Confronting A Global Radiotherapy Shortfall

By Scott Whitaker, President and CEO, AdvaMed

It may not surprise you to learn that cancer is now the leading cause of early death worldwide, and cancer rates are expected to continue to rise dramatically. Studies project that cancer cases will increase from 14.1 million in 2012 to 24.6 million by 2030. In addition to the lives impacted by cancer, its global economic burden is also staggering — $2 trillion in 2010 alone.

What may surprise you, however, is that given the profound toll that cancer takes on individuals, families, societies, and economies, as much as 60 percent of the world’s population does not have access to a cost-effective form of cancer treatment and management therapy that saves lives and improves clinical outcomes.

This missing piece of the cancer management puzzle is radiotherapy, also known as radiation therapy. Radiotherapy is integral to the management of most cancers, including the three most common cancers in the world — breast, prostate, and lung cancers. Radiotherapy provides targeted, localized tumor control, often preserving the form and function of affected organs. Radiotherapy can also play a significant contributing role in multi-modal treatment protocols, improving surgical and chemotherapy outcomes.

In addition to the clinical benefits, radiotherapy can also be more cost-effective than other forms of cancer treatment, such as chemotherapy and surgery, and some 55,000 patients may benefit from treatment with each radiotherapy device.

Yet, global access to radiotherapy services is inconsistent and insufficient to meet current worldwide cancer demand — much less projected future demand. The Lancet Oncology Commission recently released a startling report on the global radiotherapy shortfall we are facing. The authors estimate that only half of cancer patients have access to radiotherapy services, and in low-income countries, 90 percent of the population lacks access. This gap is the difference between cancer as a treatable disease and a death sentence.

Take cervical cancer, the third most common cancer among women. Radiotherapy is estimated to improve the absolute five-year survival rate of women by 17 percent compared to surgery and chemotherapy. In countries where women are not routinely screened for cervical cancer, studies show that in the next 20 years, 11 million women will be diagnosed with advanced cervical cancer — a diagnosis that will be fatal for many women if they do not have access to radiotherapy as a treatment option.

While increasing access to radiotherapy services may prove challenging, doing so will provide tangible economic benefits both in the U.S. and abroad. There are some efforts underway that could make radiotherapy more accessible. For example, in China, where the incidence of cancer continues to grow at an alarming rate, the government’s ongoing health reforms offer a unique opportunity to establish a modern health care system, including improved access to radiotherapy. In Europe, where we will see an increase in cancer incidence of over 30 percent in some countries by 2025, European funds can be made available at the country level to invest in radiotherapy. But in Europe as in China, the timeline to make these investments must be accelerated, and comprehensive cancer programs need to be developed to address this urgent need.

Many other countries are also exploring innovative ways to build a skilled health care provider workforce needed to expand radiotherapy capacity. For example, Bangladesh, with the assistance of a number of international organizations, is working with the U.S., Germany, Singapore, and India to create training programs for Bangladeshi providers. In Brazil, a manufacturer commissioned by the government to install radiotherapy facilities will open a local manufacturing plant and source many of the parts, accessories, and software from Brazil. In India, the government has invested in local companies to spur manufacturing of equipment by Indian companies.

The Lancet Oncology Commission estimates that expanding access to radiotherapy in low- and middle-income countries would produce economic benefits ranging from $278 billion to $365 billion over the next two decades — all for an initial investment of $97 billion. More importantly, such an expansion could save 27 million life-years. The commission estimates that by 2035, if all patients needing radiotherapy had access, cancer in 2.5 million people would be prevented from progressing and 950,000 people would have an overall survival benefit.

The Obama administration’s “Cancer Moonshot” initiative, led by Vice President Biden, has tremendous potential to advance innovative treatments and diagnostics, and has helped to refocus the nation on the need to fight — and cure — cancer. Radiation therapy is a key tool in the fight against cancer. Investing in radiotherapy services — building a skilled workforce, investing in capital projects to shore up facilities and infrastructure, establishing regulatory oversight — will take time. That is why we must act now.

The radiotherapy shortfall we currently face will only increase in the wake of our ever-growing cancer burden. Globally, a long-term commitment to cancer treatment needs to include a long-term commitment to investing in radiotherapy services.

About The Author

Scott Whitaker is president and CEO of the Advanced Medical Technology Association (AdvaMed), the leading national medical technology association.

Editor’s Notes:

To learn more about Scott Whitaker, his background, and his vision for medtech, read his recent Q&A with MDO chief editor Doug Roe.

For more information on the global radiotherapy access crisis, check out 3 Strategies For Expanding Global Access To Your Medical Device: A Radiotherapy Case Study, a guest column by the president and CEO of radiation therapy pioneer Elekta.