goodideapublichealth

goodideapublichealth:

An Unexpected Choir with a Powerful Message

The audience at the São Paolo’s Museum of Art was waiting to listen to the famous São Paulo University choir. Instead, a choir of 12 laryngectomy patients went on stage and performed All You Need is Love by the Beatles using esophageal voice, prosthesis and electronic larynx. Most of the singers lost their voice due to larynx cancer, as a result of smoking.  At the end of the performance, they displayed the sign: LISTEN TO THIS CHOIR’S VOICE: DON’T SMOKE

 

Chart: The Deadliest and Most Common Cancers

Cancer mortality rates at five, 10, 15, and 20 years after diagnosis.

By Chris Kirk and David Taylor



Here’s a chart that’s a little disturbing: The interactive graphic above, created by biotechnologist David Taylor and appearing first on his data-visualization blog, illustrates how common and deadly various types of cancer are. Each pie chart represents an organ (matched for color) and is sized according to the incidence of cancer of that organ. The charts are based on data from the American Cancer Society and a 2002 study of long-term survival rates. The red wedges show the proportion of patients who die from the cancer within the selected number of years after diagnosis.


As the chart reflects, breast and prostate cancers are the most common, with 235,000 and 239,000 new cases last year respectively. Fortunately, they are relatively survivable cancers, though their mortality rates more than double by the 20-year mark. Pancreatic cancer is the most deadly, killing 96 percent of patients within five years. That’s partly because pancreatic cancer typically does not cause symptoms until it’s at a late stage of progression. For the same reason, liver cancer is the second-deadliest cancer, killing 93 percent of patients within five years.
(From SLATE)
Chart: The Deadliest and Most Common Cancers Cancer mortality rates at five, 10, 15, and 20 years after diagnosis.

By Chris Kirk and David Taylor

Here’s a chart that’s a little disturbing: The interactive graphic above, created by biotechnologist David Taylor and appearing first on his data-visualization blog, illustrates how common and deadly various types of cancer are. Each pie chart represents an organ (matched for color) and is sized according to the incidence of cancer of that organ. The charts are based on data from the American Cancer Society and a 2002 study of long-term survival rates. The red wedges show the proportion of patients who die from the cancer within the selected number of years after diagnosis.

As the chart reflects, breast and prostate cancers are the most common, with 235,000 and 239,000 new cases last year respectively. Fortunately, they are relatively survivable cancers, though their mortality rates more than double by the 20-year mark. Pancreatic cancer is the most deadly, killing 96 percent of patients within five years. That’s partly because pancreatic cancer typically does not cause symptoms until it’s at a late stage of progression. For the same reason, liver cancer is the second-deadliest cancer, killing 93 percent of patients within five years.

(From SLATE)

