantic database of your cells. Then they'll be able to use some heuristics to determine whether any given cell is a menace to your health.
You've basically described the immune system!
The immune system is imperfect, but it's a lot more complicated than any man-made system so far. Trillions of cells, thousands of genes controlling each one, hypermutations creating billions of different antibodies, slipping into and out of each corner of the body. Basically, organized chaos; by some measures, more complicated than the brain.
I would welcome potential designs for an auxiliary system, but what we have already is hard to understand, much less supplant. Certainly the concept of retraining the immune system is appealing, and looking beyond the OP's microbead/reinfusion rigamarole, we've already been doing that for decades via vaccines.
As far as I understand it, the main problem is that the error rate of DNA replication is somewhat high ~ 1 error per 5 megabytes of data. As you've mentioned quite a lot of data needs to be copied during cell replication. So that's the problem to be solved - diminishing this error rate. And improving replication / correction mechanisms.
And considering that there are no laws of nature that prohibit redundant replication of data with virtually no errors there should be no limit to improvement in that area.
> There are no laws of nature that prohibit redundant replication of data
There most certainly are, at the information density of DNA. DNA is about a thousand times more information dense than our best hard drives. At that level, a passing photon can change or break enough chemical bonds to alter the bits. A nearby high-energy molecule can do the same. This actually happens gazillions of times per day in our body and we have a few hundred enzymes to automatically correct errors and a few hundred more to detect when those can't fix the problem and shut down the cell. The fact that it works at all is jaw-droppingly amazing. We take copying bits on and off hard drives for granted, and they only work for a few years max--cells operate on an entirely different scale of information transfer and yet some multicellular organisms live for centuries.
Unfortunately, I don't think you could improve the error checking mechanisms in our cells without fundamentally redesigning a lot of how we work. It would be interesting to try to add more "parity" mechanisms besides the complementary base pairing, which is used by most of the repair enzymes. From an evolutionary standpoint, no species would ever naturally develop perfect DNA replication because it would halt diversification, which is needed to survive continually changing environmental threats.
I should also add that it's a misconception that every cell in our body has the exact same DNA. That's only a half-decent approximation. In reality, a lot of our cells accumulate trivial mutations and it's OK. Some cells even rely on editing their own DNA to perform their primary function: that includes the B and T cells [1] which the cancer in the OP arise from.
Your points on how curing cancer basically cures aging and the fact that we can't prevent copying errors are spot on. That's why I've often thought that the recommendations people make for preventing cancer (taking antioxidants, avoiding certain foods/chemicals) probably have little or no impact on the odds of getting cancer, or are even counterproductive because they prevent apoptosis. What seems to generally work better is simply eating a variety and exercising, and assuming that the body is being bombarded by mutagenic toxins/radiation constantly and trying to stay strong in the face of them so that if (when) the time comes to undergo treatment, the body has enough reserves to survive it.
My gut feeling is that the final cure for cancer (and by extension aging and other diseases) will come about through a much simpler mechanism (more basic I mean, not easier), more in line with engineering than medicine. They’ll need to be able to systematically map any type of cell in the body and trigger its death, then insert a replacement cell at that site or coerce the body into doing it. It may not be possible with just our immune systems because it’s an area that evolution overlooked and we just don’t have the genes and cellular machinery for it.
I’m really skeptical that we’ll have nanobots to do that anytime in the foreseeable future, but, there are tons of other options like engineered viruses or chromosomes that don’t seem nearly as far-fetched. If we forget about medicine for a moment and just think about the fact that the compressed human genome fits on a CD, then the mutations in a cancer cell are going to be much smaller than that, potentially small enough that they can be encoded as something akin to lisp programs. They could find markers from a cancer cell in the lab, and then evolve genes to recognize them and tag or kill the cells with genetic algorithms in a computer. When we hear about engineered viruses killing the people they were meant to treat, I think that happens because humans just can’t program something like that manually. It has to be evolved over generations to take into account countless factors that might not occur to us.
To me, that kind of simulation is straightforward. It’s just another big data problem, and we need better sequencing so that patients can get loaded into a computer cheaply. Once a solution has been evolved with a high degree of certainty (like thousands of times the confidence level of anything today), and has a reliable cutoff switch, then synthesizing that becomes “just an engineering problem”.
