US spend massive and massive about of money on cancer research compared to Japan, South Korea, Singapore, China and Taiwan?

[CharonY]

1 hour ago, TheVat said:

Especially if there is an overall increase in immune system disorders in the population.  Which there is.  We live in a sea of immune disrupters.  A weakened immune system doesn't handle neoplasmic cells as well.  

While not wrong, it is IMO also a bit complex. There are significant overlap in many functions with the immune system, and there is often a somewhat myopic view regarding how they work (or fail to work) together to prevent certain conditions. Typically (and in part this is how funding and research works), research groups focus on a specific aspects from a specific viewpoint. And this is clearly needed to address any issues with some depth. A big challenge in biology is the how the many parts intersect with each other and you could look at any mechanisms from many different viewpoints (the immune lens being one of them, and that in itself is split into many sub-topics). At the same time, we need overarching concepts and narratives to understand and teach what is going on. However, cancer and cell biology tends to be maddening siloed (with highly specialized viewpoints).

The reason is quite clear, the subject is too complex to be handled with a single narrative or viewpoint, but if you look at things at sufficient depth, the same mechanism can be discussed in wildly different contexts, frequently without acknowledging each other.

Sorry for the rant, I got caught up in one my pet peeves again.

[TheVat]

23 hours ago, CharonY said:

Sorry for the rant, I got caught up in one my pet peeves again.

Don't be.  It was a good rant.  I have tended to look at cancer too much through the immune lens, and gotten eye strain.

[StringJunky]

Cellular machinery can't keep replicating perfectly after the telomeres are depleted. Cancer isn't something that can be beaten, only delayed or sidelined by some other fatal experience. Cancer ultimately is bound to increasing entropy; the tendency for systems to become disorganized.

[CharonY]

24 minutes ago, StringJunky said:

Cellular machinery can't keep replicating perfectly after the telomeres are depleted. Cancer isn't something that can be beaten, only delayed or sidelined by some other fatal experience. Cancer ultimately is bound to increasing entropy; the tendency for systems to become disorganized.

In most cancers the opposite is the problem, they won't stop replicating. Again, depending on cell line and type, some look like reverting back into pluripotent cell status (but with weird modifications), for example. Remember, many cells, once differentiated, do not replicate anymore. One of the mechanisms involved in limiting replication (but again, this is really an oversimplification) is the telomerase. Or more precisely, silencing of telomerases (the enzyme that extend telomeres), so that the telomeres get shortened and the cell stop replicating. In fact, in most cancer cell types (but not all) the silencing of the telomerase is not happening or is reversed.

So yet another way (aside from the immune system), we are looking at elements of cell cycle control and cellular differentiation and senescence. This is also why I am highly skeptical regarding many one-approach-solutions, such as targeting telomeres to improve longevity (my question is always what one would then do regarding cancer?). Conversely, AFAIK drugs aimed at silencing telomerases for cancer treatment have failed. 

Again, biology is stupid complicated.

[StringJunky]

1 hour ago, CharonY said:

In most cancers the opposite is the problem, they won't stop replicating. Again, depending on cell line and type, some look like reverting back into pluripotent cell status (but with weird modifications), for example. Remember, many cells, once differentiated, do not replicate anymore. One of the mechanisms involved in limiting replication (but again, this is really an oversimplification) is the telomerase. Or more precisely, silencing of telomerases (the enzyme that extend telomeres), so that the telomeres get shortened and the cell stop replicating. In fact, in most cancer cell types (but not all) the silencing of the telomerase is not happening or is reversed.

So yet another way (aside from the immune system), we are looking at elements of cell cycle control and cellular differentiation and senescence. This is also why I am highly skeptical regarding many one-approach-solutions, such as targeting telomeres to improve longevity (my question is always what one would then do regarding cancer?). Conversely, AFAIK drugs aimed at silencing telomerases for cancer treatment have failed. 

Again, biology is stupid complicated.

I did say "....can't keep replicating perfectly". My point was that even if you can avoid carcinogenics and the like, telomere shortening will get you in the end. cancer is not really something you can overcome.