Rates of indoor tanning among female high school students lowest in states with multiple restrictions on youth access
Female high school students in states with indoor tanning laws, particularly those with parental permission laws and age restrictions, were less likely to engage in indoor tanning compared to students in states without any laws, according to a CDC study published online by the American Journal of Public Health.
Skin cancer is the most common form of cancer in the United States. Approximately 3.5 million cases of nonmelanoma skin cancers are treated annually, and over 60,000 melanomas are diagnosed annually. While most cancers have been on the decline since the 1990s, melanomas, which are the most fatal of skin cancers, have been on the rise, especially among young women. Increased exposure to ultraviolet radiation through indoor tanning may be partially responsible for the continued increase in melanoma.
Researchers, led by Dr. Gery Guy at CDC’s Division of Cancer Prevention and Control, analyzed results of the 2009 and 2011 National Youth Risk Behavior Surveys of U.S. high school students in grades 9-12, and examined the details of each state’s indoor tanning laws. Among high school students, 23.4 percent of females engaged in indoor tanning, and 6.5 percent of males engaged in indoor tanning.
Dr. Guy and his colleagues looked at state indoor tanning laws, and the relationship between teens’ tanning behaviors and state laws. System access laws included warning statements and signs, limited advertising about the benefits of tanning, mandatory protective eyewear, operator-required incident reports, and penalties for violations. Youth access laws included parental permission for minors and age restrictions.
The odds of female students engaging in indoor tanning in states with any indoor tanning laws were 30 percent less than those in states without any indoor tanning laws. The odds of female students in states with systems access, parental permission, and age restriction laws engaging in indoor tanning were 42 percent less than those in states without any laws. Laws were not associated with the prevalence of indoor tanning for male youth.
States with laws that included systems access, parental permission, and age restrictions had the lowest rates of indoor tanning among teen girls.  This is the first study to look at the impact of such laws on indoor tanning rates.
“State indoor tanning laws, especially age restrictions, may be effective in reducing indoor tanning among our nation’s youth,” said Gery Guy, PhD, health economist and the study’s lead author. “We need to address the harms of indoor tanning, especially among children. Indoor tanning laws can be part of a comprehensive effort to prevent skin cancers and change social norms around tanned skin.”
The numbers of states implementing new laws, particularly age restrictions, have increased substantially in recent years. Currently, six states (California, Illinois, Nevada, Oregon, Texas, and Vermont), restrict indoor tanning among minors aged younger than 18 years. A number of states are either considering new youth access legislation or strengthening existing laws.
The World Health Organization recommends that no one under the age of 18 years use indoor tanning. The Food and Drug Administration has proposed reclassifying indoor tanning devices from low- to moderate-risk devices. The proposed order advises against the use of indoor tanning among minors aged younger than 18 years.
(From CDC)
Rates of indoor tanning among female high school students lowest in states with multiple restrictions on youth access

Female high school students in states with indoor tanning laws, particularly those with parental permission laws and age restrictions, were less likely to engage in indoor tanning compared to students in states without any laws, according to a CDC study published online by the American Journal of Public HealthExternal Web Site Icon.

Skin cancer is the most common form of cancer in the United States. Approximately 3.5 million cases of nonmelanoma skin cancers are treated annually, and over 60,000 melanomas are diagnosed annually. While most cancers have been on the decline since the 1990s, melanomas, which are the most fatal of skin cancers, have been on the rise, especially among young women. Increased exposure to ultraviolet radiation through indoor tanning may be partially responsible for the continued increase in melanoma.

Researchers, led by Dr. Gery Guy at CDC’s Division of Cancer Prevention and Control, analyzed results of the 2009 and 2011 National Youth Risk Behavior Surveys of U.S. high school students in grades 9-12, and examined the details of each state’s indoor tanning laws. Among high school students, 23.4 percent of females engaged in indoor tanning, and 6.5 percent of males engaged in indoor tanning.

Dr. Guy and his colleagues looked at state indoor tanning laws, and the relationship between teens’ tanning behaviors and state laws. System access laws included warning statements and signs, limited advertising about the benefits of tanning, mandatory protective eyewear, operator-required incident reports, and penalties for violations. Youth access laws included parental permission for minors and age restrictions.

The odds of female students engaging in indoor tanning in states with any indoor tanning laws were 30 percent less than those in states without any indoor tanning laws. The odds of female students in states with systems access, parental permission, and age restriction laws engaging in indoor tanning were 42 percent less than those in states without any laws. Laws were not associated with the prevalence of indoor tanning for male youth.

States with laws that included systems access, parental permission, and age restrictions had the lowest rates of indoor tanning among teen girls.  This is the first study to look at the impact of such laws on indoor tanning rates.

“State indoor tanning laws, especially age restrictions, may be effective in reducing indoor tanning among our nation’s youth,” said Gery Guy, PhD, health economist and the study’s lead author. “We need to address the harms of indoor tanning, especially among children. Indoor tanning laws can be part of a comprehensive effort to prevent skin cancers and change social norms around tanned skin.”

The numbers of states implementing new laws, particularly age restrictions, have increased substantially in recent years. Currently, six states (California, Illinois, Nevada, Oregon, Texas, and Vermont), restrict indoor tanning among minors aged younger than 18 years. A number of states are either considering new youth access legislation or strengthening existing laws.