TL;DR: We need github for medicine so that all of the tools in the arsenal can be recruited as external libraries and simulations can be run in a distributed fashion by hackers who handily find solutions to any problem that’s thrown at them but can’t be bothered to obtain medical degrees.
That is highly doubtful. Cancer will surely not evolve to fight the successful cure. Each cancer has to start its micro-evolution from 0, since they can not survive to pass its progeny to other hosts. Each cancer has its own space to evolve and different spaces do not communicate. If there is a cure, you are basically reverting its evolution to day 0. All cancers use similar mechanisms because of concept known as convergent evolution.
Once cure exists - the real cure, meaning no single cell is left from original cancer that survived the latest 'cure' to then pass its genes to its progeny (which is maybe impossible, who can say) - there is no risk to adaptation to the cure.
Now, I can imagine scenarios when this would not hold - for instance vertical genetic transfer to different hosts via some infectious vector but that is probably highly improbable.
> All cancers use similar mechanisms because of concept known as convergent evolution.
First of all, this hypothesis is still highly contested in the literature. There are no doubt certain pathways (usually part of cell cycle regulation) that happen to be used by most cancers, but there are hundreds of genes involved in the cell cycle and we aren't even close to enumerating all the ways that it can malfunction. The fact that most cancers use similar pathways is no doubt reflective of the fact that they are the easiest pathways toward malignancy, not the only pathways.
Secondly, say we do take the top N common mechanisms and create a bulletproof inhibitor. Now your statement about convergent evolution is no longer true. Anything that kills cancer cells (excision, radiation, chemotherapy, something targeted) exerts selective pressure, and you will instead start seeing cancers that utilize the (N+1)th easiest pathway, (N+2)th, and so on. It's like trying to stop all the ways that a car could break down: possible up to a certain point, impossible in the long run.
I also contest the statement that "you are basically reverting its evolution to day 0". Germline predispositions for cancer are an important part of the disease and not selected against in a society where people have natural-born kids between 20 and 40. If there were a cure for cancer, it would probably involve genetically engineering humans that are extremely unlikely to get it (and also age very slowly, etc.). But then you are looking at a totally different kind of society.
> genetic transfer to different hosts via some infectious vector but that is probably highly improbable
This is not only probable, it is known (so far, 12% of human cancers). Viruses linked directly to cancer include HPV, EBV, HTLV, and polyomavirus [1]. A virus that causes cancer can be a very successful virus, depending on how long the infectious/replicative phase is compared to the symptomatic phase. Replicating infected host cells = more viral production = greater likelihood of survival and transmission.
There are some researchers that think that all cancer is caused by viruses that have yet to be identified. I don't think that's literally true, but we can find all kinds of remnants of ancient viruses in our genome, so in a way, they might be on to something.
> I detest articles that use the word "cure" and "cancer" in the title. They are without fail so breathless about the clichéd achievement that they are exploiting in the headline that they either fail to acknowledge the real magnitude of the problem or gloss over it with practiced sleaze (not sure which happened to the writers here).
> There is no "magic bullet" that cures every single cancer, just like there is no "magic antibiotic"
This.
People need to stop thinking cancer as a single disease, but as a constellation of disease. Just like you cannot "cure" the Internet from computer viruses with a magic program, you cannot cure cancer in with an unique solution.
Honestly, I hope for the best, but even if you find a way to break down the walling mechanisms of one cancer, a hundred will spring up to take its place. Leukocyte extravasation and infiltration is an intensely complicated process and has many more failure scenarios than working scenarios. It's akin to a cop on foot trying to get into a rock concert, find one wanted man in the crowd, and get out, all without stopping the performance. (Since this is cancer, the bad guy can also clone himself every few minutes and have his clone try a different strategy.) Every cancer will evolve to find yet another of the failure scenarios.
continuing that quote "The current CARTs kill not just cancer cells but any B-cell, the type of white blood cell that goes wrong in leukemia. Patients are likely to get injections of a protein that B-cells make, called gamma globulin, for the rest of their lives; if the treatment becomes popular there may not be enough gamma globulin to go around."
Friend of mine had to get gammaglobulin shots for a few years (8 or so years ago): The stuff supposedly cost about 10k a vial, because it was filtered out of the plasma of many of people per vial and put through several complicated processes to isolate and sterilize it.
