Why sequential treatment matters for all of us

If you had metastatic breast cancer or lung cancer and your first treatment ceased to be effective, you would, without question, begin a second drug. When that second drug ceased to be effective, you would likely receive a third drug, and a fourth, and so on. We all know that sequential treatment is essential to the long-term management of metastatic cancer.

So why is it that kidney cancer patients only get one kick at the can? Our provincial governments currently fund first-line treatment only. In some provinces (BC, for example) you now have the choice of Sutent, Nexavar, or Torisel in the first line. However, if that drug stops working or you cannot tolerate the side effects after 6 months, your provincial government will not provide you with any other funded treatment option.

If you’re lucky, your oncologist will find you a trial or you will find a free access program (like the one for Afinitor that we noted earlier will run out on Jan 20 2011).

But what if it’s January 21st 2011 and there is no clinical trial that you are eligible for? Unfortunately the answer is that you will have to pay for your second-line treatment yourself. Most of us can afford the occasional prescription cost, but these drugs all cost in the range of $5-7,000 per month. In some provinces you might be lucky enough to have private drug insurance that covers cancer drugs, but many Canadians don’t have such coverage.

That’s why we’re gearing up to make sure we have access to second-line treatment in Canada. In the coming months we’ll be encouraging patients and family members to get involved in this battle for funding.
We all know that provincial drug budgets have their limits, but it is fundamentally unfair that patients with rarer life-threatening cancers get routinely denied treatment options that could significantly extend their lives.

As a patient who is living well 18 months into second-line treatment (thankfully from a trial), I am willing to take up this message with provincial governments — and I (We, KCC) will need your help as voices from those provinces. Stay tuned. If you have questions, thoughts, or ideas, feel free to add a comment here.

And yes, please ask your oncologist: what options will patients in your province have on January 21st if we don’t have second-line coverage? We need the answer, even if it’s not one we want to hear.


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