Top 5 Cancers Creating Major Challenge To The Global Healthcare System

Over the past few decades Cancer has emerged as a major public health concern worldwide. Cancer is the second leading cause of deaths that takes place worldwide. Every sixth death is due to cancer, and in 2018 was estimated to be responsible for 9.6 million deaths. Costing people quality of lives and eventually leading to death, if not treated timely, the cost of the treatment of cancer is another problem that patients and their caretakers deal with. Even though there exists better healthcare insurance policies in developed countries, out of pocket expenditure incurred in the treatment is again high. As per WHO, “The total annual economic cost of cancer in 2010 was estimated at approximately US$ 1.16 trillion; and has been on a steady increase”.

The impact of cancer worldwide can be witnessed globally. The Middle and low income countries worldwide are lacking in terms of timely quality diagnosis as well as treatment that results in huge loss of life. While in the higher income group countries with high end healthcare services the overall survival rate has increased over the years but the cost of novel target therapies are burning holes in the pockets of patients.

In men Stomach, liver, lung, prostate, and colorectal cancer are most common while females are mostly found affected with breast, cervical, lung and thyroid cancer. 

Here are the most prevalent forms of cancer in terms of number of cases and deaths worldwide includes-

Lung Cancer

Lung cancer causes a major disease burden on the healthcare system, as it accounts for the highest number of diagnosed and cancer-related death cases worldwide. It starts in the cells lining the bronchi and the parts of the lung such as the bronchioles or alveoli. It may spread to lymph nodes or other organs in the body, such as the brain. Cigarette smoking is the major risk factor for lung cancer. Quantity and duration of smoking increase the risk. The lung cancer is mainly of two types small cell lung cancer ( SCLC ) and non-small cell lung cancer (NSCLC) which is more common. 

As per the National Institutes of Health (NIH), “out of the total lung cancer cases approximately 85% of lung cancers are NSCLC. Among those cases, squamous cell carcinoma comprised 30% cases, adenocarcinoma comprised 40% cases, and large-cell carcinoma comprised 15% cases”.

There are different types of treatment available for NSCLC; however, mostly 10 types of standard treatment are used for NSCLC, which includes Surgery, Radiation therapy, Chemotherapy, Targeted therapy, Immunotherapy, Laser therapy, Photodynamic therapy (PDT), Cryosurgery, Electrocautery, and Watchful waiting.

While on the other hand, SCLC accounts for approximately 10-15% of all lung cancers. It is often referred to as oat cell cancer. SCLC grows aggressively and spreads faster as compared to NSCLC. The SCLC creates large tumors and often metastasizes quickly. In about 70% cases, patients affected with SCLC are diagnosed when they are at an extensive-stage of disease. The SCLC responds well to chemotherapy and radiation therapy.

Worldwide, some of the key companies such as AstraZeneca, G1 Therapeutics, PharmaMar, EpicentRx, and others are involved in developing drugs for ES-SCLC.

Colorectal Cancer

Colorectal cancer basically starts in the colon or the rectum (parts of the large intestine). It is also called bowel cancer, colon cancer, or rectal cancer. 

As per WHO, “around 1.80 million cases and 862,000 deaths occur due to Colorectal cancer worldwide every year“. Similarly, as per the American Cancer Society’s estimates “around 104,610 new cases of colon cancer and 43,340 new cases of rectal cancer are expected to occur in 2020 in the United States”. In united states the 5-year survival rate for Colorectal cancer is around 64 percent (2008–2014)

Old age and lifestyle are two main factors for the Colorectal cancer, however a small number of cases may also occur due to genetic disorder. Lack of physical activity, family history of colon cancer, diabetes,  inflammatory intestinal conditions are some of the other risk factors associated with Colorectal cancer.

Some of the common symptoms of colorectal cancer includes persistent change in bowel habits, rectal bleeding, abdominal discomfort, dark-colored stool, diarrhea, abdominal cramping or pain, decreased appetite, and weight loss, and many others. Surgery, chemotherapy, targeted therapy, and Immunotherapy are generally used for the treatment of Colorectal cancer.

Skin Cancer

Skin cancer is one of the most common types of cancer in the United States. Skin can be divided into two categories namely non-melanoma and melanoma. Non-melanoma skin cancer basically occurs in the basal cell and squamous cell. Apart from these two many other types of skin cancer fall within the broader category of Non-melanoma skin cancer such as Angiosarcoma, Sebaceous carcinoma, Merkel cell carcinoma, Cutaneous B-cell lymphoma, and many others. Most of the Non-melanoma skin cancers are curable. The melanoma skin cancer is serious skin cancer as compared to Non-melanoma skin cancer. The melanoma skin cancer accounts for approximately five percent of all diagnosed skin cancer but contributes around 75% of deaths related to skin cancer. 

As per the American Academy of Dermatology Association estimation “one in five Americans will develop skin cancer in their lifetime & approximately 9,500 people in the U.S. are diagnosed with skin cancer every day”. 

Some of the top risk factors for skin cancer includes history of sunburns, a lighter natural skin color, excessive exposure to sun, large number of moles, exposure to certain substances, family history, older age,  exposure to natural and artificial ultraviolet light, and many others. 