So...if we had considerably larger plasma donations, maybe?
That would help up to a point, but there also ongoing research to manufacture it using recombinant techniques - that is, genetically engineering bacteria to produce the required protein product and then purifying it out. Then your limiting factor is a reproducible manufacturing process rather than availability of human sources.
This is akin to how, for example, insulin and human growth hormone are now produced; previously they also lacked scalability due to having to be sourced from cadavers.
So yes right now it's not scalable, but in the future this limitation will hopefully be corrected.
I know nothing about this so forgive my ignorance, but could synthetic blood provide what's needed? From what I understand we're making progress with synthesizing blood.
Pretty much no. Most synthetic blood efforts are focused on replacing the oxygen-carrying components of blood i.e. red blood cells and the hemoglobin they contain. That is what's needed in emergency settings and surgery where lack of blood flow can kill tissues in minutes. Immunoglobulins (aka antibodies) are important for preventing infection and thus long term health but they would be difficult to impossible to produce synthetically.
* Immunoglobulins (aka antibodies) are important for preventing infection and thus long term health but they would be difficult to impossible to produce synthetically.*
Yes, there are ways of producing antibodies outside the body. One could argue whether hybridomas (essentially immortalized b-cells used to produce a specific antibody) constitute truly synthetic production. I considered mentioning them, but decided it was probably more in depth answer than the GP's question really needed.
Since you asked though, I don't think hybridomas really solve the difficulty of reconstituting a persons antibodies ex vivo. A healthy human has somewhere around a trillion different antibodies circulating. I would conservatively estimate that the research community has produced a few thousand different hybridomas since they were first described in 1975. The problem of scaling that or any other in vitro technique to the trillions seems unlikely to be solved.
Now, I get into the domain of wild speculation. What you'd really need is a single system capable of producing a nearly unlimited variety of different antibodies. The most viable option to my mind would be a transgenic mammal (let's say a goat since it's easy to get antibodies from milk) which would produce humanized antibodies. However, given the relatively small demand for such treatments, I think any such efforts are unlikely.
Without wanting to get into parsing the word 'cure' imho this is a cancer cure. The reason the treatment kills the B-cells as well is because that is how it identifies the cancer cells. It is the marker that enables the T cells to recognize the cancer cells. But the fact that it kills the B cells does not mean that it does not successfully treat the cancer cells. It appears that it does. And hence it seems fair to call it a cure.
All I know is I lost a loved one last weekend to Cancer and until you've been that close to the process you have no idea how you hope and pray for anything that will help no matter how radical.
It's one way we're curing cancer. Other promising avenues include personalized cancer vaccines which essentially recruit your immune system to attack the tumor[1], or other viral vectors such as the recent Mayo success[2] using the measles vaccine to counter cancer.
The good news is that this is happening faster than you would think. Having a father who is a leader in the field I can tell you the initial trials look very promising. However vaccines might not be the cure to end all cures. A very aggressive cancer might kill you before your immune system is able to re-engage to fight the cancer. So a combination of vaccines and more traditional treatments is likely to be the answer in this case.
My understanding is that one of the main benefits of vaccines will be to make relapse much less likely as the stimulated immune system will eradicate any leftover cancer cells in the body.
I'm a total "noob" in this field so I'm sorry if I can sound stupid: I thought that traditional methods to cure cancer (like chemio or radio therapy) have all the side effect of partially (or even totally) destroy the patient immune system. So how can we combine those with these special vaccines which surely need a strong immune system to be effective?
Not at all a stupid question. I don't even have a great answer for you. My understanding is that, at least for some cases, you can target e.g. radiation enough to shrink the tumor enough for these therapeutic vaccines to be effective.
> The good news is that this is happening faster than you would think.
The research might be moving fast, but access to these new treatments still moves at a glacial pace. At least for the people who need them... patients have to wait years until drug trials run their full course, even when preliminary results consistently show these treatments are effective.
One can understand why these rules and regulations are in place, but surely there's a better way of assessing the risk/benefit of prematurely approving certain treatments for diseases that will almost certainly kill (or gravely, permanently debilitate) those who suffer from them long before the drug is approved.
Speaking from personal experience dealing with this right now, it's extremely frustrating that these treatments are just out of reach because access to them is surrounded by so much red tape -- If you don't have $120k sitting in your wallet, that is.
