and then the stops within the load. they're not above the nope. and we've had the other models of this picture here. and we believe that's um, our plans would be able to indicate the rights for the cost. we have a fair quotes and i think of these sufficient evidence without see the numerous reports and some clue bucket fee to the gets box that documented some of these abuses. but even more importantly, and they identify what seem to guide you in their reports, in november, still months, the commission and you, or on, or the human rights, or the phone to look at some of these things and from what you've been able to see and some of these that have pressure points there, or it's a pointed by delmonte themselves on find that the human rights mission. so i think it's beyond question that they have be nearby initial. it's a question of the extent of those are relations and what is good to be done about the plumbing and the shots up for these,

the families of that full or the 10 who may present the but also in a sustainable long term mind. you know, uh the dental motor from covers the itself like did anything between 715 or 20000 because and then picks up a lot of them london. yeah. uh from the surrounding community. so we do need a lot. busy of lasting and long term solution to the continued use of the funds and the communities around and shut down wants to be found comfortable in this investigation. in this case, what kind of impacts do you think it would have on delmonte the operations and can you. and again, hopefully this gets some presidents, mtv. so you may have been aware of but case involving a coffee. and then this, in some ways is similar. number one would be a program for a fucked up full engagement with the community. how do you and get to the community

without these um, never ending leg if something comes out of the difference of abuse by then once the employees. so that's number one. number 2, kenya's constitutional unfolds and do an elements of compensation for those who will be in there who had their rates and violates. and so i think is i see as i see a global adults immeasurable. the only positive october can come. a beast is month to embracing human rights respects as part of the operational and that's number one . number 2 is that i will have money and gets to the community the draw all the resources and the $2.00 different much it benefits at a full many. as i've already had similar problems with them, please me. in some ways some people say that is all set the now bits of listeners to, for the employees. and so we look for a single outcome with it for minutes. that leaves around and watch it. thank you so

much for speaking to us today. told me to tell you and advocates of the high course you can you appreciate your time. thank you. you're most welcome and thank you for joining us. hey on, on the international with back of the top of the yeah, we do the very nice the the no diagnosis strikes fear into the hearts of patients more than the dreaded c word cancer. it is a war we all fear, and yet every day, more of us are forced to face it. unfortunately, it is becoming more and more common as a world health organization hasn't feel that it has overtaken heart disease as the biggest killer globally. the growth and the incidence of cancer parallel as the

industrialization and chemical as ation of the world, the more developed the country is the more cancer there is the higher per capita income, the higher incidence of cancer. i'm crisp and you're watching the cost of everything we're today. we're going to be faced with the cost of cancer. the panther is the 2nd leading cause of death in the us. but luckily, today, many kinds of cancer can be prevented or caught early. leading risk factors for preventable cancers, our smoking, getting too much uv radiation being overweight and drinking too much alcohol. at this point, one and every 3 people, you know, will have cancer in their lifetime, which is a horrifying statistic. breast cancer survival rates go up. 2 and a price tags of life saving treatments, monthly drug costs may reach a $100000.00,

causing money to struggle with the high costs, even worse. others are completely priced out of even the hope for cure the low income families that americans who are uninsured or under insured face medical bills, more than 4 times their annual salaries and simply cannot afford the rising cost of cancer treatments. cancer patients are 2 and a half times more likely to declare bankruptcy and 71 percent are more likely to experience a severe adverse financial event then healthy people. now, in the us alone, over 1900000 new cancer cases were diagnosed in 2023. the average total cost of cancer treatments run in the a $150000.00 range, but it doesn't paint an accurate picture. total out of pocket costs depend on a number of factors including insurance coverage, the types of cancer and treatment, the frequency of treatment, and the costs related to the cancer center. he will therapy is one of the most

common cancer treatments. and depending on the drugs and the type of cancer at the average monthly cost of chemo can range from a $1000.00 to $12000.00. if a patient requires 4 rounds of chemo, then that would cost some up to $48000.00 total. we just beyond the average annual income, other costs associated with cancer include hiring caregivers or a home health aide. transportation lost wages by specialty items such as certain types of food wigs or fertility treatments that can all add up. the 4 of the 5 most expensive cancer drugs on the markets are types of amino therapies. these drugs cost as much per month, then what the average american makes and a year, which is $52800.00. but ironically, despite the high price tag, the drugs don't work for most patients. a studies showed only 13 percent of patients actually benefit from these types of treatments. and now today we're

