On any video discussing research on new cancer therapeutics or diagnostics, there are a few types of comments that always seem to show up. One of them is a variation upon:
“There is already a cure for cancer, but the pharmaceutical companies/government are hiding it”
The idea is that treatments for cancers sell for so much money that those who stand to profit are highly motivated to maintain that status quo. I see where this is coming from, but it doesn’t seem like it could be correct for a few reasons:
There is not just one type of cancer. There will likely never be a single cure for all “cancer”. There are over 100 different types and subtypes of cancers that all present unique biological circumstances requiring different approaches to treatment. This is the reason why the treatment paradigms for various types of cancers can be very different.
The government spends an enormous amount of money each year while paying for cancer treatments and diagnostics. It's estimated that about 43% of the costs of cancer treatment in 2018 were paid by the government (Medicaid/Medicare), or roughly $48 billion of the $183 billion spent overall on cancer treatments. That number is projected to increase each year as the population grows and becomes older over time. From a financial standpoint, the government could save money as long as cancer cures were sold at a price that was less than the cost of cancer treatments (which can be extremely expensive!) The government would lose a lot of money by keeping a cancer cure secret.
Companies can sell cures for incredibly large amounts of money. Although I wish it were not the case, curative treatments for serious diseases can fetch an extremely high price tag in the United States markets. Any company that was the first to develop a super effective “curative” treatment for a type of cancer would quickly establish itself as the “first-line” therapy and be able to charge incredible amounts of money.
For example, hepatitis C is a serious infection that can lead to liver cancer and death. Luckily, there have been several treatments developed that can lead to cure in upwards of 90% of people. Those treatments have price tags ranging from $40k to about $95k. If any pharmaceutical company could take 100% control of the treatment market for any given type of cancer and charge potentially $100k+++ per treatment , they would do so as quickly as possible. For example, CAR-T cell therapies for some types of cancer have price tags on the order of $300k-$2M, with a median of ~$610k. Simply put, there is a lot of money to be made from highly effective cancer treatments, and companies want to take advantage of that fact to dominate market share as the first line therapy and make immediate profits, not keep it a secret.
Pharmaceutical companies are in fierce competition with each other There is a big risk that any company has to consider: if a pharma company were to discover a cancer cure and decide to hide it rather than pursue development, there is a risk that a competitor might learn of the technology (either through a defector scientist or through independent discovery) and then benefit from the combination of ~100% market share and big price tags. Given the potential $$ in question, competition among pharma R&D is fierce, as recently seen in the race to develop the fastest, most effective, and safe vaccines and treatments for COVID-19. Although COVID vaccines are sold for only ~$4-$20 per dose, COVID treatments such as monoclonal antibodies or oral medications can fetch closer to $700-$2,000+. This has not stopped companies from developing COVID vaccines that are highly effective in reducing risk of severe disease/hospitalization.
Pharma companies are not the only ones doing cancer research There are scores of individual research labs at universities, government institutions, and non-profit organizations across the world that have no connection to pharmaceutical companies’ interests. In each of these cases, there is intense motivation to be the first to make a significant step forward toward improved therapeutic and diagnostic options for any type of cancer (let alone a cure for all cancers). The incentive structure for researchers at academic and government institutions is largely based on prestige and publishing any major advance in a cancer therapeutic would be a career supercharger. Not to mention, the researchers who have been studying cancer and cell biology for decades probably truly want to contribute to improvements to patient outcomes. It doesn’t seem likely that someone would conduct research for decades in pursuit of a big discovery, only to keep it a secret once they found it. Further, the whole research lab would have to keep it a secret, not just the lead researcher/PI! Research labs can easily consist of dozens of people, and it seems unlikely that that many people could be coerced to keep a cancer cure secret without there being an anonymous leak.
There are probably some more reasons that I haven’t thought of here! As discussed in my prior post (also linked below), the field has made incredible advances in cancer therapies in the last few decades, leading to improved patient outcomes, and I expect that trend to continue. However, it is unlikely that a single silver bullet will be the end to all cancer. It will take continued advancements for each of the diverse types of cancer.
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