Interesting article, but as it mentions, this is the latest in a series of breakthroughs in cancer treatment. What is missing for me in there is any idea of the number of people that this could affect.
This would put the date at which cancer is "cured" at somewhere in the 2090s. So, are we talking about continuing this trend or surpassing it? How much of a step forward is this and is it likely to be applied trivially to other forms of cancer?
Cancer survival rates are usually five year survival from diagnosis. We've gotten better at detecting cancer earlier, meaning people are more likely to make it to five years, but, from what I've read (and I'd love to see research showing what I've seen is wrong!), the number of people living longer than they would have 30 years ago has not gone up as dramatically (there are some cancers that have seen tremendous improvement, though).
I think we should stop saying things like "Is this how we will cure cancer". It's like saying "X will stop accidents". There are many different types of accidents, just like there are many types of cancers.
We should be saying "Is this how we will cure a cancer?"
Interesting read is "The Emperor of All Maladies: a Biography of Cancer" by Siddhartha Mukherjee.
There have been several miracle "cures" for cancer, none of them has turned out to be a miracle cure. Even the idea that cancer is not "one cause, one cure" has not been held for a long time, and was never universally held. Lymphoma was always treated differently than breast cancer, for instance.
But the more interesting point in the book, re a cure for cancer: "the only intervention ever known to reduce the aggregate mortality for a disease--any disease--at a population level was prevention. Even if other measures were chosen to evaluate our progress against cancer...it was indubitably true that prevention, as a strategy, had been neglected by the NCI in its ever-manic pursuit of cures."
In other words: cures make good headlines; we get excited by cures. But the only way to reduce the mortality rate of cancer is through prevention. Long-term we'll make more progress finding ways to prevent cancer, not cure it.
Cancer is a diverse phenomena (even within a single type) but there are lots of similarities in how cells evade programmed cell death or how tumors feed themselves that could be targets for wide reaching therapy. the idea that we've identified meaningfully separate types of cancers may be the flawed one...it is usually just based on where the cancer occurs not how it works or looks ona genetic level and other classifications may be possible.
Cancer is the inevitable outcome of aging in a long-lived multicellular organism.
It is a fundamental principle of evolution that things that replicate faster and survive better will prevail. We are made of coordinated, replicating cells. They happen to be in a mutual "truce" to act as one organism at the expense of individual cell survival. Most cells that break the truce do badly on their own and die out. However, given enough tries at the prize, some cells will find a way to beat the system and replicate at the expense of the other cells still serving the whole body.
Some people have genetic deficiencies that give potentially malignant cells a jump start on the process. Certain environmental exposures will increase the rate of errors and therefore the frequency of tries that cells will get to become cancerous. But the outcome will always be the same; as we prolong human life through better medical care the incidence of cancer can only rise.
It would be most accurate to say that cancer is an evolutionary phenomenon that occurs between cells of a multicellular organism and causes a heterogenous group of diseases.
> Patients stay on it for years, and it is so valuable that Novartis has quadrupled its annual price from $24,000 per year in 2001 to more than $90,000 today. Even the stingiest insurers pay, though some patients get it free.
I understand supply and demand...but come on! We're talking about people's lives here. This just sounds like exploitation. The fact that the insurance company has to pay doesn't make it any better. Just easier to get the money.
So, there's a compromise. The high price of the drug also drives other companies into cancer research as they also want a piece of the pie. That leads to better treatments for everyone. If prices were lower, then there would be less motivation to develop the drugs.
I wholly believe there are hundreds of thousands of researchers who would happily spend their lives in poverty researching cures. The difficulty is that you can't research a cure to anything that's still uncured in a garage with the money you make begging on the street, or manufacture whatever cures you do discover.
The corporations who have billions and billions to spend on it, they need a profit motive to give someone a research budget. It's why they have the billions and billions.
It's not the only system imaginable, but it's the one we got.
I am not saying researchers should live in poverty. However, the Forbes article is peppered with distasteful quotes from CEOs salivating over the billions they stand to make from cancer treatments. Imagine a real person saying "Sure, I could help you with your cancer... if you make me rich" -- they would be called a psychopath. But corporations somehow get a pass.