joined by doctor has shown posing oncologist at christmas saint michael on ecology clinic. now dr. which types of cancers are most prevalent on a global scale, and how has this changed over the years? well, cancer varies between different populations and every type is rare in some part of the world. many specific causes are now known um, but a large proportion of global variation for common catches remain on remains unexplained. concerning both sexes, either female breast, male, prostate or several cancer is most commonly diagnosed cancer over the in over 70 percent of the countries. um the, the number of cases had been increasing, but the number of new cases in deaths had been decreasing over the past 20 years, which is pretty example right. as far as the most common cancer is, it depends on which areas we're talking about. the most common problem in kansas around the gold is breast cancer. the, the most common cause of death of cancer around the world as lung cancer is now.

and if we're talking about particular regions, mostly north america, uh, north america, uh, a western europe. uh, mostly its a female with breast cancer and mostly most common cause of lung cancer. so certain populations in west africa and said that south africa, the most common is cervical cancer. and those are the reasons for that as far as um, certain places in asia in mongolia most common is liver cancers. and south of japan is stomach cancer, gastric cancer. so all depends, but yeah, that's those are the most common that we see worldwide us. and gladly we are, you know, thankfully there are decreasing cases over the past 1015 years. are there particular regions or countries experience a higher incidence? a certain cancers? yeah, pretty much, uh, in terms of uh, certain regions. uh, like i said, most highly industrialized countries mostly is preston, uh,

breast cancer as well as by mail, prostate cancer and lung cancer. the reason is because there's better screenings in those countries as far as those other regions. i mentioned before so south africa and western western africa, the higher incidence, and that's from several cancer because there is a lack of screening, a circle cancer. there's a very simple test that we do call the pap smear, which is not developed in those countries. hopefully there be proceeding along as far as mongolia that i mentioned before. there's a high high instance of liver cancer over 80 other cancer. and the reason is the high rates of hepatitis b and c and liver and alcohol. alcohol consumption, which is a, has a high propensity for developing liver cancer as far as uh, south depend, there, there are that most common is gastric cancer. and the reason for that is the smoke needs that they use. and the high incidence of h priority, which he will, he will go back to by laurie, which is a bacteria infection which is known to cause stomach cancer. what cultural or environmental factors might contribute to these regional variances?

well, the cultural is pretty much a maintaining a healthy lifestyle, and i think some of the cultures that we see around the world, even including a united states in western europe. the, there are the culture that we see is you know, less less of a healthy lifestyle. more propensity to being towards uh, having uh hi. hi saturated set aside the diets as well as increase to their store, increased amounts of smoking and in those parts of the world. but those are the most common causes of uh, uh, uh, of incidence of a lot of those cancer. um, but like i said, mentioned before, 70 percent of them are unexplained, but yeah, those are the thoughts of lifestyles and just sometimes having basic, you know, mentoring needs as can lead to cancer's. unfortunately, in those lower income uh, lower income countries, they don't have access to health care. they don't have access to screen programs.

even so certain parts united states has no access to screening. either significant differences in cash or outcomes between high income and low income countries. yeah, overall, although the overall into this case has lower and lower income countries compared with high income countries, the total cancer related mortality is significantly higher and lower income countries, especially for people younger than age of 65. and the greater economic impact as a result is premature mortality and loss of yours productivity. it's especially a problem that for these low income countries, i think of 201570 percent of all global debts attributed to non communicable diseases including cancer occurred in lower income countries with nearly 50 percent of debts in lower income countries considered to be premature so pretty much we're seeing them and younger populations um just because of the lack of screening and when they catch these certain types of cancers and these lower income countries that are always advance and stage disease locally advanced disease, where the,

