Innovate and Palliate

If I was a pure businessman, cancer drugs would be an interesting market niche to occupy. Research and development would be a potential problem. How many people in the world have the knowledge required to develop new cancer drugs? Not many. To top it off, most of them have no understanding or passion for business. Many of these scientists work in universities so as to not be bothered by corporate executives and the like.

On the other hand, you don't really have to accomplish much to hit it big. What happens if you come up with a drug that extends life by three months in metastatic lung cancer? Currently, that would probably make you a billionaire. That's right. Billion with a capital B. We simply don't have any great treatments for this, so anything that gives people longer survival by any length of time is pure gold.

The funny part is that we actually have a product that can increase survival by a few months without any of the nasty side effects of chemo. In fact, patients that use this product have drastically improved quality of life. What is this wonder drug, you might ask? Where can I buy stock in this? Actually, you can't buy stock in it at all. It's palliative care.

You can bet that us medical folk were a wee bit surprised when we found out that palliative care extends life in advanced lung cancer. The article was published in the New England Journal of medicine in 2010 (link here). Most physicians and patients think of palliative care as a fancy way of saying "we surrender." Nothing could be further from the truth. Early involvement of palliative care generally results in symptoms that are better managed and patients with better quality of life, regardless of whether curative treatment is being offered.

In general, the medical community doesn't get palliative care involved early enough. The aforementioned "we surrender" attitude means that physicians won't consult palliative care until the very end, which doesn't allow the time necessary for palliative care's full benefits to come to fruition. If we withheld a similarly performing medication, then it would be on the front page of CNN that physicians across America were being negligent. Would they be wrong? I don't like to think about the answer to that question...