Leading cancer institutions say the time has come to offer prevention and care in every country across the globe.
First we had European cancer experts deliberating on the shores of a Swiss lake in Lugano. Now the premier cancer research organisations in the world, led by the National Cancer Institute in the US and Cancer Research UK, are speaking out. They are saying much the same things: it is time to take what we know about basic cancer prevention and care into the poorest countries. It is also time to rethink the way ahead for cancer research, so everybody benefits and money is not wasted on hugely expensive but ineffective treatments.
Wednesday’s statement is published in the Science Translational Medicine journal and is authored by Harold Varmus, Nobel prize-winning director of the National Cancer Institute in the US and by Harpal Kumar, CEO of Cancer Research UK on behalf of leading institutions from Australia to Argentina and Taiwan to Turkey. The piece came out of a meeting at the NIH last November, where scientists from 15 countries came together to discuss what should be done.
There are two massive issues, which the cancer experts attending the European School of Oncology in Lugano also tackled – as I wrote in an earlier post. The more troubling is that the cancer burden in developing countries is high and growing, yet there is very little treatment, let alone prevention, even though basic interventions such as screening for cervical cancer and giving women with breast cancer cheap generic drugs such as tamoxifen would save thousands of lives. The other is that the vast amount of cancer research is failing to make the sort of progress we once expected and is costing a fortune. New so-called targeted drugs are not living up to their promise. Cancer treatment is becoming unaffordably expensive, even in rich countries.
This is the how the statement neatly defines the problem:
The global burden of cancer includes 12.7m newly diagnosed cases per year, of which more than half occur in less developed regions of the world. Cancers now account for more than 15% of the world’s annual deaths (>7.5 million per year), and that number is rising, especially in less affluent countries. Moreover, cancers are among the most feared medical conditions, often causing prolonged periods of suffering, requiring substantial healthcare expenditures for advanced care, and being fought with medical tools that are relatively ineffective and themselves frequently disabling.
The authors want the cancer community to come out of its silos. Instead of each country tackling the particular cancers that afflict its citizens, there is a need to join together to make better progress, as well as to start things happening in countries where there is no help at all for men, women and children with the disease. And there are some things that can be done without advanced laboratories. First, there needs to be a big push against tobacco, which is a major cause of many different cancers. The report urges action from governments in the developing countries that tobacco companies now consider their best hope of more profits. It calls for big taxes on tobacco to try to prevent the habit taking off in sub-Saharan Africa, efforts to deglamourise it and stop health professionals setting a bad example by smoking.
This is Hazel Nunn, head of health and evidence and information at CRUK:
While the focus of an organisation like Cancer Research UK must begin at home, we have a moral responsibility to work with others to ensure the scourge of tobacco-related cancers doesn’t engulf the poorest countries of the world while we are looking the other way.
The scientists call for cheaper versions of the HPV vaccine, against the virus which triggers most cervical cancer, to be developed and used across poor countries. And they want more research into vaccines against other cancer-causing viruses, like hepatitis C. They want all countries to develop their own cancer plan and for new drugs to reach them faster.
On research, the statement calls for scientists to share their results in more open databases, so that everyone can learn from what goes well and what goes wrong. And they are categorically opposed to the patenting of genetic data – as companies have tried to do with breast cancer genes. These, they say, are obstacles to cancer research.
Cancer Research UK hopes this document will prove a turning point in the fight against cancer, enlisting governments as well as scientific establishments and research funders in a global cause – to defeat a disease that knows no borders.