Edited August 14 by StringJunky

[CharonY]

1 hour ago, StringJunky said:

I did say "....can't keep replicating perfectly". My point was that even if you can avoid carcinogenics and the like, telomere shortening will get you in the end. cancer is not really something you can overcome.

Fair enough. I must have misunderstood the sentence. Though just to be sure that we are on the same page- the issue with cancer cells is they do not properly shorten their telomeres (and thus keep replicating), yes?

 

[nec209]

What is nano particles? I keep seeing it many new articles about cancer the use of nano particles.

 

 

[StringJunky]

7 hours ago, CharonY said:

Fair enough. I must have misunderstood the sentence. Though just to be sure that we are on the same page- the issue with cancer cells is they do not properly shorten their telomeres (and thus keep replicating), yes?

 

That's something I  didn't know. Makes sense, they avoid programmed cell death and the fidelity of resultant copies degrades? I thought the telomeres helped to avoid that copy degradation, but the price was guaranteed senescence.

Edited August 14 by StringJunky

[CharonY]

5 hours ago, StringJunky said:

That's something I  didn't know. Makes sense, they avoid programmed cell death and the fidelity of resultant copies degrades? I thought the telomeres helped to avoid that copy degradation, but the price was guaranteed senescence.

It is not just a programmed cell death (apoptosis) issue. Generally speaking, only a small set of cells are able to replicate, and are responsible for renewal and repair. The rest differentiates into a specific final form that is no longer replicating and which do their job until they are eliminated. In those cells, the telomerase (which, as a I mentioned, is the enzyme that elongates the telomeres) is inactive as part of a larger system that stops cells from replicating.

In cancer cells, the telomerase retains activity and adds to telomere length, though the length is usually shorter compared to other actively replicating cells. 

[CharonY]

On 8/13/2024 at 10:37 PM, nec209 said:

What is nano particles? I keep seeing it many new articles about cancer the use of nano particles.

 

 

Nanoparticles are just things that are, well, the size in the nanometer range. In terms of pharmaceuticals, nanoparticles can be used to encapsulate drugs or vaccines. Recent mRNA vaccines use lipid nanoparticles to encapsulate and stabilize the mRNA, for example. Specifically for cancer, the idea is to encapsulate the drug, which is typically cytotoxic, in a way that it will preferentially taken up by cancer cells. I.e. the idea is to use them for targeted delivery (e.g. with special coatings) so that the drug kills cancer cells more than normal cells.

[nec209]

35 minutes ago, CharonY said:

Nanoparticles are just things that are, well, the size in the nanometer range. In terms of pharmaceuticals, nanoparticles can be used to encapsulate drugs or vaccines. Recent mRNA vaccines use lipid nanoparticles to encapsulate and stabilize the mRNA, for example. Specifically for cancer, the idea is to encapsulate the drug, which is typically cytotoxic, in a way that it will preferentially taken up by cancer cells. I.e. the idea is to use them for targeted delivery (e.g. with special coatings) so that the drug kills cancer cells more than normal cells.

In the case like cancer that say the person has liver cancer. How does the cancer drug or chemotherapy drug using nanoparticles know to travel to the liver and release it there and to not travel any where where else in the body?

 

[StringJunky]

2 hours ago, nec209 said:

In the case like cancer that say the person has liver cancer. How does the cancer drug or chemotherapy drug using nanoparticles know to travel to the liver and release it there and to not travel any where where else in the body?

 

The molecular configuration on the surface of a nanoparticle have specificity for certain predefined target cell surface features, where they interact and deliver the therapeutic substance to them. They can move around passively and stochastically in the circulation until it connects with the target that has compatible surface features

Edited August 17 by StringJunky

[CharonY]

It should also be noted that the specificity is far from absolute. Liver is a bit easier as it is the space where most stuff gets metabolized. I.e. when you almost any drug, they end up in the liver, which is why so liver and kidney damage are frequent side effects of many drugs. Many decorations of these encapsulations as StringJunky mentioned can be used to make enrichment in liver more efficient. This can be further enhanced by moieties that target receptors that are a bit more frequent in certain cancer cell types.  Could be as simple as a folate or more complex like certain peptides.