Why can an Internet store convince its investors to operate at a loss, while a pharmaceutical company cannot tell its investors: "Hey guys, we're working on a freaking cancer cure for humanity, this is way bigger than space travel, so we're not going to be profitable in the near future, a'ight?".
It really depends how the pharmaceutical company is using its quadruple profits. If it is using them for executive compensation, returns to the investors, and gold plated fountains, that's one thing. The corporation could be focused on the short term extraction of as much money from as many dying people as possible.
However, the corporation (and its investors) focusing on long term profits and long term good is not incompatible with charging quadruple the price for its existing drugs. Bringing in more money faster means having more money to reinvest on R&D to research more new cures faster. In which case, double the price again if insurance companies will keep paying it.
At the end of the day those obscene profits are coming from insurance premiums spread over nearly the entire population, making it effectively a private sector tax. If that tax is, in fact, largely going to cancer research, I'm OK with it.
Of course, I'd personally prefer a public sector tax that I knew was going to research and not gold-plated fountains.
Good points. A system with universal private health insurance and pharma companies that reinvest all their profits into research seems equivalent to a system with publicly funded research. (Of course, in private systems there are many uninsured people -- doubling the price of cancer treatments means, to some extent, funding future research from poor, sick people.)
The pat, dismissive response (which you've already gotten several times) is "Hey, cancer research is expensive. Somebody's gotta pay for it."
In a healthy society--at least, a healthy society that is also as wealthy as ours--the solution would be to recognize medical research as a clear public good, and reallocate some of our society's wealth to fully fund both research and production of medicines.
What we have instead is...well, we have a lot of different factors interacting. But just to name a few: we have a government that has convinced us that propping up the military-industrial complex is the most important possible use for billions of dollars, and we have private wealth concentrated in a small number of people who will fight like mother tigers against any attempt to appropriate the smallest amount of their money for the public good.
But that's all complicated and unpleasant to think about. So...hey, cancer research is expensive.
Exactly. We could have a government program to develop nuclear weapons (I wonder if the director of that program made as much as the CEO of Novartis), but we can't have a government program to cure cancer.
There's something wrong with a system where the primary purpose of institutions who fight disease is to make money. Super-valuable research is treated in the same way as making widgets or developing Facebook games -- all that matters is how many dollars it generates for each $100 invested. I find it simultaneously outrageous and ludicrous that the yardstick against which the CEO of Novartis will be judged is how much money the company made, not whether it cured freaking cancer.
I love these sorts of excluded-middle arguments. "Our government wastes hundreds of billions of dollars on war toys that are at best unnecessary and at worst a threat to humanity's continued existence. And as if that weren't bad enough, we have a lot of selfish, wealthy asshats who don't want to give even more of their money to the same government."
Yes, it's exactly the same, when you don't trust the government to allocate your tax funds in a sensible manner.
The only diseases governments have helped us with are those addressable by public health programs (and there are quite a few of those, to be fair.) For the rest, no one has ever found a more effective funding mechanism than private industry.
It's important to understand these prices in context of how much it costs to take a drug through FDA trials (~$1 billion), and the likelihood of success (~10%), combined with drugs that are recalled after they've gone through the whole process and are on the market. Given the costs, how much does a drug have to earn to have it make sense financially?
There appears to be billions to be made in profits from anti cancer drugs, no surprise that companies are spending like crazy on cancer research.
On finding replacements / alternatives for our fast reducing arsenal of effective antibiotics - not so much. We are on the brink of a very scary phase in modern medicine - where antibiotics may soon become almost useless and very little is being done about it because it is not profitable.
Using viruses to fight diseases might seem dangerous compared to current therapies, but viruses are already in use for therapeutic purposes on a large scale for almost 100 years.
Most people here don't know about it, because it's in use since ~1920 in the sowjet union/russia/eastern europe and not in the west. (for example to fight bacteria, that is resistant to all antibiotics)
>rheumatoid arthritis drug that stopped the immune system storm
Damn...that must have been some industrial strength RA meds to work that fast. Plus that is quite a leap of faith even in isolation...those meds don't always drop the white cell count as expected.
