Bloomberg Prognosis: Reshaping Cancer Care
The Covid-19 pandemic has laid bare the inequality in our global healthcare system. While wealthier nations rush to secure vaccine booster shots and millions in poor countries await their first jabs, an age-old scourge remains a constant threat: cancer. Cancer remains a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020. Even as the medical community makes outstanding progress in cancer research, the stark reality is that many patients lack access to affordable, high-quality care. There are significant disparities in cancer outcomes which depend on a person’s socioeconomic status, racial background, education, health insurance coverage, geographical location and access to medical facilities. Unless we take decisive action, the number of lives lost to cancer is set to rise.
Research shows that improvements in cancer prevention, screening, treatment, and follow-ups helps reduce the number of people who die from the disease. But, a world where everyone has equal access to cancer care requires significant changes. Cancer care needs to be accessible and affordable. Governments need to place cancer care high up on the national agenda. We need further advances in surgical techniques. And patients deserve culturally sensitive, targeted and personalized services.
At “Bloomberg Prognosis: Reshaping Cancer Care,” we gathered health-industry executives and policymakers for in-depth conversations on how to revamp cancer care and create innovative ways to deliver uniform, high quality, accessible and affordable care to every patient in need of treatment.
Click HERE to view the video of the full discussion.
- Dr. Bhavagaya Bakshi, Co-founder & CEO, C the Signs
- Dr. Jaideep Gogtay, Global Chief Medical Officer, Cipla Ltd
- Camille Hertzka, Vice President, Head of Medical Affairs, US Oncology, AstraZeneca
- Adrian Hill M.D., Director, Jenner Institute, University of Oxford
- Dr. Sunita Maheshwari, Chief Dreamer and Loop Closer, TeleRadiology Solutions
- Bernd Montag, CEO, Siemens Healthineers
- Dr. Joel M. Mubiligi, Partners in Health
- Keller Rinaudo, Co-founder and CEO, Zipline
- Anil K. Rustgi, Interim Executive VP; Dean of the Faculties of Health Sciences & Medicine at NewYork-Presbyterian/Columbia Univ. Irving Medical Center
- Susanne Schaffert, President, Novartis Oncology
- Robert Stone, President and CEO, City of Hope
- Drew Armstrong, Bloomberg News
- Emma Court, Bloomberg News
- Michelle Cortez, Bloomberg News
- Sam Fazeli, Bloomberg Intelligence
- Deirdre Hipwell, Bloomberg News
- Mallika Kapur, Deputy Global Editor, Bloomberg News
- Suzi Ring, Bloomberg News
- James Paton, Bloomberg News
Launching the event were Bernd Montag, CEO, SIEMENS Healthineers and Susanne Schaffert, President, Novartis Oncology, discussing the short- and long-term impacts of Covid-19, the structural shift in cancer care and introduction of artificial intelligence (AI). Delayed screenings will have huge impacts, with Schaffert estimating “millions of people walking around undiagnosed.” Montag spoke to how Covid-19 provided much-needed change to public and government perspectives on healthcare; focusing less on economics in favor of national welfare. At 20 million deaths per year, “Cancer is a pandemic that’s always there,” he said. The vaccine process demonstrated that information and risk-taking is essential. “You have to be willing to be disruptive in cancer research, and bring people together before there is a final solution,” Schaffert said. Montag sees AI allowing for gradual improvements in efficiency as it assumes routine physician tasks, or brings virtual doctors to the underserved, but cautioned that there are still billions of people who live where there is no technology. In India, Schaffert said, finding ways to virtually monitor health has removed a “huge burden” from patients.
In the next session, new approaches, access for oncology services, especially in underserved areas, and the process of catching up were considered by Dr. Bhavagaya Bakshi, Co-founder and CEO of C the Signs, Dr. Sunita Maheshwari, Chief Dreamer at Teleradiology Solutions and Dr. Jaideep Gogtay, Chief Medical Officer, Cipla LTD, who all agreed early diagnosis and treatment are key. Dr. Maheshwari said medical technology has come a long way, but the real challenge right now in India is a lack of radiologists and accredited labs. The “next big thing” could be as simple as radiologists working diagnosing virtually. Progress is also being made with autodetecting algorithms that would be “game-changers,” and legalization of medical teleconferencing. Dr. Bakshi noted that globally, half of cancer diagnoses are made late-stage, due in large part to deferred healthcare during quarantine. Refined remote diagnostics are helping us catch up, as will a triage-like process for funneling patients through the system in an effective way. Standard treatment is physically and financially toxic, according to Dr. Gogtay. Much recent progress is being made on targeted therapy, with 89 antibodies approved so far. “It’s not a magic pill, but it could have a significant impact on some cancers.” That kind of innovative thinking has been the silver lining of the pandemic.