the mortality is higher, especially as opposed to patients that people, patients are people in hiring countries have access to screening. they have treated early the a, catch the early disease and they survive longer because they're either treated with surgery, radiation or chemotherapy. so although the incidence has higher and higher income countries because of screening, the mortality is higher and lower income country and how, how the technological advancements such as precision medicine and amino therapy impacted the cost and efficacy of cancer treatments globally. and are there disparities and the adoption of these technologies across different countries? well, with the advent of the middle therapy, which came about in both certain drugs, game and prior to 2012 most come a immunotherapy sub game in 2012. there had been for the past 4 years, the precision medicine which is based on something, all next generation sequencing or molecular testing in which we could pinpoint and have a predictive, precise, accurate attack form

a attack towards these cancer. so basically what these molecular testing is, precision testing models on or these testing that performs is basically a gene panel. and. ringback take, i've done a 5 actionable mutations in which the oncologist can predict a good could provide a, provide a certain of care, a certain type of drug that tax the certain attacks the cancer itself. so for since the advent of time, oncology care is basically using conventional chemotherapy which is kind of like a quote unquote shopping approach in which it destroys all cells. it just attacks the dna and unfortunately there is severe side effects associated with. ringback the advent of targeted therapy with, for example, testing kinase inhibitors, basically attacking certain types of cancer cells or immunotherapy, which makes them unit system, hybrid, vigilant or on mass the tumor. it allows for better precision, guided uh, therapy for cancer and has allowed for higher response rates. longer duration of

responses, disease, free survival, and more importantly, overall survival which has impacted cancer care in the past 20 years given her and trends what day for c as a feature challenges and opportunities in addressing the global impact of cancer. busy vaccines are sometimes a little disappointed in cancer diagnosed to a screen equipment in surgical facilities that may be non existent. often cancer patients in low income countries are not diagnosed until disease bids making from treatment less effective and more costly. um, so um those are the most of these, the future challenges is how much one, how much the gum regulation prevents for the access to health care and to pretty much the population access to screening and diagnostic testing and allowing along the treatment for early stage disease thank you so much dr. heavy. but please

stick around. a doctor has shawn has a must stay with us right after the break and when we come back, not only the patients have to deal with the burden of the disease, but also the burden associated with cancer care. we'll have more after the break, the car acceptance, and i'm going to plan with you whatever you do. do not watch my, your show seriously. why watch something that's so different opinions that he won't get anywhere else. what could i please or do the have the state department c i a weapons, bankers, multi 1000000000 dollar corporations. choose your fax for you. go ahead. i changed and whatever you do, don't want my show state main street because i'm probably going to make you uncomfortable. my show is called stretching time, but again, it's not, we don't want to watch it because it might just change the way inside

the even one diagnosed early and attacked with the latest treatments. cancer still has the power to kill. according to the world health organization, the 3 can, so if that killed the most people world wide and 2020 were lung cancer at 1800000. that's colorado counts or 916000 deaths and liver cancer at 830000 deaths. prostate cancer and breast cancer on the other hand are among the most common and prevalent types of cancer is now a cancer diagnosis can affect life in many ways for both the people with cancer and for their families. in addition to the many physical and emotional challenges, many people worry about how they will pay for the treatment or what will happen if they aren't able to work or need to make a change and how they work. in 2019,

the national patient economic burden associated with cancer care was estimated to be $21000000000.00. this estimate includes out of pocket cost, at $16200000000.00 and patient time cost of $4900000000.00. without insurance. the national cancer institute found that the average cost of medical care and drugs to be over $42000.00 in a year after a cancer diagnosis. they tend to have poor access to care poor cancer outcomes and experienced a greater amount of financial hardship. they also tend to be diagnosed with cancer at a late stage when the disease is also harder to treat. the global oncology market was valued at over $200000000000.00 in 2022. and this is expected to reach over $400000000000.00 by 2032. and unfortunately therapies now routinely cost more than $100000.00 per year. and many of these therapies are often mis prescribed

