Chad le Clos documentary, Unbelievable, puts trends in cancer occurrence, cost and care under spotlight

At a preview of Unbelievable: The Chad le Clos story, Dr Jonathan Broomberg CEO of Discovery Health on Friday, 22 July 2016, highlighted trends, costs, and advances in cancer care. It comes in the light of the Vitality Ambassador’s journey to the Rio Olympics captured in a fascinating documentary that takes a look at highlights and unreported tragedies of the athlete’s life. The documentary brings to sharp focus the man behind the star, and also his family’s personal battle with cancer.

“It’s rare to find a family who has not been touched by cancer these days. Our data shows a steady and significant increase in incidence of cancer. Data from medical schemes administered by Discovery Health show a 36% increase in the number of people diagnosed with cancer,” Broomberg said. In just the past four years, Discovery Health Medical Scheme saw an 83% increase in the cost of treatment, and spent a total of 13.9 billion on cancer care.

Broomberg highlighted that cancer treatment is one the fastest evolving medical fields.Treatment has evolved from single agent chemotherapy in the 40s, combination chemotherapy in the 70s, and chemotherapy and radiotherapy combinations in the 80s, to oral chemotherapy treatments in the 90s. The 2000s introduced more targeted treatments, including biologics and, today, the first immunotherapy medicine has been approved for use in South Africa.

Broomberg added that, “The trend in cancer care seems to be focused on both the development of new therapies and procedures, and also increasing use of generic alternatives where these exist. These alternatives have similar therapeutic value than the original medicine.” He showed that the development of one generic medicine to treat leukaemia reduced the cost for each patient by as much as 28%, illustrating the value of generic medicines to help manage cost without compromising quality. "The use of generics where available increase the amount of funding available for the newer, higher cost medicines," he said.

Highlighting breast and prostate cancer care

Since 2007, there has also been an increased use of biologic agents in some cancers. Over this period, 2 724 women were diagnosed with breast cancer and received treatment with Herceptin. Herceptin comes at an average cost of R171 000, compared with the average of R30 000 for other chemotherapy for breast cancer, but is highly effective when used appropriately.

“The trend is similar in prostate cancer with the introduction of new treatments, such as a robotic prostatectomy procedures. This procedure increased treatment cost for prostate cancer by 87% in the past four years,” he explained. In 2012 treatment for prostate cancer consisted mainly of open and laparoscopic procedures with a total cost of R32 million for the 366 cases. By 2015, as many as 234 of the 563 cases were robotic prostatectomy procedures, increasing the total cost of open, laparoscopic and robotic procedures to R60 million.

“Although costs have increased exponentially for healthcare funders over time, Discovery Health has a focus to make sure the members of medical schemes we manage have access to the best care.” Broomberg said this as he spoke of their pilot project with Oncotype DX, which is able to predict which women with early stage breast cancer can possibly avoid chemotherapy due to very low risk of their cancer recurring. “We are seeing positive results. Of the 135 people enrolled, 40 had a low cancer recurrence score following a year of using the service,” he said.

The future of cancer care

“In just a decade we have moved towards targeted therapies, and are on a pathway towards more personalized care for each individual patient”. Broomberg mentioned that Discovery Health, in a global partnership with Human Longevity Inc. has also initiated a genomics programme for members.

This programme will bring the benefits of whole-exome screening to members of scheme managed by Discovery Health at the lowest cost in the world. Currently awaiting the required licences, this programme will enable sequencing and genome analysis, and provide access to genetic counselling. Discovery Health already has 42 South Africans in a 'genomics pioneer' group, among them Adrian Gore, Chief Executive of Discovery, and Olympic Champion and Vitality Ambassador, Chad le Clos. “Collecting this data on the South African population will enable further research into targeted and more personalised treatment as we move towards the era of greater advances in cancer screening and prevention,” said Broomberg.

Even 2.5 hours of brisk walking a week notably reduces risk for cancer

Broomberg also highlighted the benefits of physical activity and of regular screening in the context of cancer. “With regular screening, we see a higher proportion of patients being diagnosed at an earlier stage. Early diagnosis has many patient benefits, and it reduces cost of treatment by up to 9%.” He also shared a study of 1.4 million people by the American Institute for Cancer Research. The study showed that regular physical activity reduced the risk for certain cancers by up to 20%.