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The Times - Stuttaford, Dr. Thomas - Hope for Kidney Cancer patients

The Times - Stuttaford, Dr. Thomas - better NHS treatment in Scotland?

2007.04.25 - The Times - Insurance for Cost of Drugs

Insurance policy promises to supply the cancer drugs NHS will not pay for

Nigel Hawkes, Health Editor April 25, 2007

A new way of guarding against the NHS postcode lottery and ensuring that drugs for cancer treatment are available when needed has been introduced by an insurance company.

Policy-holders will pay an annual premium equal to their age in years, £58 at age 58, for instance. If they develop cancer, they will have access to £50,000 of treatment with drugs that are proven to be effective but are often unobtainable on the NHS.

The policy, announced by Western Provident Association (WPA), has limitations. It is available only to the under-65s, and cannot be started after cancer has been diagnosed.

People who have a parent or a brother or sister who died of cancer below the age of 60 are also excluded.

But for those who qualify, the equivalent of a tankful of petrol every year will entitle them, says WPA, to a range of new drugs including Avastin, Erbitux, Tarceva and Velcade, that are extremely hard to get through the NHS. Many people have been forced to pay for these drugs themselves, or if they cannot afford them, to do without. None is a cure, and most offer only a few months’ extra survival, but WPA expects many people to think it worthwhile paying the modest premiums to guarantee access.

Julian Stainton, chief executive of WPA, said that he viewed the new policy, called mycancerdrugs, as both a business opportunity and a challenge to the NHS.

Cancer is no longer an inevitable death sentence” he said yesterday. Mycancerdrugs helps fund the cost of such advanced drugs where the NHS denies their use. It is now time for this sort of top-up to be available to the public.”

He insisted that such top-ups already existed in the NHS, were intended to be part of the system by its originator, Lord Beveridge, and that opposition to the idea was “authoritarian”.

Some consultants have refused to treat patients who have bought themselves supplies of cancer drugs, on the grounds that to do so would create a “two-tier” system. Others take a less ideological position.

WPA has sought the advice of a QC, Nigel Griffin, whose opinion is that there is nothing in the law to bar a patient from buying their own drugs and having them administered as part of NHS treatment.

The Scottish Executive has confirmed this view of the law, saying that there is no legislation that allows the NHS to require patients to pay for all aspects of their treatment if they opt to pay for a particular drug themselves.

Karol Sikora, a leading cancer specialist, said: “It is the doctor’s duty to find the best way forward for a patient, and this is the least inequitable way of doing it.”

In a report published on Monday, Doctors for Reform pointed out that co-payment, or top-up payments, are commonplace in the NHS and range from dentistry to prescription charges, audiology, ophthalmology and maternity services.

Cost of living

Licensed advanced cancer drugs unlikely to be prescribed on the NHS:

Alimta (pemetrexed) for treating mesothelioma and small cell lung cancer. £8,000 monthly

Velcade (bortezomib) for multiple myeloma in patients who have had at least one earlier therapy or are unsuitable for a bone marrow transplant. £3,050

Avastin (bevacizumab) for colon or rectal cancer and also used for treating age-related macular degeneration. £1,849

Erbitux (cetuximab) for colorectal and head and neck cancers. £3,685

MabCampath (alemtuzumab) for chronic lymphocytic leukaemia. £9,619

Sutent (sunitinib) for kidney cancer or for gastrointestinal stromal tumours. £3,304

The Original is available Click Here

2004.02.20 - The Times - KC vaccine

Lung and Kidney Cancer Vaccine Breakthrough

By Nigel Hawkes, Health Editor, 2004.02.20

A vaccine designed to treat lung cancer wiped out the disease in a few patients and slowed its spread in others, new results show.

The study is the second in a week to show benefits from cancer vaccines. In the other, survival after surgery for kidney cancer was enhanced by the use of a vaccine.

Vaccine studies are a growing area of cancer therapy. Unlike most vaccines, which seek to prevent disease, cancer vaccines are used as treatments. The idea is to boost the body's own ability to eliminate tumours.

In the lung cancer trial, published in the Journal of the National Cancer Institute, 43 patients with non small-cell lung cancer were injected in the arm and leg every two weeks for three months with a vaccine that included cells from their own tumours.

The cells were modified to contain a gene, CM-CSF, which alters the surface of the cells to make them more recognisable to the immune system.

The vaccine was developed by researchers at Baylor University Medical Centre in Dallas, and the research was funded in part by CellGenesis, a pharmaceutical company that hopes to produce the vaccine.

Three patients with advanced stage cancer had no recurrence of the disease for three years after the treatment. In another 30 patients with advanced disease, the tumours grew less quickly, but in ten patients with early-stage disease there was no effect.

"The results are very promising for patients with non-small cell lung cancer, which is frequently resistant to chemotherapy," said Dr John Nemunaitis, a Baylor oncologist who led the study.

Non-small cell lung cancer is a leading cause of death, the commonest form of cancer caused by smoking. It is often difficult to treat, and patients normally die within eight to nine months.

Chemotherapy is successful in about 3 per cent of patients. "The most exciting thing is in those who responded to the vaccine, it was complete," Dr Nemunaitis said. "It's given us a lot of encouragement."

Dr Richard Sullivan, Head of Clinical Programmes for UK Cancer Research agreed that the results were encouraging.

"Lung cancer treatment is a big problem," he said. "It's an aggressive cancer that takes years to come up.

"Chemotherapy is very toxic and to kill the cancer, you often end up killing the person.

"Getting the immune system to recognise the lung cancer is an exciting prospect. It is very promising, there's no doubt about it.

"This is a small trial, it needs to be replicated in a large study before we can be sure that it will be beneficial to everybody and is not just a fluke.

"You can get results by chance which have nothing to do with the reality."

A second success with a cancer vaccine is reported in this week's Lancet. A team led by Dieter Jocham from the University of Lubeck Medical School treated 379 patients from 55 medical centres in Germany for kidney cancer.

The results show that five years after their operations, 77 per cent of those given the vaccine, and 68 per cent of the control group are still alive. The vaccine was well-tolerated, with only a few adverse reactions. Although the improvement is modest, it is encouraging.

Mayer Fishman and Scott Antonia from H Lee Moffitt Cancer Centre and Research Institute in Tampa, Florida, say in an accompanying editorial that it is an 'immunological breakthrough'.

In future, they say, such additional treatments may become a routine part of kidney cancer treatment and contribute to increasing survival from the disease.

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