. a study found that physicians who consistently put pharmaceutical money in their bank accounts or more likely to prescribe that company struct. meanwhile, on colleges are hesitant to prescribe generics because such prescriptions cost them money, oncologists receive a 6 percent markup, meaning when they infuse a patient with a $10000.00 monthly course, a chemo, their practice yields an extra $600.00. if they prescribe generic, they would be out most of that extra money. so unfortunately, while you're forced to trust that your physician has your best interest at heart, that may not always be the case. so for this and more let's bring in again, dr. has sean posing oncologist at christmas saint michael oncology clinic? now what factors contribute to the high cost associated with the different types of cancer treatments? so the factors, um, basically, and i'm pretty much going to be talking about mostly united states,

i guess because i, i'm well versed in that, but the health care delivery systems are 3rd party pairs private or government which covers the cost of cancer treatment in ensure public has a presume and possibly go right across all approved drugs, which is a debate within so the sorting price of cancer drugs have at least $3.00 major problems. first, the absolute crossing cost to society will become increasingly on affordable um to with some of the cancer drugs that are not the approved basically through regulations that leads to increased costs, which is out of pocket for the patient. and um and um, and basically new drugs are unpredictable and geographically diable as a result, charge payments in need to be meaningful increase to keep up with the costs of care . and basically, off label use may use expenditures and drugs that offer little to know, express advocacy, which we don't know about the, and basically other factors are basically the patent system which leads to

a monopoly. this is doing parts of biological conducting and cancer. basically, certain drugs attack certain parts of the dna, certain companies can have a pine on it and that could lead to less innovation. and just having one company control that drug in particular. and this is due basically to regulation high cost of developing the drugs. so basically in order to meet certain regulations, the drug companies have to spend a certain, uh, certain amount of money to go from bench research to actual clinical trials which leads to a problem within itself. so those are the multiple, multiple factors that we see that are um, impacting the impacting kendra care and access to cancer care. can you break down the typical expenses involved in cancer treatment, including medication surgeries and other interventions? well, well, good talking to in terms of cancer drugs, basically in early 2000 and ten's, you know, cancer care for certain medications to undergo chemo therapy was about

$1500.00, you know, in terms of medication out of pocket for the patient. now in 2020 are, you know, from the, from the studies that we have from 2020, nothing after 2020 that are designated, but the average cost for a person to undergo keyma therapy in terms of medications. doctors appointments, no transportation or social economic factors basically went from $1500.00 to $5000.00. now as far as chemo therapy goes for a certain drug, one type of amino therapy, 3 doses are equivalent to $12000.00, which is pretty, pretty high. for started surgery that would be almost as the cost of a surgery or even radiation therapy itself. these costs of these newer drugs which are amazing in terms of breakthrough technology and increasing lights or in light survival in terms of the cancer patients. unfortunately,

these are highly expensive drugs and one because of like i mentioned before, monopoly government regulations, which increased costs from the pharmaceutical companies and the lack of uh, coverage from insure insurances. so hopefully the answer this question and how effective is health insurance and covering the costs of cancer treatments and what are the gaps in coverage that patients often experience? well, unfortunately, like i mentioned before, the insurance is don't cover the costs of the drug. the reason one is if a drug is shown to be applications in a certain type of cancer, it might be lagging and time for at the approval. regulation and insurance is loved to go on to the approval. if it's not, the approved insurance will not cover it. regardless, it's a like saving drug, even though it's been proven. and there's been multiple randomized space phase 3 trials in terms of the drugs showing the application. insurances won't cover it. number 2, some are certain insurance companies won't cover it if the drug is not listed in ncc and guidelines, which is and then our guidelines are bible for treating certain types of cancer. so

basically the insurance won't cover it or they won't cover fully unless it's on that, and that takes time itself to be listed on ncc. and i enter this as i'm talking in regard to united states practice is another thing would be a cancer pathway. basically these pathways are formed by certain for a certain organizations of certain kids or organizations. and if there's a list in the pathway that insurance doesn't cover it. and then of course you have medicare with certain type of coverage, 80 percent, which a supplemental is needed to cover the rest. so sometimes it covers all, sometimes it covers non, it's very lay bile in terms of you know, what kind of the cost uh does the patient and car from the out of pocket as opposed with the insurance covers. and to what extent are generic drugs and bio similar as contribute to making cancer treatment is more affordable. so they contribute. a

