February 4th of each year is World Cancer Day.
Its aim is to increase the global awareness of cancer, especially in economically less developed countries, where 70% of cancer deaths occur.
World Cancer Day was created at the first ever World Summit Against Cancer meeting in Paris, 2000. Government agency and cancer organisation leaders from all over the world signed the Charter of Paris Against Cancer. The charter is comprised of: “10 articles that outlined a cooperative global commitment to improving the quality of life of cancer patients and to the continued investment in and advancement of cancer research, prevention, and treatment.” Article X of the charter formally declared February 4 as World Cancer Day “so that each year, the Charter of Paris will be in the hearts and minds of people around the world.”
There have been many advancements in the understanding, diagnosis and treatment of cancer which have lowered the mortality rates, yet due to the increasing size in population, the number of global cancer cases is increasing. In 1990 there were 8.1 million new cancer cases which has grown to 14.1 million in 2012. According to the World Health Organisation, 40% of deaths due to cancer are preventable, and awareness is the first big step towards achieving this goal. The International Union Against Cancer is dedicated to raising awareness globally about cancer, which includes the coordination of World Cancer Day.
World Cancer Day is an opportunity to declare new themes and release new publications for the World Cancer Campaign lead by the union. The campaigns are mainly partnerships with health and cancer institutions as well as creating educational materials about cancer and its prevention.
The BBC published an interesting article for World Cancer Day, querying whether we are fighting cancer in the right way. The number of new cancer cases is predicted to hit 24 million by 2035 so the BBC World Service Inquiry programme asked four experts on their opinions and thoughts about our approach to curing cancer.
The most shocking comments in my opinion were made by Dr Vincent DeVita, a leading cancer specialist in the USA. He also helped develop a cure for Hodgkin‘s disease in the 1960‘s. DeVita‘s main concern is that:
“The process we’re going through now stifles innovation. We’re doing a lot of things right. We’re in the middle of a molecular revolution, but we’re not taking advantage of all the information that we have because of the regulatory apparatus. A few years ago a study looked at how long it took an idea to [become a cancer treatment] protocol, be approved and initiated. The average was 800 days, in some cases 1,000. And if you made a change in the protocol, you had to start all over again. In some cases, 29 signatures were required to approve a protocol. The programme which ultimately cured Hodgkin’s disease took us three years. It would take us 15 years to do it now.”
That in itself is worrying. DeVita continues to explain that cancer cells need to be attacked with a combination of different drugs at the same time, as the cells can quickly learn and adapt to any one drug. Most cancer treatments require combination drugs to be effective. DeVita says that once drugs get approved by the Food and drug Administration (FDA), a lot of innovation occurs in this period where doctors test combinations of drugs and perform studies. This fruitful period is now tightly regulated.
DeVita continues to give a very personal example of his sister, whom he lost in May 2015 from lung cancer. She couldn‘t be treated with the right drug as it was not FDA approved for lung cancer at the time. It had only been approved for melanoma. DeVita says: “She [his sister] missed an opportunity to have maybe a 60% chance of a good prolongation of her life. That’s happening all over the country – drugs are being tested in ways that are unnecessary, delaying access to patients who can benefit from them.” He concludes his comments by noting the good intention of strict regulations of drug testing yet he feels the rules are starting to harm patients too.
Another expert interview is Heidi Williams who talks about most FDA approved drugs being for very late stage cancer patients – those who are approaching the end of their lives. She states, “It’s very rare that we see drugs approved to treat early stage cancers or to prevent cancer.” She continues: “For patients with, say, localised breast cancer who are relatively healthier, you would need a much longer clinical trial in order to show evidence that your drug reduces mortality rates. That difference in clinical trial lengths matters because longer trials are more expensive and take more time.”
Dr Christopher Wild, the director of the international Agency for Research on Cancer focuses on prevention. He states that 40-50% of cancers could be prevented. But this would require a translation of our knowledge of causes into effective interventions and reduction to risk factors. Wild also notes the difference in cancer patterns across the world: “What we’re seeing is the addition of cancers now which are more common in high-income industrialised countries, such as breast cancer and colorectal cancer, prostate cancer. If you look at a country’s progression in relation to colorectal cancer rates, those two things go up together. It’s almost as if colorectal cancer is a good index of development.”
What do we conclude from all of this? At the end of the day, many of us are confronted with either a cancer scare in ourselves or cancer affecting someone close to us. The emotional battle is already hard enough without questioning the purity and focus of available treatments. The positive aspect to focus on I believe is that there are new treatments emerging all of the time, such as Proton beam cancer therapy and the beginnings of Designer Biomimetic Vector gene manipulation.
We send everyone who is having a cancer related experience our best wishes for recovery and to those mourning the loss of loved ones, we wish you strength and peace.