Americans and Europeans may sometimes associate China with software piracy, huge trade imbalances, or censorship of the Net. But China and its Western trade partners are fighting together on at least one front: the war on cancer.
Consider the case of a 42-year-old civil servant who wishes to be known as "Ms. Li." She received a mammogram at General Military Hospital in Beijing in June, which was an unusual event given that the equipment is still scarce and the price for such tests is high. Lucky for Li, her office picked up the tab as part of a new government-backed program to test 1 million women in the next three years. Many of them, like Li, will be screened and treated using the most advanced technology the West has to offer. Li's doctors discovered an early-stage tumor, and they plan to treat it aggressively. "Cancer is curable," says Li. "People who make a face when they hear the word 'cancer' don't understand science."
Enlightened self-interest is driving Western medical companies and research institutes to join China's war on cancer. Naturally, they want to help upgrade patient care at a time when cancer rates are soaring. With pollution fouling the air and the tobacco industry booming, the lung cancer toll alone could triple within two decades from the current 340,000 per year. At the same time, the researchers want access to China's pool of talented scientists and its enormous patient population.
Technology helps with the first part of the agenda, as the new breast cancer program demonstrates. Using an approach called digital mammography that is just starting to catch on in the U.S., doctors gather test results in a central database in Beijing, which is open to researchers around the country. Chinese are also experimenting with new forms of ultrasound screening. "They are moving at warp speed, relative to what would happen in the U.S.," says Dr. Stephen F. Sener, a surgeon at Evanston Northwestern Healthcare who advised the Chinese on the new program. "We would still be having committee meetings."
In exchange for helping the Chinese in such efforts, Western experts gain the freedom to work in China, where doctors and patients can help them test the latest drugs and procedures. AstraZeneca (AZN) recently announced plans to invest $100 million in China, much of it going to cancer-related research. GlaxoSmithKline (GSK) and Eli Lilly (LLY) have launched cancer trials in China. Yale University is licensing technology for ovarian cancer screening to SurExam Life Science & Technology in Shenzhen. And last month, Houston's MD Anderson Cancer Center teamed up with a university hospital in Tianjin, its fourth partnership with a Chinese hospital. Together, "we will answer questions [about cancer] that we are incapable of answering in the U.S.," says John R. Seffrin, CEO of the American Cancer Society, which is working closely with Chinese oncologists.
EASY TRIAL RECRUITMENT
China's vast patient population is a big draw for clinical oncologists around the world. For one thing, researchers can study forms of the disease that are rare in the U.S. or Europe, says Dr. Zhang Shangwen, a professor at the Beijing Medical University School of Oncology. What's more, some drugs may work best on Asian patients. Dr. Tony Mok, a professor of clinical oncology at the Chinese University of Hong Kong, is enrolling 1,200 patients in China and several other Asian countries to assess new uses for AstraZeneca's drug Iressa. The treatment has a disappointing track record with Western lung cancer patients but is showing greater success in Asians, possibly because of genetic differences in the populations. Ten years ago, such a trial would have been unthinkable. "The quality of the researchers wasn't high enough," says Dr. Mok, "but now a good number of sites in China are competent to carry out this research."
In general, recruitment for clinical trials is easier in China. Because of poverty and the lack of medical infrastructure in many parts of the country, patients often jump at the chance to enroll. They're willing to take part "because they don't have any other option," explains Dr. Zhang. For many reasons, both inspiring and sad, China may be the brightest hope for breakthroughs against this disease.
By Bruce Einhorn