A Health Affairs study that made news this week notes the increasing cost of cancer drugs, as well as the effect rising prices have on prescribing practices. A survey of nearly 1,400 oncologists in the US found 84% say treatments are influenced by their patients’ out-of-pocket spending. While the vast majority supported further research into comparative and cost effectiveness, nearly half of oncologists believed a drug was of good value for $50,001-$100,000 per life-year gained.
The New York Times also recently took a look at high-price cancer drugs. When it comes to drugs like Folotyn — for which a month’s worth of treatment costs up to $37,000 — pharmaceutical companies point out the funds needed for research and development.
But the current system is one of heartbreak: It’s not unheard of for individuals to mortgage their house or even file for bankruptcy due to the high cost of their cancer medications. To put into perspective just how much some cancer patients have to spend, it might be useful to compare these drug prices to a well-known commodity; and please know that, in doing so, we in no way mean to imply that the medicines are not worth the cost. Here are the cars you could afford with the same amount of money as a month’s worth of some cutting-edge cancer drugs (below the fold):
For: Certain forms of colorectal, lung, and breast cancer
Average treatment cost: $8,800/month
For that price: 2 Tata Nano LX cars
For: Certain forms of colorectal and head and neck cancer
Average treatment cost: $10,000/month
For that price: ’10 Hyundai Accent
For: Chronic lymphocytic leukemia
Average treatment cost: Approximately $16,000/month
For that price: ’10 Pontiac Vibe
For: B-cell chronic lymphocytic leukemia
Average treatment cost: $20,000/month
For that price: ’10 Toyota Camry
For: Peripheral T-cell lymphoma
Average treatment cost: Up to $37,000/month
For that price: ’10 Nissan 370Z
For: Pediatric acute lymphoblastic leukemia
Average treatment cost: $68,000/2 weeks of treatment**
For that price: ’10 Lexus SC 430
Car prices via Consumer Guide Automotive and infibeam.com
DEFEATING CANCER
Prostaglandins are infinitesimal, ephemeral and powerful molecules, regulating the chemistry of every cell, including those regulating mood, and those regulating immune function. Thromboxanes, first cousins of prostaglandins, regulate the flow and clotting of blood. When produced within normal limits, prostaglandins regulate the chemistry of every cell; when produced excessively, physiology becomes pathology. In 1966, Williams, working at the Makerere Medical College in Uganda, was the first to establish a role for prostaglandins in cancer, by demonstrating a significant increase of prostaglandins in the plasma and thyroid of patients with medullary cancer of the thyroid.
At the University of Nairobi medical school, David Horrobin, the head of the physiology department, and Rashida Karmali, his graduate student, were interested in prostaglandins. Rashida, whose career took her to the Sloan- Kettering, showed that prostaglandins are tumor initiators, promoters, and instigators of metastases, and provided evidence suggesting that thromboxanes determine which organs are sites of metastases.
In 1973, Horrobin, having moved to Canada, and his team of pharmacologists and physiologists, showed that antidepressants inhibit prostaglandins and thromboxanes, and in 1977 that prostaglandins regulate nucleic acids (DNA and RNA).1,2 Others subsequently showed that prostaglandins regulate the synthesis, inhibition, and expression of genes, and the growth, differentiation, and replication of cells, with cancer the accelerated replication of abnormal cells.1,2 Excessive synthesis of prostaglandins induces cancer, with genes determining the variations. In 1990, prostaglandins had a lock on the science of cancer, but not on its politics, exploitation, commercialization, and corruption.
In the mid-nineties, I was aware of the immunostimulating and antimicrobial properties of antidepressants, and had striking but limited evidence for their possible anticancer actions. In 1998, Brenda Penninx showed that at age 70, chronically depressed people have an increased risk of 88% of developing cancer, and a 50% increased risk of dying of it. To me that tipped the balance, but not to the editors and peer reviewers of cancer journals, who concocted reasons to reject my articles.
More than seventy clinical, laboratory, and epidemiological studies have shown that antidepressants kill cancer cells, inhibit their proliferation, convert multidrug resistant cells to chemotherapy sensitive, augment chemotherapy, protect nonmalignant cells from damage by radiation and chemotherapy toxicity, and target the mitochondria of cancer cells while sparing those of healthy ones.1,2 Antidepressants have therapeutic potential in many cancers that are often treatment resistant, such as gliomas, cancers of the lung, kidney, liver, and uterus, inflammatory breast cancer, and multiple myelomas.2 Antidepressants are capable of arresting lung cancer in advanced stages, and significantly extending life. That antidepressants are effective for a multitude of malignancies, decries the myth that cancer is a hundred diseases, when it is one disease with a hundred variations.
Antidepressants can alleviate cancer pain, alone or combined with narcotics, remit nausea and vomiting, promote sleep, relieve anxiety and depression, and combat fatigue. Other inhibitors of prostaglandins, such as COX-1 and COX-2 inhibitors, also have potential value in defeating cancer. Such COX-1 inhibitors as aspirin can prevent the development of colon cancer, and the spread and recurrence of breast cancer. The components are in place for a revolution in cancer prevention and treatment, as may be confirmed by accessing “Medline” or “Pubmed,” and entering “antidepressants” and “cancer.”
Sincerely,
Julian Lieb, M.D
1.Lieb, J.”The multifaceted value of antidepressants in cancer therapeutics.” Eur J Cancer. Editorial Comment. (2008) 172-174
2 Lieb,J.”Defeating cancer with antidepressants.”ecancermedicalscience”DOI. 10.3332/eCMS.2008.88
3.Lieb, J “Killing Cancer.” (1010) Amazon (in press).