The World Health Organization recommends that no one under the age of 18 years use indoor tanning. The Food and Drug Administration has proposed reclassifying indoor tanning devices from low- to moderate-risk devices. The proposed order advises against the use of indoor tanning among minors aged younger than 18 years.

(From CDC)


World Cancer Report 2014

This book from the International Agency for Research on Cancer, the specialized cancer agency of the World Health Organization, provides a unique global view of cancer, including cancer patterns, causes, and prevention. The World Cancer Report series is recognized as an authoritative source of global perspective and information on cancer. The first volume appeared in 2003 and the second in 2008. This third volume in the series encompasses both established knowledge and recent research achievement.
World Cancer Report provides a professional, multidisciplinary assessment of all aspects of the geographical distribution, biology, etiology, prevention, and control of cancer, predicated on research. The concise nature of the text and the high graphic content (hundreds of colour maps, diagrams, and photographs) make the publication accessible to a broad readership. World Cancer Report is designed to provide non-specialist health professionals and policy-makers with a balanced understanding of cancer control and to provide established cancer professionals with insights about recent development.
The book includes chapters in which distinguished scientists from around the world provide a broad overview of established knowledge and then emphasize research activity and progress. In addition, text boxes distributed throughout the book provide short, in-depth discussions of selected questions or topics. A new feature of this volume is the inclusion of Perspectives considering the future development of different aspects of cancer research, written by those whose record of outstanding achievement qualifies them as individuals having unique vision.
(From International Agency for Research on Cancer, World Health Organization)
http://www.iarc.fr/en/publications/books/wcr/index.php

World Cancer Report 2014

This book from the International Agency for Research on Cancer, the specialized cancer agency of the World Health Organization, provides a unique global view of cancer, including cancer patterns, causes, and prevention. The World Cancer Report series is recognized as an authoritative source of global perspective and information on cancer. The first volume appeared in 2003 and the second in 2008. This third volume in the series encompasses both established knowledge and recent research achievement.

World Cancer Report provides a professional, multidisciplinary assessment of all aspects of the geographical distribution, biology, etiology, prevention, and control of cancer, predicated on research. The concise nature of the text and the high graphic content (hundreds of colour maps, diagrams, and photographs) make the publication accessible to a broad readership. World Cancer Report is designed to provide non-specialist health professionals and policy-makers with a balanced understanding of cancer control and to provide established cancer professionals with insights about recent development.

The book includes chapters in which distinguished scientists from around the world provide a broad overview of established knowledge and then emphasize research activity and progress. In addition, text boxes distributed throughout the book provide short, in-depth discussions of selected questions or topics. A new feature of this volume is the inclusion of Perspectives considering the future development of different aspects of cancer research, written by those whose record of outstanding achievement qualifies them as individuals having unique vision.

(From International Agency for Research on Cancer, World Health Organization)

http://www.iarc.fr/en/publications/books/wcr/index.php

nprglobalhealth

nprglobalhealth:

Cancer Cases Rising At An Alarming Rate Worldwide

As countries modernize around the world, they’re increasingly being hit with one of the curses of wealth: cancer.

There are about 14 million new cancer cases globally each year, the World Health Organization reported Monday. And the trend is only getting worse.

The global burden of cancer will grow by 70 percent over the next two decades, the WHO predicts, with an estimated 22 million new cases and 13 million deaths each year by 2032.

The majority of cases now occur in low- and middle-income countries, the agency found. Many of these nations’ health care systems are ill-equipped to deal with the flood of complicated conditions that go along with disease.

Cancer in the developing world is a “time bomb,” says Dr. Bernard Stewart, an epidemiologist at the University of New South Wales, in Sydney, Australia, who helped edit the WHO report. The problem, Stewart says, is that treatment availability for cancer hasn’t kept up with the rise in its prevalence.

The long-held idea that cancer is a disease that affects primarily rich countries is slowly being undermined.