significant portion of about similar is are basically just another synthetic version of the drug itself. and it's allow, allows for affordable fordable purchases from hospital or health care organizations in which they're able to purchase the drugs uh, in an affordable manner. um it's still quite expensive, but it has allowed for some hospitals and some private organizations to stay afloat because of the so synthetic variance and it bypasses the monopoly of certain drug companies. unfortunately, there's been a influx of bio similar uh, unfortunate or certain insurance companies which will purchase a certain type of bias on there. and then there's the hospital organization or the private organization, which only allows certain, formulated by the sellers. so there's head to head, you know, always battling getting authorization and payment when dealing with different types of insurance and different types of health care organizations. um yeah, it's, it's label but does it improve a cheaper for. ready health care?

yes, absolutely. for certain types of patients and certain types of insurance is here in united states. either barriers or challenges in the adoption of generic alternatives. and how can these be addressed? basically, the barriers mostly is federal regulations at the approval for certain drugs. those are the biggest barriers because if they don't get the approval, if they don't have a certain regulation to go from a bench research to clinical phase studies involving humans, then that that can lead to huge barriers going developing of a certain types of drugs, but also allow it to be affordable and covered by in certain insurances. so mostly it's government regulation and how it can be addressed is basically the, um, voting for the proper uh, regulations in the escalating the regulations on certain types of parts of the company and the regulating certain uh to allow for a better open market. and for less of ultimately about creating cancer drugs and

the pharmaceutical industry contributed to making cancer drugs more affordable without compromising innovation. yes, they can, if the, you know, the certain rules on patents in terms of one particular drug company, i know of only allowing to access that certain type of drug allowing for a generics to be brought about more by a civil. there's that could, you know, lead to that, allowing less regulation in terms of research and making it more affordable for certain pharmaceutical companies instead of they're allowing to, you know, increase the price of certain drugs based off, you know, what they're, what they're doing. so those are the types of you know, innovations that will allow to affordable access and health care. are there existing models or practices that demonstrate a balance between profitability and accessibility? i literally touched on this basically clinical pathways and basically uh, health care teams are a comprehensive cancer organization. so basically health care pack pathways are

a pathway that was developed by the organist. ready asian in terms of how to treat certain cancers and which pathway allows you know, which way the physician or the condition will allow the go to treat the patient. basically it's a standard of care for certain types of cancer patients. for example, if you have an early stage breast cancer, you want to go down this testing pathway. and if this test turns out to be positive, you go down that pathway and negative turn on the best. and it leads you to the proper treatment and ensure it is our side to recognize that more and starting to approve it based on those pathways and multiple different organizations of different pathways, but mostly generally the same. so those pathways allow it to be to allow for less spending because they were approved and less for less error in terms of patient care. and the other thing i mentioned was the comprehensive cancer team. so basically, instead of the condition taken on the burden of being the social worker, the physical therapy is the dietician nutritionist, we have nutritionist we have is the therapist. we have social workers, we have um,

nurses, we have oral, we have certain pharmacist on the team and as a team we cater to that one patient and we all focus on our respective specialities, and that has led to less hospitalizations, less emergency room visits in the in the 1st year of kendrick treatment. so very common thing is for patients who are under the chemo therapy or immunotherapy or any type of targeted therapy, 70 percent of them end up in the emergency room. and that's from a lack of education, or lack of access to certain specialties. and basically that could save up to $200000.00 a year for one patient. so those are the 22 mortality is that i see in my mind that have demonstrated that balance between profitability, accessibility for treatment. thank you so much, dr. has in for all your time today. the cancer continues to be in a loose of disease as myriads of mutations exist. every cancer is caused by a different set of mutations. and as

a tumor grows more and more mutations accumulate. this means that every tumor has an individual set of mutations. so a drug that works for one patient might have absolutely no effect on another. it is not a single disease, but rather a group of diseases with more than a 100 different types of cancers. they are also caused by different things. so no one strategy can prevent them. while we may never be able to completely cheer, cancer scientists are optimistic that vaccines, personalized medicines and smart lifestyle choices will help to prevent and treat a much greater proportion of cases then currently today i'm christy. i thanks for watching and we'll see you right back here next time on the cost of everything. the

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