But again, these receptors are also found in other cells.

[nec209]

Also if I’m not mistaken it is the US that is spending lots of money on cancer research and medicine where as Japan, South Korea, Singapore, China and Taiwan hardly spend any money on cancer research and medicine but they spend lots of money on electronics/computers/robotics, AI and robots research.

[CharonY]

4 hours ago, nec209 said:

Also if I’m not mistaken it is the US that is spending lots of money on cancer research and medicine where as Japan, South Korea, Singapore, China and Taiwan hardly spend any money on cancer research and medicine but they spend lots of money on electronics/computers/robotics, AI and robots research.

I don't think that this is true. The US had some big initiatives on cancer, including trials which could skew results a bit, but especially if you talk about health research in general, China and Japan is certainly investing a fair bit into it. I am not sure why you would think that it is the case in the first place.

[swansont]

7 hours ago, CharonY said:

I don't think that this is true. The US had some big initiatives on cancer, including trials which could skew results a bit, but especially if you talk about health research in general, China and Japan is certainly investing a fair bit into it. I am not sure why you would think that it is the case in the first place.

According to this, the US accounts for more than half of recent cancer funding, with China and Japan just under 5%

https://ascopost.com/news/june-2023/global-funding-for-cancer-research-2016-2020/

I suspect the US’s for-profit healthcare system contributes to this

[nec209]

12 hours ago, CharonY said:

I don't think that this is true. The US had some big initiatives on cancer, including trials which could skew results a bit, but especially if you talk about health research in general, China and Japan is certainly investing a fair bit into it. I am not sure why you would think that it is the case in the first place.

If you look at this https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(23)00182-1/fulltext

Well than China is 4%, Japan is 4%, UK is 9%, USA is 57%

 

So not sure why the US is so high compared to other countries and why Japan and China is so low.

Edited September 2 by nec209

[CharonY]

As I mentioned before, the USA has established a number of cancer research programs, which funneled quite a bit of money into this area, to some chagrin of other health researchers, who were looking at fundamental or non-cancer related health aspects. I don't have the exact split, however. But the claim I was most hung up on was

16 hours ago, nec209 said:

Japan, South Korea, Singapore, China and Taiwan hardly spend any money on cancer research and medicine

South Korea has a higher proportion of R&D in health (0.21% 2016) compared to the average of high income countries (0.19%). But overall I think it is fair to say that the US is among the highest R&D spenders in the world, especially compared to e.g. their neighbor Canada. I am a bit surprised that the difference in cancer specifically is that high, suggesting that other countries spend more on other health research. There is a reason for that, though. I remember that there was a paper about 10 years back suggesting that the return of interest is dismal in cancer research for a number of reasons (including lack of consolidation and piecemeal approaches).

 

[nec209]

46 minutes ago, CharonY said:

As I mentioned before, the USA has established a number of cancer research programs, which funneled quite a bit of money into this area, to some chagrin of other health researchers, who were looking at fundamental or non-cancer related health aspects. I don't have the exact split, however. But the claim I was most hung up on was

South Korea has a higher proportion of R&D in health (0.21% 2016) compared to the average of high income countries (0.19%). But overall I think it is fair to say that the US is among the highest R&D spenders in the world, especially compared to e.g. their neighbor Canada. I am a bit surprised that the difference in cancer specifically is that high, suggesting that other countries spend more on other health research. There is a reason for that, though. I remember that there was a paper about 10 years back suggesting that the return of interest is dismal in cancer research for a number of reasons (including lack of consolidation and piecemeal approaches).

 

That is odd I wonder if the reason the US spends so much money on cancer research is because the lobbyist is so massive in the US the pharmaceutical companies and universities are so massive in the US and are lobbying the government to spend money on cancer research.

