Investing in research is the way to make oncology cheaper – 05/25/2023 – Health
“Doctors Use Robot to Operate on Lung Cancer,” stated the headline on a page of the December 20, 2010 issue of this Sheet. Instead of opening the patient’s chest, as in traditional surgery, the technique left three two-centimeter cuts. “The robot takes advantage of recovery time, lower rates of infection and less postoperative discomfort,” read the text.
Since then, robotics and less invasive surgeries have become more frequent in oncology. Diagnostic imaging with PET-CT has expanded and there has been an evolution in radiotherapy, with specific and precise ways of delivering the radiation dose. But the most relevant change, says oncologist Paulo Hoff, was the change in the understanding of cancer.
“We stopped seeing the tumor as a problem that originated in an organ and started to see it as a problem that originated in the cell”, he says. As an implication, doctors have been realizing that two tumors in the same organ can have different origins, such as mutations in specific genes.
The new paradigm permeates the customization of treatments, one of the major transformations in the area, and research in oncology, including those awarded the Octavio Frias de Oliveira Prize. The award is promoted by Icesp (Cancer Institute of the State of São Paulo Octavio Frias de Oliveira) in partnership with Grupo Folha and aims to stimulate the production of knowledge about cancer in Brazil.
Created in 2010, the award honors Octavio Frias de Oliveira, publisher of Sheet died in 2007.
“Among the works awarded, we had new diagnostic protocols that consider the panel of genetic alterations and follow up the cases of patients with cancer, showing their impact on the prognosis”, says oncologist Roger Chammas. He and Hoff are members of the Board of Directors of Icesp, professors at the Faculty of Medicine of USP (University of São Paulo) and coordinators of the award, whose registration closes this Friday (26).
Accuracy in diagnosis and customization of therapies, however, come at a cost. “What the good news of recent years does not expose is the gap in the forms of treatment in public and private. Many treatments are effectively expensive and we will not be able to apply this in the public environment, so we, as a society, will have to discuss the implementation of different forms of treatment, more cost-effective ways for public health”, says Chammas.
“Our great challenge is to guarantee access, to ensure that patients have the best possible treatments”, he sums up.
And the way to do that, experts say, is to invest in research and innovation in the country. For Hoff, the moment is propitious because we are at the beginning of new therapies and there is still time to participate in their development. “If we have national technology, we won’t need to import or pay royalties abroad. Maybe we can even export.”
The trade deficit that Hoff talks about involves billions. A survey led by the current Secretary of Science, Technology, Innovation and Health Complex of the Ministry of Health, Carlos Gadelha, showed that, if in 1996 the difference between imports and exports was around US$ 4 billion, in 2019 it was close to of US$15 billion – the largest share of the country’s high-tech trade deficit.
“An award like the Octavio Frias de Oliveira Award stimulates Brazilian researchers, who are ultimately those who have the capacity to generate internal knowledge that makes us independent or less dependent on international technology”, evaluates Hoff.
“Without science, we’re going to be dependent on the world. We’re going to have to buy technology all the time”, adds Chammas. “Science can increase our protagonism, and the increase in this protagonism implies revenue generation, cost relocation and improved access.”
But the formation of an ecosystem favorable to investments in health research and development goes far beyond researchers. Chammas mentions, for example, the need to attract members of the industrial sector and investors, something in which the award can also collaborate.
“Awards create a culture of recognition”, he ponders. “We’ve started to create a culture where the community is achieving goals together. And that’s what we need to celebrate.”