You’re still more likely to get cancer if you live in a wealthy country than if you live in a developing one. But you’re more likely to die from the disease if you live in a poor country because cancer is often detected later in developing countries, and treatments are limited.

"The drug treatment path is simply not an option for the vast majority of low-income countries," Stewart says.

Continue reading.

Top: Annual number of new cancer cases and deaths, worldwide, is expected to rise about 60 percent over the next two decades.

Middle: Breast cancer represents about a quarter of all cancers reported among women worldwide. But in parts of Africa and South America, cervical cancer is a bigger problem.

Bottom: Prostate cancer is the most common cancer for men in the West, while lung and liver cancers are the top problems in Asia.

Graph by Michaeleen Doucleff/NPR. Maps courtesy of the World Health Organization.

World Cancer Day 2014 is Tomorrow, February 4
This year’s event will build on the success of last year’s campaign, by again focusing on Target 5 of the World Cancer Declaration: Reduce stigma and dispel myths about cancer, under the tagline “Debunk the myths”.
World Cancer Day is a chance to raise our collective voices in the name of improving general knowledge around cancer and dismissing misconceptions about the disease. From a global level, we are focusing our messaging on the four myths above. In addition to being in-line with our global advocacy goals, these overarching myths leave a lot of flexibility for members, partners and supporters to adapt and expand on for their own needs.

(From WorldCancerDay.org)

World Cancer Day 2014 is Tomorrow, February 4

This year’s event will build on the success of last year’s campaign, by again focusing on Target 5 of the World Cancer Declaration: Reduce stigma and dispel myths about cancer, under the tagline “Debunk the myths”.

World Cancer Day is a chance to raise our collective voices in the name of improving general knowledge around cancer and dismissing misconceptions about the disease. From a global level, we are focusing our messaging on the four myths above. In addition to being in-line with our global advocacy goals, these overarching myths leave a lot of flexibility for members, partners and supporters to adapt and expand on for their own needs.

WCD_Logo_RGB_2012.png

(From WorldCancerDay.org)

Why Everyone Seems to Have Cancer
By George Johnson
EVERY New Year when the government publishes its Report to the Nation on the Status of Cancer, it is followed by a familiar lament. We are losing the war against cancer.




Half a century ago, the story goes, a person was far more likely to die from heart disease. Now cancer is on the verge of overtaking it as the No. 1 cause of death.
Troubling as this sounds, the comparison is unfair. Cancer is, by far, the harder problem — a condition deeply ingrained in the nature of evolution and multicellular life. Given that obstacle, cancer researchers are fighting and even winning smaller battles: reducing the death toll from childhood cancers and preventing — and sometimes curing — cancers that strike people in their prime. But when it comes to diseases of the elderly, there can be no decisive victory. This is, in the end, a zero-sum game.
The rhetoric about the war on cancer implies that with enough money and determination, science might reduce cancer mortality as dramatically as it has with other leading killers — one more notch in medicine’s belt. But what, then, would we die from? Heart disease and cancer are primarily diseases of aging. Fewer people succumbing to one means more people living long enough to die from the other.
The newest cancer report, which came out in mid-December, put the best possible face on things. If one accounts for the advancing age of the population — with the graying of the baby boomers, death itself is on the rise — cancer mortality has actually been decreasing bit by bit in recent decades. But the decline has been modest compared with other threats.
A graph from the Centers for Disease Control and Prevention tells the story. There are two lines representing the age-adjusted mortality rate from heart disease and from cancer. In 1958 when the diagram begins, the line for heart disease is decisively on top. But it plunges by 68 percent while cancer declines so slowly — by only about 10 percent — that the slope appears far less significant.
Measuring from 1990, when tobacco had finished the worst of its damage and cancer deaths were peaking, the difference is somewhat less pronounced: a decline of 44 percent for heart disease and 20 percent for cancer. But as the collision course continues, cancer seems insistent on becoming the one left standing — death’s final resort. (The wild card in the equation is death from complications of Alzheimer’s disease, which has been advancing year after year.)
Though not exactly consoling, the fact that we have reached this standoff is a kind of success. A century ago average life expectancy at birth was in the low to mid-50s. Now it is almost 79, and if you make it to 65 you’re likely to live into your mid-80s. The median age of cancer death is 72. We live long enough for it to get us.
The diseases that once killed earlier in life — bubonic plague, smallpox, influenza, tuberculosis — were easier obstacles. For each there was a single infectious agent, a precise cause that could be confronted. Even AIDS is being managed more and more as a chronic condition.
Progress against heart disease has been slower. But the toll has been steadily reduced, or pushed further into the future, with diet, exercise and medicines that help control blood pressure and cholesterol. When difficulties do arise they can often be treated as mechanical problems — clogged piping, worn-out valves — for which there may be a temporary fix.
Because of these interventions, people between 55 and 84 are increasingly more likely to die from cancer than from heart disease. For those who live beyond that age, the tables reverse, with heart disease gaining the upper hand. But year by year, as more failing hearts can be repaired or replaced, cancer has been slowly closing the gap.
For the oldest among us, the two killers are fighting to a draw. But there are reasons to believe that cancer will remain the most resistant. It is not so much a disease as a phenomenon, the result of a basic evolutionary compromise. As a body lives and grows, its cells are constantly dividing, copying their DNA — this vast genetic library — and bequeathing it to the daughter cells. They in turn pass it to their own progeny: copies of copies of copies. Along the way, errors inevitably occur. Some are caused by carcinogens but most are random misprints.
More…
(From The New York Times)
Why Everyone Seems to Have Cancer

