Curing Cancer: A Small Effect
on Life Expectancy, A Large Effect on Our Budgets
By
Leonard Zwelling
What does that phrase, “curing cancer,” mean?
Essentially it means that all patients diagnosed with a
malignant disease die of something else and manage to inch their way back onto
the actuarial survival charts used by insurers and government economists.
In the Wall Street Journal on March 17, Sumathi Reddy
reports on novel clinical trials aimed at the pharmaceutical slowing of aging.
Metformin is one of the drugs being proposed for testing. It is to be given to
healthy adults to prevent the onset of the common chronic diseases like cancer,
heart disease, and hypertension that kill Americans, often prematurely.
In the headlines and accompanying data for this article the
following facts are posted. US life expectancy is now 76 for men and 81 for
women. Eradicating cancer would add about 3.5 years to these totals.
Eliminating heart disease would extend life by 4.5 years. Ten to 15 years might
be added to life expectancy if all common chronic diseases could be tamed.
But let’s drop back to that cancer figure.
We are certainly spending a whole helluva lot of money, tax
payers’ and otherwise, to extend the life of the average American 3.5 years by
doing all of this cancer research. Of course, if it is your life, the
investment would be considered worthwhile by you especially since most of it
isn’t your money. If you had to decide where to spend limited resources would
it be to cure cancer or prevent it? Would you invest in more targeted drugs or in massive, national programs of tobacco use
cessation, diet counseling, exercise programs to reduce obesity and courses that teach people “how to go to the doctor 101” for all of those who have acquired health insurance
for the first time on the exchanges and no longer need to use emergency rooms for their primary health care?
These
are not inconsequential questions. We are spending billions every year
developing novel ways to treat established cancer. It is pretty discouraging to
learn that even if we are successful, the prolongation of life in America is
rather modest. Again, if it is your life, it seems well worth it, but from an
economic perspective, cancer centers may not be the bargain they appear to be,
with the exception being the treatment of pediatric cancer which when cured can
extend life by decades.
I am not saying we should stop treatment-based research. I
am just reminding everyone that on the global level, our goal of life extension
through the development of better treatments for adults with established cancer is rather
modest. You can each decide if it is worth the money, time and effort. I guess
it depends whether or not it is your time, your money or your effort.
