Incidence of Cancer

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The Hindu Business Line  May 18  Comment 
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GenEng News  May 14  Comment 
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In modern times, cancer has emerged as a leading cause of death, particularly in developed countries. Whereas vaccines and cures have eliminated many of the diseases that, in the past, were common causes of death, there is no such cure for cancer. Additionally, the quality of modern medical care, combined with new therapies, enables people to live longer lives than ever before. While innovative developments can make certain cancer treatments more chronic, cancer is often the result of cumulative damage to cells that's built up over time. Longer lifespans provide more time for damage to accumulate, which might be a factor in the incidence of cancer.

As the second-largest cause of death in developed countries and the third-largest worldwide, cancer has spawned the development of an entire industry dedicated to its treatment. Pharmaceutical companies, medical device manufacturers, and biotech companies, among many others, contribute to the overall treatment of cancer. Every year, universities, governments, and foundations spend billions of dollars on cancer research. Due to the vast amounts of time and money required to develop new treatment options ranging from tumor vaccines to selective nanoparticle based targeting of cancer cells, chemotherapy drugs and other cancer-related treatments are often quite costly. With longer life durations enabled by chemotherapies and other treatments, medical costs have risen drmatically. Fees for cancer therapy are often reimbursed by either insurance companies or government health plans, however, allowing companies to maintain their pricing power. In addition, the grave nature of the disease minimizes the "Vioxx effect", or the risk that a cancer drug's adverse side effects will severely impact its manufacturer. Patients are often willing to accept a certain degree of risk if a drug's benefits are large enough.

Which companies offer products related to the treatment of cancer?

Supportive care

Companies that make supportive care products -- which treat the side effects of cancer treatment instead of treating the cancer itself -- can have broader exposure to the oncology market than the makers of therapeutic drugs themselves. Therapeutic drugs to treat cancer are often specialized and used in just a few different tumor types, while supportive care products tend to treat side-effects of cancer treatment that are common to almost all cancer patients.

  • Amgen (AMGN) has an enormous oncology supportive care franchise with over $7 Billion a year in sales. Amgen produces Neupogen and Neulasta, two drugs that combat neutropenia, a condition in which chemotherapy depletes neutrophils, a type of white blood cell. This can help offset the immunosuppressive effects of chemotherapy. Amgen also makes Aranesp, which is used to treat anemia, another common side effect of chemotherapy, by stimulating red blood cell production.
Antiemetics

Antiemetics control the nausea that is a common side-effect of chemotherapy and radiation

Therapeutic Drugs

  • Genentech (DNA) produces Avastin, which is used in the treatment of colon and lung cancers, and Herceptin, a blockbuster breast cancer drug. Additionally, its drug Tarceva is used to treat advanced lung and pancreatic cancers.
  • Novartis AG (NVS) makes Gleevec, a drug designed for first-line treatment of chronic myeloid leukemia, a rare disease affecting between 5,000 and 8,000 MS symptoms patients each year.
  • ImClone Systems (IMCL) and Bristol-Myers Squibb Company (BMY) distribute the drug Erbitux, which is used to treat both colorectal and head and neck cancers.
  • GlaxoSmithKline (GSK) received FDA approval in March, 2007, for Tykerb, a second-line cancer drug used for advanced sacroiliac joint pain cases of breast cancer.
  • Sanofi-Aventis SA (SNY) produces Eloxatin, a chemotherapy drug used to treat colorectal cancer. Sanofi-Aventis has recently filed lawsuits against both Teva Pharmaceutical Industries (TEVA) and Sandoz, a division of Novartis AG (NVS) for filing for FDA approval to sell generic versions of Eloxatin in the U.S. If either of these two companies were to win their court battles and gain FDA approval, they would benefit greatly (at Sanofi's expense).
  • Dendreon (DNDN) is a biotech company focused almost exclusively on drugs aimed at fighting cancer. Its drug Provenge is currently being reviewed by the FDA.
  • Spectrum Pharmaceuticals (SPPI) is a biotech company with a primary focus on oncology. It currently markets Zevalin used in the treatment of Refractory Non-Hodgkins Lymphoma through radioimmunotherapy.

Drugs in the development pipeline

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Distribution of Cancer Drugs

What is cancer?

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U.S. new cancer cases per 100,000 people, 1975-2004

Cancer is a unique disease in that it comes in many different forms and can entail any of a variety of treatment options. Cancer is characterized by a group of abnormal cells that grow and replicate uncontrollably. These cells' rapid replication allows them to invade adjacent tissues and organs and even spread to other parts of the body. As they replicate, they can crowd out organs, preventing the body's essential processes from occurring normally. Cancer, if left untreated, can hinder the body's organs from performing their functions enough so as to cause death. In the U.S. and other developing countries, cancer is responsible for around 25% of all deaths, second only to cardiovascular disease.

What causes cancer?

In the majority of cases, cancer results from a mutation of cells' genetic code. Healthy cells follow a highly regulated cycle of cell division and cell death. This cycle maintains a balance in the body, with new cells being formed only as fast as old cells die. Cancer results when a cell with mutated DNA divides and passes on the mutation to its daughter cells, which starts a cycle of erratic, uncontrolled cell division leading to the formation of a tumor, or mass of cancerous cells.

There is no one factor that guarantees that cancer will form, but there are several things that have been proven to increase the risk of genetic mutation leading to cancer. These factors range from environmental influences to hereditary factors.

  • Common Causes
    • Smoking tobacco
    • UV radiation
    • Viral infections
    • Hormonal imbalances

Treatment

There are a variety of treatment options for various types of cancer. The most common methods of treatment are surgery, radiation therapy, and chemotherapy (drug therapy), which are often used in conjunction with one another to treat various aspects of cancer. Surgery is used to remove physically remove cancerous cells from the body, while radiation therapy damages cancer cells' genetic material, rendering them unable to replicate. Chemotherapy drugs work to destroy cancer cells by interfering with cell division in a number of different ways. Newer experimental treatments such as gene therapy have demonstrated some effectiveness, but are not ready for widespread adoption. Due to the varied ways in which they function, these drugs are often used in combinations of two or more, attacking cells from various angles.

In addition to curative treatments, cancer often necessitates supportive care, including symptom control and palliative care. Treatments such as these are not aimed at curing or halting the spread of cancer. Rather, supportive care is designed to reduce the severity of cancer's symptoms and improve patients' quality of life. Examples include treatments for the side effects of chemotherapy and radiation therapy, which can include anemia, immunosuppression, nausea, skin damage, and swelling, among many others. Though supportive care is not directly involved in the treatment of cancer, it has become recognized as an important part of overall cancer therapy.

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