By George Johnson

EVERY New Year when the government publishes its Report to the Nation on the Status of Cancer, it is followed by a familiar lament. We are losing the war against cancer.

Half a century ago, the story goes, a person was far more likely to die from heart disease. Now cancer is on the verge of overtaking it as the No. 1 cause of death.

Troubling as this sounds, the comparison is unfair. Cancer is, by far, the harder problem — a condition deeply ingrained in the nature of evolution and multicellular life. Given that obstacle, cancer researchers are fighting and even winning smaller battles: reducing the death toll from childhood cancers and preventing — and sometimes curing — cancers that strike people in their prime. But when it comes to diseases of the elderly, there can be no decisive victory. This is, in the end, a zero-sum game.

The rhetoric about the war on cancer implies that with enough money and determination, science might reduce cancer mortality as dramatically as it has with other leading killers — one more notch in medicine’s belt. But what, then, would we die from? Heart disease and cancer are primarily diseases of aging. Fewer people succumbing to one means more people living long enough to die from the other.

The newest cancer report, which came out in mid-December, put the best possible face on things. If one accounts for the advancing age of the population — with the graying of the baby boomers, death itself is on the rise — cancer mortality has actually been decreasing bit by bit in recent decades. But the decline has been modest compared with other threats.

A graph from the Centers for Disease Control and Prevention tells the story. There are two lines representing the age-adjusted mortality rate from heart disease and from cancer. In 1958 when the diagram begins, the line for heart disease is decisively on top. But it plunges by 68 percent while cancer declines so slowly — by only about 10 percent — that the slope appears far less significant.

Measuring from 1990, when tobacco had finished the worst of its damage and cancer deaths were peaking, the difference is somewhat less pronounced: a decline of 44 percent for heart disease and 20 percent for cancer. But as the collision course continues, cancer seems insistent on becoming the one left standing — death’s final resort. (The wild card in the equation is death from complications of Alzheimer’s disease, which has been advancing year after year.)

Though not exactly consoling, the fact that we have reached this standoff is a kind of success. A century ago average life expectancy at birth was in the low to mid-50s. Now it is almost 79, and if you make it to 65 you’re likely to live into your mid-80s. The median age of cancer death is 72. We live long enough for it to get us.

The diseases that once killed earlier in life — bubonic plague, smallpox, influenza, tuberculosis — were easier obstacles. For each there was a single infectious agent, a precise cause that could be confronted. Even AIDS is being managed more and more as a chronic condition.

