Cutting the rate of cancer deaths has been on our collective consciousness since former President Richard Nixon declared “war” on the disease in 1971. In more recent months, President Joe Biden has made sweeping statements and budget proposals that ask Congress for more than $2.8 billion in the federal budget to help advance his cancer-fighting goals, hoping to continue the momentum of the program that was first set forward by former President Barack Obama in 2016. The funding request is intended to close gaps in cancer screenings, better understand social determinants of health that can lead to cancer, and reduce the rates of more preventable cancers, like those linked to tobacco consumption. While the goal of the Cancer Moonshot is strategically broad, there is an important element excluded from the initiative: improving the quality of life for cancer patients. Increasingly, cancer patients can survive longer, making cancer more like a chronic disease. Yet, patients consistently experience a lower quality of life (QoL) as a result of this type of disease management.
One of the first qualitative studies that explored a patient’s quality of life during active cancer treatment found that when patients were asked what negatively impacted their QoL during cancer treatment, their primary and often only response was the side effects of treatment.
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
With women in the U.S. having a 13% chance of developing breast cancer in their lifetime, the disease consistently remains one of the most prevalent types of cancer in the country and breast cancer patients report dissatisfaction with their QoL at some of the highest rates. Although breast cancer therapies have become more targeted since I watched my mother receive radiation and an aromatase inhibitor, aggressive side effects still plague patients undergoing treatment. Despite grand measures to slash the rate of cancer deaths and advancements in oncology, there still seems to be little regard for a patient’s QoL while receiving treatment.
We need more research and consideration of other approaches to cancer treatment and development of new therapies that better account for the QoL of cancer patients.
A “war” on cancer might also mean a war on our bodies
It is an incredible feat of the scientific community to have successfully lowered breast cancer-related deaths over the last few decades. Since 1989, breast cancer deaths have declined by 43% through 2020. Disease treatment has come to mirror that of a chronic illness, as opposed to a life-threatening disease — but that should not mean that we ignore a patient’s QoL during such treatment. Surgery, chemotherapy, and radiation therapy all come with a laundry list of side effects, from nausea, anemia, infection, fertility problems, kidney problems — the list goes on. There has been such a successful and bold approach to lowering the fatality rate of breast cancer, but the next frontier of medicine must focus on reducing the side effects of our tried-and-true cancer therapies.
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
The importance of targeted therapy
As the medical community, including researchers and drug developers, moves into the next phase of cancer care, a central question will be: Can we reduce the side effects of these treatments without compromising the efficacy of treatment? Yes, there are interventions to help cancer patients mitigate their side effects; but on a larger, more institutional scale, the community must realign its goals when developing drugs. The very phrase “war on cancer” implies an aggressive, and sometimes destructive, approach to treatment. Many of the therapies on the market today utilize a “carpet-bombing” approach to treatment, but it is this very method that leads to more intense side effects in an individual, and therefore a lower QoL.
While treatments for breast cancer are incredibly patient-dependent, there has been a rallying cry in recent years to increase therapy options that will be less detractive to a patient’s day-to-day life. Chemotherapy is effective in treating breast cancer, but it has been cited as one of the most aggressive, debilitating forms of treatment because it not only kills cancer cells, but it also kills or slows the growth of healthy cells. Disrupting healthy cells can cause a myriad of side effects like exhaustion, nausea, hair loss, and mouth sores. Targeted therapies, like monoclonal antibodies (mAbs), have promised to be a less toxic approach to other breast cancer treatments on the market. mAbs are man-made versions of immune system proteins that attach to the HER2 protein on breast cancer cells, which can help stop the cells from growing. They essentially mark cancer cells so the immune system can more easily destroy them; by interfering directly with the specific proteins that make up breast cancer, the treatment is able to stop the cells from spreading throughout the body. This precision medicine approach decreases side-effects, maximizes efficacy, and allows breast cancer patients to have the highest QoL.
While there has been a proliferation of clinical trials for the use of mAbs to treat breast cancer in recent years, mAbs have not yet reached their full potential and they are still considered a relatively young treatment. Because of that, the price of mAb treatments for cancer is expensive; in some instances, the average cost for one year of FDA-approved treatment can be up to $100,000. There are also the potential side effects and risks associated with taking the treatment; according to the Mayo Clinic, rare but potentially serious side effects include increased blood pressure, risk of congestive heart failure, and infusion reactions that can occur shortly after while receiving the treatment.
Listening to our patients
In a recent op-ed from The Guardian, one woman details her journey with chemotherapy to treat breast cancer. She describes how the treatment made her feel both physically and emotionally, and how no number of consultations with her physicians could prepare her for the actuality of the treatment. She closes the piece by stating that she was ultimately “willing to suck up pretty much anything if it gives [her] a chance of surviving a killer disease.” As an oncologist and drug developer, I urge my colleagues to view cancer not as a war on the body, but as an opportunity to heal sick cells on a more individual, more targeted level.to view cancer not as a war on the body, but as an opportunity to heal sick cells on a more individual, more targeted level.
Photo: belchonock, Getty Images
Dr. Chan is a physician-inventor. He is currently Chairman, Co-Founder of Abpro, CEO of rHEALTH, and President, CSO of DNA Medicine Institute, a medical innovation laboratory. He has been honored as Esquire magazine’s Best and Brightest, one of MIT Technology Review’s Top 100 Innovators, and an XPRIZE winner. His work has contributed to the birth of next-generation sequencing, health monitoring in remote environments, and therapeutics. Dr. Chan holds over 60 patents and publications, with work funded by the NIH, NASA, and USAF. Dr. Chan received an A.B. in Biochemical Sciences from Harvard College summa cum laude in 1996, received an M.D. from Harvard Medical School with honors in 2007, and trained in medicine at the Brigham and Women’s Hospital.