Was probably Remicade, it blocks Tumor Necrosis Factor Alpha which is a main component to the inflamation response. If you are currently experiencing a cytokine storm (which is basically run away inflamation) it will do the trick quite quickly. It is basically an artifical antibody that binds to free TNF alpha and doesn't let it interact with cells to cause its normal immune response. Very effective, and it is an IV delivered drug so it immediately starts binding to the factors that are causing the inflamation. I took it before for Ankylosing Spondylitis and you can feel better quite quickly.
If its not Remicade it is probably something in that family of therapies and would have similar quick effects against a cytokine storm.
hmmm...didn't know those things work so fast. They gave me a low dose MTX and that took forever to kick in (month+). Then again there was no major hurry.
Well, considering the success rate of most other therapies for major cancers is at best quite modest, and likely mostly a result of lower smoking rates, maybe.
That "law" occurred to me too, but I kept an open mind until I reached the sentence:
"On paper Jimenez seems an unlikely backer for one of the most revolutionary medical breakthroughs any company has ever tried to develop. He’s a marketer by trade"
At that point I stopped reading. The answer is indeed "no."
Cancer exists because you don't need to live to 150 years old to successfully reproduce. It costs too much from a biological perspective to prevent cancer, calories and nutrients better spent on raising children and to some extent grandchildren.
People got cancer back when the environment was pristine, they were just more likely to get eaten by the crocohippo first.
I have heard this argument a lot, and I've also heard there is data to refute it. I haven't looked up the references, but this is covered in several nutrition books I have read, including: The Diet Delusion by Gary Taubes, In Defense of Food by Michael Pollan, and The Perfect Health Diet by Paul Jaminet.
The observation is always the same: Cancer is one of the "western diseases" that starts appearing in native populations when they are exposed to colonists. And it's not just because of longer lives: people start getting cancer at higher rates at earlier ages.
Taubes blames the problem on insulin-like growth hormone that is secreted in response to high-carbohydrate foods, and creates an environment perfect for rapid cell growth. Pollan doesn't speculate on the cause, other than to say that there is something wrong with the western diet. Jaminet speculates that we will find more types of cancer are cause by infectious agents, since cell immortality and rapid reproduction is a perfect strategy for a virus and since we have found several so far: http://en.wikipedia.org/wiki/Infectious_causes_of_cancer
Galen in 2nd century AD observed cancer, and used the term "oncos" to describe it. Celsus in 1st century AD did the same, and used the term "cancer" for the first time. Hippocrates in 4th century BC described several different types of cancer and called them, generically, "carcinos" ("crab" in Greek).
Egyptian texts from at least 1600 BC, with some going back to 3000 BC, describe different cases of cancer, noting with regret: "there is no treatment".
Dinosaurs, 65 million years ago and more, suffered from various types of cancer such as hemangioma, desmoplastic fibroma, and osteoblastoma.
Cancer is, has been, and always will be the evil shadow of all multicellular life.
Please, don't take your medical and scientific information from a "liberal foodie intellectual" with a B.A. in English (not that there's anything wrong with any of these attributes in particular, they're just not qualifications to talk competently about cancer).
Well; the fact that cancer was known in antiquity and that it is found in the fossil record in itself doesn't say anything about its adjusted prevalence[1] which, as it happens, was indeed much lower than it is in modern societies today. From your fourth link[2]:
"An interesting phenomenon has arisen during the course of multi-year studies related to the rarity of cancer in antiquity. This is of interest especially when considering that hundreds of Egyptian mummies and more than 10,000 dinosaur bones were evaluated. In contrast, the rate of cancer incidence has dramatically increased since the Industrial Revolution. The rarity of cancer in
antiquity has been attributed to the lack of pollution and changes in diet and lifestyle, and most recent findings suggest that cancer may be a manmade disease (Nat Rev Cancer 10, 728–733). Thus, while a lack of adequate techniques for disease diagnosis and detection may partially explain the overall lack of cancer found during the millennia, the current cancer trends are now primarily associated with carcinogens in our modern industrialized society (Nat Rev Cancer 10, 728–733)."
I am not a fan of pseudo-scientific, moral-panicky speculations about the evils of "modern life" from the likes of Pollan et al. myself; but in this particular case, as your article explains, there is considerable evidence that cancer (standardized) prevalence was indeed much lower in pre-modern societies. Also, for some types such as colorectal cancers, some dietary habits (prevalent, as it happens, in modern societies) are very well-known and well-established risk factors, accounting for up to a 70% increase in relative risk in some studies [3].