Progress against heart disease has been slower. But the toll has been steadily reduced, or pushed further into the future, with diet, exercise and medicines that help control blood pressure and cholesterol. When difficulties do arise they can often be treated as mechanical problems — clogged piping, worn-out valves — for which there may be a temporary fix.

Because of these interventions, people between 55 and 84 are increasingly more likely to die from cancer than from heart disease. For those who live beyond that age, the tables reverse, with heart disease gaining the upper hand. But year by year, as more failing hearts can be repaired or replaced, cancer has been slowly closing the gap.

For the oldest among us, the two killers are fighting to a draw. But there are reasons to believe that cancer will remain the most resistant. It is not so much a disease as a phenomenon, the result of a basic evolutionary compromise. As a body lives and grows, its cells are constantly dividing, copying their DNA — this vast genetic library — and bequeathing it to the daughter cells. They in turn pass it to their own progeny: copies of copies of copies. Along the way, errors inevitably occur. Some are caused by carcinogens but most are random misprints.

More…

(From The New York Times)

The Cancer Divide
India’s Efforts to Aid Poor Worry Drug Makers
NEW DELHI — Alka Kudesia needs an expensive drug to treat her breast cancer, but refuses to tell her children for fear they will take out loans to buy the medicine and spend the rest of their lives in debt.
“We’re barely able to afford the treatment I’m already getting,” Ms. Kudesia, 48, said with quiet defiance. “My kids are just starting out in life. There is no way I’m going to be a burden to them.”
The drug, Herceptin, is one of the most effective treatments for an aggressive form of breast cancer. But in India, at a cost of at least $18,000 for one course of treatment, only a small fraction of the women who need it get it.
The Indian government last year threatened to allow production of less costly, generic versions of Herceptin. Its maker, Roche Holdings of Switzerland, initially resisted, but surrendered its patent rights this year in large measure because it concluded that it would lose a legal contest in Indian courts.
The skirmishing over Herceptin and other cancer medicines is part of a new and critical phase in a struggle to make drugs affordable to the world’s poorest people, one that began in earnest more than a decade ago when advocates campaigned successfully to make AIDS medicines accessible to millions of Africans.
“Cancer is the next H.I.V./AIDS issue, and the fight has only begun,” said Shamnad Basheer, a professor of law at West Bengal National University of Juridical Sciences in Kolkata.
American trade officials have voiced concerns about India’s treatment of drug patents, including its reasons for sometimes overriding them. President Obama discussed the issue this year with Prime Minister Manmohan Singh of India in the Oval Office, administration officials said.
Executives in the international pharmaceutical industry, increasingly dependent on drug sales in emerging markets like India, China and Brazil, contend that India’s efforts to cancel patents threaten the global system for discovering cures while doing little to resolve the health challenges most patients here face.
“We are open to discussing what the best way is to bring innovative medicines to patients,” said Daniel Grotzky, a spokesman for Roche, which has a large portfolio of cancer medicines. “But a society that wants to develop new medicines and technology must reward innovation through a solid protection of intellectual property.”
Some health experts say investing in earlier diagnosis of breast cancer and improved testing, surgery and access to radiation therapy is more important than access to expensive drugs. “Chemotherapy is not the major issue for cancer control in India,” said Dr. Richard Sullivan, a professor of cancer policy and global health at King’s Health Partners’ Integrated Cancer Center in London.
But health advocates say similar arguments were made by the United States government and the pharmaceutical industry as they sought to protect patents on AIDS medicines through much of the 1990s, a stance that former President Bill Clinton has since said he regrets. It would be unfair to delay improving access to cancer drugs until India’s broken system for cancer care was fixed, they say. They note that more than twice as many people in India die of cancer than of AIDS.
As the world has made progress against malnutrition and infectious diseases, more people are living into old age and dying of chronic illnesses like heart disease and cancer, which now cause two-thirds of deaths globally. In 2012, there were 14.1 million new cancer cases across the world and 8.2 million cancer deaths, according to the World Health Organization. And the number of breast cancer cases is growing. About 6.3 million women were living with the disease last year.
The rise in the cancer caseload is already a heavy burden on India’s hobbled health system. Indian women, while less likely to get breast cancer than those in the United States, are far more likely to die of it. Breast cancer is diagnosed in about 115,000 women here every year, and in 2008 some 54,000 died from it, according to the World Health Organization.
At intersections in New Delhi, women carrying doctors’ notes beg for money for their prescribed treatments. India has just 27 dedicated public cancer centers for 1.2 billion people. The government has promised to add an additional 50 in the coming years, but medical experts say even that will be grossly inadequate.
India, which is one of the world’s leading producers of generic pharmaceuticals, has long viewed patent rights on medicines skeptically. It has already ruled invalid patents protecting exclusive sales of Novartis’s Gleevec, Pfizer’s Sutent and Roche’s Tarceva, all cancer medicines. In a landmark decision last year, the government agreed that the patent protecting Bayer’s Nexavar, also a cancer drug, was valid but overrode it anyway because a generic company promised to lower the price from $4,500 to about $140 per month of treatment.
More ….
(From The New York Times)
The Cancer Divide India’s Efforts to Aid Poor Worry Drug Makers