Also speaking about the pandemic learning curve were Keller Rinaudo, Co-founder and CEO of Zipline, and Dr. Joel M. Mubiligi, Executive Director of Partners in Health. Their collaboration brings medical supplies to remote areas in Africa at lifesaving speed and accuracy, using Zipline’s autonomous flying vehicles, drones and ziplines, and a complicated coordination effort on the ground by Partners in Health. “This is an area where technology has advanced really quickly,” Rinaudo said, “and where it’s making it possible to provide a different class of logistics, that then unlocks this transformative potential for health systems.”
In Rwanda, Dr. Mubiligi started working with Zipline at lockdown. It now handles essentially the entire public healthcare supply chain. Expansion from cancer patient support to other diseases is being explored, he said.
Next, Sam Fazeli, Director, EMEA Research at Bloomberg Intelligence offered a look at the revolution of targeted cancer treatment, which has reached the level of delivering a better result with a more controlled side-effect profile. “We’re marrying the antibodies that were developed to target tumors with the chemotherapy payload, and therefore, that chemotherapy ends up only in the tumor.” Unfortunately, Fazeli said, most treatments start with expensive diagnostics that don’t breach the socioeconomic gap. The same goes for the newest diagnostic tool, blood markers, that determine cancer risk factors.
What’s the next big thing in cancer care? Robert Stone, President and CEO of City of Hope told Bloomberg’s Emma Court that it’s about more than the science of exciting breakthroughs like gene sequencing technology. The field is heading into the future with a chronic disconnect. “There’s so much hope created by these innovations and discovery, but there’s a gap that continues to widen for those who actually have access to the discoveries.” Stone said 80-percent of cancer care is delivered in communities by doctors who can’t keep up with innovations in academic healthcare settings, and their patients don’t have access to clinical trials. Initiatives by City of Hope include outreach and patient advocacy, such as the patient bill of rights passed by the California legislature. Stone summed it up as treatment outcome not being “dictated by your zip code.”
Dr. Adrian Hill, Director at Jenner Institute, University of Oxford, explored the issue of cancer vaccines. Big advances in the past year in viral vector technology are getting a push from the success of the accelerated Covid-19 vaccine and clinical trials are showing early, promising results. Vaccines might even be added to chemotherapy. The takeaway from Covid-19 was that it doesn’t take 10 years to develop a vaccine, which is contributing to increased investment. “And, of course, cancer is one of the great prizes, and I’m sure we can have a vaccine against cancer,” Dr. Hill said, adding that cancers with viral antigens will likely be the first successes. They could include vaccines against viruses that lead to cancer, such as HPV and hepatitis B.
In the final session, we heard about the ripple effect of Covid-19 from Camile Hertzka, Vice President, Head of Medical Affairs, US Oncology at AstraZeneca and Anil K. Rustgi, Interim Executive VP; Dean of the Faculties of Health Sciences & Medicine at NewYork-Presbyterian/Columbia Univ. Irving Medical Center. Both described how a pandemic highlights societal gaps and provides a realistic appreciation for the struggles that undermine healthcare. Rustgi said cooperation between the public and private sectors is absolutely necessary toward a remedy. Columbia, he said, invested in infrastructure support, adding services such as translators, navigators, homecare and community partnerships. But not even the biggest change – the marriage of new technology with healthcare delivery – is as simple as it sounds. “Not everyone has internet access, so, for x-percentage, it’s seamless, but for y-percentage, it’s still challenging, “Rustgi said, “So, we have to come up with a diverse portfolio of technologies.” It all points to a strategy of working directly in the communities. Hertzka said one focus at AstraZeneca to alleviate healthcare disparities is to bring more diversity to clinical trials.
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