Where those other countries only have handful of pharmaceutical companies and universities unlike the US that has hundreds of pharmaceutical companies and universities.

Edited September 2 by nec209

[CharonY]

Just now, nec209 said:

That is odd I wonder if the reason the US spends so much money on cancer research is because the lobbyist is so massive in the US the pharmaceutical companies and universities are so massive in the US and are lobbying the government to spend money on cancer research.

 

Well, there are multiple reasons for it, and quite a few a very good. One being the recognition that folks are getting older, and more treatments are needed. Some of the initiatives, e.g. the Cancer Moonshot, were initiated by the White House and I think at that time it was one of the big initiatives of then Vice President Biden. I am sure he had advisors who might also have been lobbyists, but among researchers it is certainly a prime target (for a long time).

Universities generally do not lobby such things they are very different from companies on the research front (initiatives are led by researchers, and, when you are lucky, your university might support you). That being said, some of the investment is to promote translating pre-clinical findings into clinicals. That is very expensive and companies do not like to do that unless they can see the money coming out of it. The US has been shouldering quite a bit of these burdens (as they had for COVID-19 vaccine development).

[swansont]

9 minutes ago, nec209 said:

That is odd I wonder if the reason the US spends so much money on cancer research is because the lobbyist is so massive in the US the pharmaceutical companies and universities are so massive in the US and are lobbying the government to spend money on cancer research.

Where those other countries only have handful of pharmaceutical companies and universities unlike the US that has hundreds of pharmaceutical companies and universities.

It’s almost like I didn’t point out the for-profit healthcare system motive a few posts back…

[nec209]

11 minutes ago, swansont said:

It’s almost like I didn’t point out the for-profit healthcare system motive a few posts back…

You mean the cancer treatment sites lobbying the government and is massive in the US unlike those other countries.

[swansont]

37 minutes ago, nec209 said:

You mean the cancer treatment sites lobbying the government and is massive in the US unlike those other countries.

I mean you wondered if the massive pharmaceutical industry had an effect, as if I hadn’t raised the issue already

[CharonY]

2 hours ago, nec209 said:

You mean the cancer treatment sites lobbying the government and is massive in the US unlike those other countries.

And it does not necessarily mean lobbying. Some agencies might see it as a good opportunity for investment, as companies obviously have a track record of putting things to the market.

The whole pathway from pre-clinical research to product development is complex and gets more expensive every step. Countries with fewer pharmaceutical companies in the cancer market obviously will not invest in developing things. And many companies are multinationals. Roche, for example is a Swiss company, but invests a lot in the US market. There are far more University hospitals to work with, plus the aforementioned opportunities with funding. They would not be able to make that much money if all their research was limited to Switzerland.

Edit: With regard to OP, I also wanted to add that at scale, new treatment options are not the only (or even the most important) thing to influence survival rates. More important are prevention, access to healthcare, early detection and affordability. Arguably, reducing tobacco smoking and air pollution will prevent more deaths than a lung cancer drug. 

[nec209]

1 hour ago, CharonY said:

And it does not necessarily mean lobbying. Some agencies might see it as a good opportunity for investment, as companies obviously have a track record of putting things to the market.

The whole pathway from pre-clinical research to product development is complex and gets more expensive every step. Countries with fewer pharmaceutical companies in the cancer market obviously will not invest in developing things. And many companies are multinationals. Roche, for example is a Swiss company, but invests a lot in the US market. There are far more University hospitals to work with, plus the aforementioned opportunities with funding. They would not be able to make that much money if all their research was limited to Switzerland.

Edit: With regard to OP, I also wanted to add that at scale, new treatment options are not the only (or even the most important) thing to influence survival rates. More important are prevention, access to healthcare, early detection and affordability. Arguably, reducing tobacco smoking and air pollution will prevent more deaths than a lung cancer drug. 

But I wonder if one reason is the US has hundreds and hundreds of pharmaceutical companies and universities where has in those countries they have only handful of pharmaceutical companies and universities.

So the US government likes giving money to universities.