As I said: I symphatize with your view, but be mindful of confirmation bias.
[1] Eg. controlling for age and other risk factors in the study population.
When you lay an argument out like this, it's easy to knock over, however, that doesn't mean that there isn't some truth in it. It's abundantly clear that the Western lifestyle is carcinogenic, especially for certain types of cancer, like colorectal, prostate and breast cancers.
The actual causes are less well understood. One hypothesis is that we live longer, but given studies that have tracked aboriginal people who moved into cities and compared them against their native kin have shown an increase in the Western cancers, that hypothesis is weak at best. Beyond the unhealthy SAD ("standard American diet"), we also have pollutants, stressors, and who knows what else that can influence cancer.
So you're left with a slew of variables and a lot of sick people. Fifty years ago, cancer was seen as a metabolic disorder, and maybe some are. One of the largest pieces of evidence for this is cancer's inability to metabolize anything but glucose for energy. Cancers that are metabolic diseases would certainly be affected negatively by a growth-hormone-rich environment coupled with consistent access to as much blood sugar as the cancer wants.
Trying to oversimplify with "it's the bread" causes a near visceral reaction in many people, which is unfortunate, because, while it may not be the bread, the bread may be acting as Miracle Grow for the cancer. For me, I'm choosing a diet that, hopefully, won't be an energy smorgasbord for tumors.
I will second endersshadow's recommendation, and suggest that you read "The Emperor of all Maladies: A Biography of Cancer". The author talks about this subject, and the evidence he presents is that cancer has always been with us.
There is a max 10% genetic risk and also getting older makes the body more fragile for every illness not just cancer but the causes as outlined in wikipedia are 90% environmental.
Environmental doesn't necessarily mean it is something we've done to the environment. Even if the world's environment were reverted to "untouched by humans" status, you can still get melanoma from too much sun exposure, and that would still be an "environmental" factor.
Unhealthy eating (especially very salty/spicy/fermented foods), alcohol use, and so on also classify as environmental factors. But they are not caused by pollution or chemical-laden foods, merely bad life choices. Copious quantities of red meat isn't good, organic or no.
I don't meant to imply our bad handling of the planet causes no cancer, it certainly does. But it does not cause anywhere close to 90% of cancer cases. Not by a long shot.
I believe that's what OP was referring to, considering his link. No one was presuming environment meant the conditions of the natural world.
The point stands. How many people consciously make an effort to prevent cancer in every aspect possible? On a personal level as much as a societal level, we're doing little to address the preventable causes of cancer. Why are so many people making so many "bad life choices"?
It was a study done on mice, and it had nothing to do with ingestion of capsaicin:
"These results might imply that caution should be exercised when using capsaicin-containing topical applications in the presence of a tumor promoter, such as, for example, sunlight."
The wikipedia article on capsaicin links to this study as well as several others and indicates that capsaicin may have carcinogenic or anticarcinogenic properties based on several studies: http://en.wikipedia.org/wiki/Capsaicin#Effects_of_dietary_co...
You probably shouldn't be all that concerned about eating spicy food... on the other hand, if you don't smoke, you eat well, and you aren't obese, you're roughly 55-65% less likely to die of cancer: http://en.wikipedia.org/wiki/Cancer#Causes
You need to read The Emperor of All Maladies[1]. If you think cancer is just an effect of our environment, you are wildly, disasterously, and disappointingly misinformed.
I have not read that book, but I will throw this in for the sake of counterargument. That said, I don't believe anyone is saying cancer is "just" an effect of environment.
"Cancer is caused by both internal factors (such as inherited mutations, hormones, and immune conditions) and environmental/acquired factors (such as tobacco, diet, radiation, and infectious organisms). The link between diet and cancer is revealed by the large variation in rates of specific cancers in various countries and by the observed changes in the incidence of cancer in migrating. For example, Asians have been shown to have a 25 times lower incidence of prostate cancer and a ten times lower incidence of breast cancer than do residents of Western countries, and the rates for these cancers increase substantially after Asians migrate to the West."
Interestingly enough the longer you live the less likely the cancer is to kill you as the cancer cells originate from "old" cells and have degraded ability to divide. If you are 90 years old and get cancer it's unlikely it will kill you before you die of natural causes.