NEW DELHI — Alka Kudesia needs an expensive drug to treat her breast cancer, but refuses to tell her children for fear they will take out loans to buy the medicine and spend the rest of their lives in debt.

“We’re barely able to afford the treatment I’m already getting,” Ms. Kudesia, 48, said with quiet defiance. “My kids are just starting out in life. There is no way I’m going to be a burden to them.”

The drug, Herceptin, is one of the most effective treatments for an aggressive form of breast cancer. But in India, at a cost of at least $18,000 for one course of treatment, only a small fraction of the women who need it get it.

The Indian government last year threatened to allow production of less costly, generic versions of Herceptin. Its maker, Roche Holdings of Switzerland, initially resisted, but surrendered its patent rights this year in large measure because it concluded that it would lose a legal contest in Indian courts.

The skirmishing over Herceptin and other cancer medicines is part of a new and critical phase in a struggle to make drugs affordable to the world’s poorest people, one that began in earnest more than a decade ago when advocates campaigned successfully to make AIDS medicines accessible to millions of Africans.

“Cancer is the next H.I.V./AIDS issue, and the fight has only begun,” said Shamnad Basheer, a professor of law at West Bengal National University of Juridical Sciences in Kolkata.

American trade officials have voiced concerns about India’s treatment of drug patents, including its reasons for sometimes overriding them. President Obama discussed the issue this year with Prime Minister Manmohan Singh of India in the Oval Office, administration officials said.

Executives in the international pharmaceutical industry, increasingly dependent on drug sales in emerging markets like India, China and Brazil, contend that India’s efforts to cancel patents threaten the global system for discovering cures while doing little to resolve the health challenges most patients here face.

“We are open to discussing what the best way is to bring innovative medicines to patients,” said Daniel Grotzky, a spokesman for Roche, which has a large portfolio of cancer medicines. “But a society that wants to develop new medicines and technology must reward innovation through a solid protection of intellectual property.”

Some health experts say investing in earlier diagnosis of breast cancer and improved testing, surgery and access to radiation therapy is more important than access to expensive drugs. “Chemotherapy is not the major issue for cancer control in India,” said Dr. Richard Sullivan, a professor of cancer policy and global health at King’s Health Partners’ Integrated Cancer Center in London.

But health advocates say similar arguments were made by the United States government and the pharmaceutical industry as they sought to protect patents on AIDS medicines through much of the 1990s, a stance that former President Bill Clinton has since said he regrets. It would be unfair to delay improving access to cancer drugs until India’s broken system for cancer care was fixed, they say. They note that more than twice as many people in India die of cancer than of AIDS.

