Latest news with #Carboplatin
Daily Maverick
13 hours ago
- Health
- Daily Maverick
Too little, too late – lifesaving chemotherapy drugs for kids finally arrive at Eastern Cape hospitals
A month after the Eastern Cape Department of Health promised that they had paid the overdue bills that delayed the delivery of chemotherapy drugs to Nelson Mandela Bay hospitals and that the issue would be solved, crucial chemotherapy drugs finally started arriving at Port Elizabeth Provincial Hospital. But it was too late for some children, who have missed a cycle of treatment, leaving them at high risk. A month ago, the Eastern Cape Department of Health assured the public that it had paid the overdue bills for pediatric chemotherapy drugs and that the problem was solved. Only it wasn't. And medical teams were thrown into a race against time to prevent their little patients from defaulting on their treatment. Crucial chemotherapy drugs needed to treat five children, who have already missed a full cycle of treatment, only arrived at Port Elizabeth's Provincial Hospital on Thursday, 12 June. The five children were just the most serious of cases – many others also missed a day or two of treatment and newly diagnosed patients could not receive their initial treatment. The additional month's waiting could have devastating consequences for the patients. One pediatric oncologist, who works in another province, said they have seen cancer returning if a child misses a cycle of chemotherapy, and sometimes the returned disease will be resistant to first-line drugs. On 19 May, the department indicated that overdue bills, which were the reason for the outage, were paid and that drugs will be delivered. Documents from senior officials in the department that have been confirmed with three sources as authentic, however, show that on 21 May, doctors were warned that 11 types of chemotherapy were not available, and in four of these cases it was due to 'closed accounts'. It is understood that companies wanted a bigger part of their overdue bills paid after an initial payment was made. Carboplatin, one of the crucial chemotherapy drugs, was, however, reported to be out of stock with a contracted supplier and needed to be sourced from another supplier. On 2 June, outages were still not addressed and the hospital had no Betamethasone, no Carboplatin, no Dacarbazine, no Methotrexate, no Leucovorin, no Polygam – either 6 grams or 12 grams – no Melphalan and no Spironolactone. Pharmacies had received Vinblastine (two months of stock) and Vincristine (commonly given as an IV injection – six months of stock). For the next 10 days, patients needing chemotherapy drugs that were out of stock were sent away. Yesterday, on 11 June, an entire contingent of patients were again sent away – five of them have by now missed an entire cycle of chemotherapy or three weeks of treatment. The South African Human Rights Commission (SAHRC) has launched an investigation into the repeated interruptions of cancer treatment for public healthcare patients in the Eastern Cape. Dr Eileen Carter from the SAHRC said the Democratic Alliance (DA) had laid a complaint with them about the matter. The oncology units in Gqeberha previously ran out of chemotherapy medication in January after the Eastern Cape Department of Health's account with a supplier was suspended due to a delayed payment. At the time, the medicines that were in short supply were Docetaxel injection vials and Anastrozole tablets. On Sunday, Sizwe Kupelo, the spokesperson for the Eastern Cape MEC for Health Ntandokazi Capa, said the department 'wishes to reassure members of the public that drug availability in our facilities is one of the top priorities'. 'An amount of R284-million has been made available to pay pharmaceutical companies and order medicines. As of the past two weeks, R60-million was disbursed and various suppliers have already started deliveries. This week, orders and payments will continue to be made. To monitor progress, the head of the department, Dr Rolene Wagner, has established a task team led by a chief director to coordinate the whole ordering and delivery of medicines, with oncology being a priority. 'Pharmacists from all oncology departments in all three of our major hospitals also had a meeting with the HOD and pharmaceutical services in Bhisho to discuss their stock levels. We wish to re-emphasise that payment of service providers is no longer an issue at this stage and medicines are being delivered. 'However, we have been made aware that some companies that are on the national contracts do not have certain products available, due to global supply chain issues. 'To address this, the task team and relevant managers are liaising with the national department to seek permission to procure outside the contracted companies,' he said. This process appears to only have been started two weeks after the out-of-stock chemotherapy drugs crisis was confirmed. 'Once again, this is a priority to both the MEC and the HOD, and both offices will continue to monitor and provide support to colleagues on the ground,' Kupelo said. DM
The Age
6 days ago
- Health
- The Age
Out of the ashes, a new treatment for a hidden cancer
Keratinocytes, like all healthy cells, carefully follow the instructions coded into your DNA. But when DNA is damaged, most-often through the photons in sunlight smashing into it, the instructions can be garbled. These new instructions can cause the cell to start dividing uncontrollably, eventually forming a cancerous tumour. Loading CSCCs typically appear on the most sun-exposed parts of our skin – the hands, the neck, the scalp or ears – as a firm bump or scaly sore. Bailey recalls 'a scabby sort of thing on my head'. As soon as his doctor saw it, he cut it out. Surgical excision, and sometimes additional radiation therapy, is the typical treatment for CSCC. In more than 90 per cent of cases, simple treatment is entirely curative. 'You cut them out, you send it off, you stitch it up, and they are cured,' says McCormack. But occasionally, the cancer has spread before it is spotted. Of every 100 cases, one to three people will die, as the cancer grows back in their lungs or livers or bones. Deaths from non-melanoma skin cancers have almost doubled in Australia in the past 20 years; globally, CSCC causes more deaths than melanoma does, despite its lack of name-recognition. About 70 per cent of us will get a non-melanoma skin cancer in our lives – hence the high number of deaths, even though the disease itself has a relatively low mortality rate. 