The abnormal pink or brown spot, patch, or growth in mole or new mole are common signs of skin cancer. Melanoma cancer is mostly developed in mole.

For the non-melanoma skin cancer, surgery is the main treatment option. Some non-surgical treatment options for skin cancer include Radiation therapy, anti-cancer creams, freezing (cryotherapy), photodynamic therapy (PDT), radiotherapy, Chemotherapy, Biological therapy, electrochemotherapy and others. 

Breast Cancer

Breast cancer is most frequently occurring cancer among women besides skin cancer. Worldwide, around 2 Million women are affected with it each year, and also causes the highest number of cancer-related deaths among womens.

As per WHO, “In 2018, it is estimated that 627,000 women died from breast cancer – which is approximately 15% of all cancer deaths among women”. A higher number of breast cancer cases has been noticed in the higher income countries, although the number of cases are increasing in almost every country around the world. The HR-positive/HER2-negative breast cancer is the most common form of breast cancer and also accounts for a higher percentage of all breast cancers.

The rate of occurrence of Breast cancer varies according to the age and ethnicities. The most common risk factors for Breast Cancer includes genetic mutations, age (mostly diagnosed after age 50), family history of breast cancer, reproductive history, lack of physical activity, and several others. 

Early detection is critical for the survival of patients in case of this cancer. Some of the early signs and symptoms of breast cancer include lump or swelling in the breast or underarm, pain in any area of the breast, change in the colour, size or shape of the breast, and many others. 

In stages I to III of ER-positive/HER2-negative Breast Cancer, the affected patient will get some drug therapy as part of their treatment, which may include chemotherapy, hormone therapy, HER2 targeted drugs, such as trastuzumab (Herceptin) and pertuzumab (Perjeta), and some combination of these.

The current therapeutics treatment options in ER-positive/HER2-negative Breast Cancer Landscape mainly aim to increase the survival rate of the patient population. The key companies such as Jiangsu HengRui Medicine, Odonate Therapeutics, Radius Pharmaceuticals, Roche, Syndax Pharmaceuticals, Merck Sharp and Dohme, GlaxoSmithKline, Takeda Pharmaceuticals, Bayer and many others are involved in the therapeutics market of Breast cancer.  Rich emerging pipelines, new endocrine targeted therapies to overcome resistance, novel chemotherapeutic approaches are some of the key drivers of the Breast cancer market, which are expected to drive the market forward in the coming years. 

Prostate Cancer 

Prostate cancer is cancer that occurs in the prostate gland (a part of male reproductive system). It is one of the most common types of cancer found in men. It is the fourth most prevalent cancer worldwide, and third in the United States. According to the Cancer Treatment Centers of America (CTCA), “about 99% of prostate cancers are adenocarcinomas, which develop in the gland cells. It is common in men of 50–64 years and over age 65; however, it can occur in men younger than 50 years”.

Some of the most common risk factors for the development of prostate cancer includes age, ethnicity, family history, smoking (the risk is higher for heavy smokers), diet and others. 

In the early stage the symptoms of prostate cancer are not apparent in the majority of cases. However in the advanced stage the following signs and symptoms such as discomfort in the pelvic area, blood in semen, trouble while urinating, bone pain, decreased force in the stream of urine, loss of appetite, erectile dysfunction and others. The symptoms often vary from patient to patients. In some cases the cancer may metastasize and can form tumors in nearby bones or organs. Similarly if it spread further to the spine, it may affect the spine nerve also.

There are several treatment options available in the market to treat Prostate Cancer. The selection of treatment options depends upon the risk associated with the cancer. Some of the treatment options include Active surveillance, Radical Prostatectomy (RP), Radiation therapy, Androgen deprivation therapy (ADT), surgery, chemotherapy, immunotherapy, and others.

The therapeutics treatment options which are available in the Prostate Cancer Landscape largely aim to provide cure to the patients suffering from this cancer, however there are various challenges which are yet to be tackled. The overall dynamics of the Prostate Cancer market is anticipated to change, as the number of companies are actively taking interest in the development of drugs for prostate cancer. Some of the key companies involve includes  AstraZeneca/Merck Sharp & Dohme, Bristol-Myers Squibb, Novartis, Myovant Sciences, Janssen Research & Development, Hoffmann-La Roche, Clovis Oncology, Hinova Pharmaceuticals USA, Pfizer/Astellas Pharma, and several others. 

Increasing use of biomarker testing, surge in awareness regarding the treatment of cancer, and an increase in demand for prostate cancer treatment products are some of the key factors expected to drive the prostate cancer market in the upcoming years. 

There is no doubt that cancer makes the lives of patients and caregivers vulnerable. But over the past few years the research and development in the field of medical science has significantly changed the scenario. 

In the coming years Precision medicine and immunotherapies are expected to further enhance the survival rate of cancer patients. In precision medicine instead of providing one-size-fits-all treatment, the focus is to deliver the right treatment for the right patient at the right time. The precision medicine treatments are created to match the genetic abnormalities of the tumor which has caused the cancer. With this approach the cancer-related genes are targeted and the DNA sequence are changes which stop the further spread of disease. Similarly, immunotherapy is also expected to make a significant impact in the cancer treatment in the coming years.