As the world has made progress against malnutrition and infectious diseases, more people are living into old age and dying of chronic illnesses like heart disease and cancer, which now cause two-thirds of deaths globally. In 2012, there were 14.1 million new cancer cases across the world and 8.2 million cancer deaths, according to the World Health Organization. And the number of breast cancer cases is growing. About 6.3 million women were living with the disease last year.

The rise in the cancer caseload is already a heavy burden on India’s hobbled health system. Indian women, while less likely to get breast cancer than those in the United States, are far more likely to die of it. Breast cancer is diagnosed in about 115,000 women here every year, and in 2008 some 54,000 died from it, according to the World Health Organization.

At intersections in New Delhi, women carrying doctors’ notes beg for money for their prescribed treatments. India has just 27 dedicated public cancer centers for 1.2 billion people. The government has promised to add an additional 50 in the coming years, but medical experts say even that will be grossly inadequate.

India, which is one of the world’s leading producers of generic pharmaceuticals, has long viewed patent rights on medicines skeptically. It has already ruled invalid patents protecting exclusive sales of Novartis’s Gleevec, Pfizer’s Sutent and Roche’s Tarceva, all cancer medicines. In a landmark decision last year, the government agreed that the patent protecting Bayer’s Nexavar, also a cancer drug, was valid but overrode it anyway because a generic company promised to lower the price from $4,500 to about $140 per month of treatment.

More ….

(From The New York Times)

Global cancer cases reach 14 million, World Health Organization says
The number of people being diagnosed with cancer in the world each year has leaped to more than 14 million, the World Health Organization says.
The data for 2012 shows a marked rise on the 12.7 million cases in 2008.
In that time the number of deaths has also increased, from 7.6 million to 8.2 million.
The rising burden of cancer is being driven by a rapid shift in lifestyles in the developing world to more closely reflect industrialised countries.
Rising rates of smoking and obesity as well as people living longer are contributing to the rise.
Lung cancer, which is mainly caused by smoking, was the most common cancer globally, with 1.8 million cases - about 13% of the total.
The WHO also described a “sharp rise” in cases of breast cancer. Both the incidence and mortality have increased since 2008. The disease in now the most common cancer in women in 140 countries.
Dr David Forman, from the WHO’s International Agency for Research on Cancer, said: “Breast cancer is also a leading cause of cancer death in the less developed countries of the world.
"This is partly because a shift in lifestyles is causing an increase in incidence, and partly because clinical advances to combat the disease are not reaching women living in these regions."
The WHO said there was an “urgent need” for the advances made in detection, diagnoses and treatment of breast cancer to be implemented in developing nations.
The WHO predicts the number of cancer cases will soar to more than 19 million a year by 2025.
(From BBC)
Global cancer cases reach 14 million, World Health Organization says

The number of people being diagnosed with cancer in the world each year has leaped to more than 14 million, the World Health Organization says.

The data for 2012 shows a marked rise on the 12.7 million cases in 2008.

In that time the number of deaths has also increased, from 7.6 million to 8.2 million.

The rising burden of cancer is being driven by a rapid shift in lifestyles in the developing world to more closely reflect industrialised countries.

Rising rates of smoking and obesity as well as people living longer are contributing to the rise.

Lung cancer, which is mainly caused by smoking, was the most common cancer globally, with 1.8 million cases - about 13% of the total.

The WHO also described a “sharp rise” in cases of breast cancer. Both the incidence and mortality have increased since 2008. The disease in now the most common cancer in women in 140 countries.

Dr David Forman, from the WHO’s International Agency for Research on Cancer, said: “Breast cancer is also a leading cause of cancer death in the less developed countries of the world.

"This is partly because a shift in lifestyles is causing an increase in incidence, and partly because clinical advances to combat the disease are not reaching women living in these regions."

The WHO said there was an “urgent need” for the advances made in detection, diagnoses and treatment of breast cancer to be implemented in developing nations.

The WHO predicts the number of cancer cases will soar to more than 19 million a year by 2025.

(From BBC)