'It's so common, people tend to trivialise it a bit,' says the University of the Sunshine Coast's Associate Professor Andrew Dettrick, who has published papers on CSCC. 'Five per cent does not sound like a lot, but it is when you times it by 200,000 people.' A new standard of treatment for an invisible disease If a doctor cuts out the tumour, and then uses beams of radiation to kill any cells they cannot reach, why does cancer sometimes come back? 'They have got microscopic disease left, either in the area that's been treated, or it has already spread. And we don't have any way of knowing that,' says Professor Danny Rischin, head of research for head and neck cancer at the Peter MacCallum Cancer Centre. The focus of Rischin's career has been on stopping that cancer coming back. In 2018, he co-authored a study testing whether Carboplatin, a chemotherapy drug, could prevent relapse. Loading Like many experiments, it did not work. The drug did not improve survival. But scientists often learn more from failure than success. Rischin's team were able to isolate a subgroup of CSCC patients within the trial who had certain features that put them at a dramatically higher rate of cancer recurrence. 'They were in need of better treatment,' he says. For this group, Rischin's team turned to one of the medicines that has revolutionised cancer treatment in the past decade: checkpoint inhibitors. Our immune system needs to run certain checks to ensure it is attacking an enemy, not one of our own cells. Cancer often takes advantage of this, generating its own codes to pass the checks. Using genetically modified antibodies, scientists in the past two decades have learned to block our own immune system's checkpoints. 'It unmasks the cancer cell, so your immune system can see it again,' says Dettrick. Perhaps a souped-up immune system could ferret out the microscopic cancers the surgeons could not? In a study sponsored by the therapy's manufacturer, published in the New England Journal of Medicine, Rischin's team randomised 415 patients, who had been treated for CSCC but had a risk of recurrence, between immunotherapy and a placebo: 87 per cent of patients on the therapy were still disease-free after 24 months, compared to 64 per cent on the placebo. About 10 per cent of patients getting the therapy had severe side effects, and one died – consistent with the normal side effects from immunotherapy.
Sydney Morning Herald
6 days ago
- Health
- Sydney Morning Herald
Out of the ashes, a new treatment for a hidden cancer
Keratinocytes, like all healthy cells, carefully follow the instructions coded into your DNA. But when DNA is damaged, most-often through the photons in sunlight smashing into it, the instructions can be garbled. These new instructions can cause the cell to start dividing uncontrollably, eventually forming a cancerous tumour. Loading CSCCs typically appear on the most sun-exposed parts of our skin – the hands, the neck, the scalp or ears – as a firm bump or scaly sore. Bailey recalls 'a scabby sort of thing on my head'. As soon as his doctor saw it, he cut it out. Surgical excision, and sometimes additional radiation therapy, is the typical treatment for CSCC. In more than 90 per cent of cases, simple treatment is entirely curative. 'You cut them out, you send it off, you stitch it up, and they are cured,' says McCormack. But occasionally, the cancer has spread before it is spotted. Of every 100 cases, one to three people will die, as the cancer grows back in their lungs or livers or bones. Deaths from non-melanoma skin cancers have almost doubled in Australia in the past 20 years; globally, CSCC causes more deaths than melanoma does, despite its lack of name-recognition. About 70 per cent of us will get a non-melanoma skin cancer in our lives – hence the high number of deaths, even though the disease itself has a relatively low mortality rate. 'It's so common, people tend to trivialise it a bit,' says the University of the Sunshine Coast's Associate Professor Andrew Dettrick, who has published papers on CSCC. 'Five per cent does not sound like a lot, but it is when you times it by 200,000 people.' A new standard of treatment for an invisible disease If a doctor cuts out the tumour, and then uses beams of radiation to kill any cells they cannot reach, why does cancer sometimes come back? 'They have got microscopic disease left, either in the area that's been treated, or it has already spread. And we don't have any way of knowing that,' says Professor Danny Rischin, head of research for head and neck cancer at the Peter MacCallum Cancer Centre. The focus of Rischin's career has been on stopping that cancer coming back. In 2018, he co-authored a study testing whether Carboplatin, a chemotherapy drug, could prevent relapse. Loading Like many experiments, it did not work. The drug did not improve survival. But scientists often learn more from failure than success. Rischin's team were able to isolate a subgroup of CSCC patients within the trial who had certain features that put them at a dramatically higher rate of cancer recurrence. 'They were in need of better treatment,' he says. For this group, Rischin's team turned to one of the medicines that has revolutionised cancer treatment in the past decade: checkpoint inhibitors. Our immune system needs to run certain checks to ensure it is attacking an enemy, not one of our own cells. Cancer often takes advantage of this, generating its own codes to pass the checks. Using genetically modified antibodies, scientists in the past two decades have learned to block our own immune system's checkpoints. 'It unmasks the cancer cell, so your immune system can see it again,' says Dettrick. Perhaps a souped-up immune system could ferret out the microscopic cancers the surgeons could not? In a study sponsored by the therapy's manufacturer, published in the New England Journal of Medicine, Rischin's team randomised 415 patients, who had been treated for CSCC but had a risk of recurrence, between immunotherapy and a placebo: 87 per cent of patients on the therapy were still disease-free after 24 months, compared to 64 per cent on the placebo. About 10 per cent of patients getting the therapy had severe side effects, and one died – consistent with the normal side effects from immunotherapy.
