[Reporter's View] Advanced cancer patients face Tx gaps

The cancer treatment landscape is shifting rapidly. However, the benefits of this trend are not equally applied to all patients. In particular, patients with advanced cancer repeatedly pushed to the back of the line regarding treatment access, even when viable treatment options exist.

The structure is evident in the field of breast cancer. Driven by the expansion of national cancer screening programs, patients with early-stage breast cancer now account for approximately 70% of all cases, many of whom are managed as healthy survivors capable of long-term survival post-treatment. This represents undeniable progress in terms of early diagnosis and clinical outcomes.

However, this progress does not translate consistently across all stages of the disease. The issue is not confined solely to metastatic (Stage IV) patients. Limitations in treatment access begin as early as the advanced stages, where the risk of recurrence is high.

Disparity is observed in the adjuvant therapy stage. Recently, indications for several therapies were expanded to include adjuvant treatment for early-stage breast cancer, yet reimbursement has failed to keep pace. While regulatory approval has been granted, actual clinical use remains restricted.

Adjuvant therapy is designed to suppress recurrence. The key is to preemptively eliminate micrometastases that may remain even after the visible lesion has been surgically removed. Although treatment at this stage can determine long-term prognosis, the current structure makes practical application difficult due to the heavy financial burden on patients.

Ultimately, this gap inevitably leads to recurrence. Recurrence is not merely a progression of the disease. Recurrence destabilizes every aspect of a patient's life. As treatment resumes, the burden of medical expenses surges, and constraints on economic activity due to prolonged treatment become unavoidable. The burden of family caregiving also intensifies once again.

Given that a significant portion of patients in certain cancer types are in their 40s and 50s, this is not just an individual issue but a cost borne by society as a whole.

Despite this, the current system is closer to a model that allocates more resources to managing the aftermath of recurrence than to reducing it. Preventive treatments are restricted due to cost, while the treatment costs and social burdens incurred after recurrence are less considered.

Industry experts point to a simple reason. The high volume of patients. As the patient population grows, the fiscal burden increases, ultimately raising the threshold for reimbursement.

It does not mean that this issue cannot be disregarded. If the structure of restricting treatment access simply because of high patient numbers persists, the burden will eventually return to the patients and society at large.

The problem is that this trend is not limited to a specific cancer type. Adjuvant therapy indications are continuously expanding, not only in breast cancer but also in major solid tumors such as gastric cancer. While treatment strategies to reduce recurrence are evolving rapidly, actual access is failing to keep pace.

The issue is not about the availability of treatments. It lies in a structure where access is not granted in a timely manner when treatment is most critical. Therefore, it is time for a more realistic view that sees intervention at the stage of reducing recurrence as a structural necessity rather than a mere cost issue.