Wednesday, June 07, 2006


They tried their best to condemn a large group of people to death

A cancere drug that the Government value-for-money watchdog wanted to deny to NHS patients has celebrated five years of use with stunning results. Glivec, the biggest breakthrough in cancer therapy for a generation, has kept alive 90 per cent of the patients with chronic myeloid leukaemia (CML) who have been taking it in those five years.

Yet, if the National Institute for Health and Clinical Excellence had had its way, many would never have received the drug. Its initial advice, in May 2002, staggered patients and specialists involved in the trials as well as the maker, Novartis. But after an outcry it reconsidered its advice, making the drug available to more patients.

Yesterday, at a meeting in London, survivors gathered to hear the latest data. Sandy Craine said: "When Glivec became available five years ago, I would never have believed I would be standing here today. "I was diagnosed in 1999 in the accelerated phase of CML and was told that, without invasive chemotherapy, followed by a stem cell transplant, I had about 12 months to live." Ms Craine travelled to the United States to get on to a trial of the drug. "Glivec saved my life," she said.

There are between 600 and 800 cases of CML diagnosed in the UK each year. It is a cancer of the bone marrow, caused by an unusual rearrangement of chromosomes 9 and 22, generating a new chromosome that in turn produces a protein that drives the disease. Professor Charles Craddock, of the University of Birmingham, said that before Glivec the outlook for such patients was "pretty gloomy". A bone marrow transplant could cure a minority. Some found the drug interferon alpha effective, but at the cost of permanently feeling that they had flu.

Glivec was fast-tracked by the US Food and Drug Administration and licensed in record time, on June 5, 2001. Since then, more than 1,000 patients have been followed. In 90 per cent of those on Glivec, the aberrant chromosome was eliminated. "There was major scepticism that a single drug would give a prolonged response, but it has," Professor Craddock said. "In 10, 15 or 20 years' time, we could have treatments based on the Glivec experience that knock out the cells that cause the problems."

The side-effects of Glivec are not negligible, but they are less than those of interferon alpha. The drug also works well for a rarer cancer: gastro-intestinal stromal tumours (GIST), which form in the digestive system. Before Glivec, there was no treatment for GIST except surgery, and the tumours often returned. The drug has greatly extended the survival of GIST patients and in many the tumours have disappeared.

The drug costs 14,000 pounds per patient per year, and for some patients with CML a bone marrow transplant may still be preferred, but for GIST patients there is no alternative. Thalidomide, notorious for causing birth defects in thousands of children in the 1960s, significantly increases survival in patients with multiple myeloma, a study shows. The results were reported to the American Society of Clinical Oncology yesterday.



A delivery driver's life was saved when his colleagues paid for a brain scan that revealed a life-threatening tumour. Gary Harris, 38, had been put on a three-month waiting list for an NHS scan but was later told by doctors that he would have died within two weeks had he not had an emergency operation to remove the tumour.

All 60 employees at Park Furnishers, Bristol, paid 12 pounds each - a total of 720 pounds - to cover the cost of having the scan done privately because Mr Harris was convinced that there was something seriously wrong. Mr Harris, a keen cyclist, said: "My workmates made sure I could live. How can I ever repay or thank them for such unimaginable kindness?" He had experienced dizziness and vomiting over five months, and went to his GP several times. He said: "I could count on one hand the number of times I had visited the doctor before all this. So in November last year, when I started experiencing dizziness and vomiting, I knew something was seriously wrong."

During the next four months GPs from The Crest Family Practice in Bedminster, Bristol, diagnosed winter vomiting sickness, vertigo, stress and possible eye strain. After one attack of vomiting and numbness he visited an accident and emergency department, where he says that he was told to take ibuprofen and paracetemol. He said: "Eventually they agreed for me to see a neurologist at the beginning of April. He thought it was neck arthritis from the cycling but said he would put me on the list for a CT scan as a precaution. That wasn't going to be until July. "He could have sent me straight away for an emergency scan, but decided not to. "Then my warehouse manager came and told me to get a private scan and not to worry about the cost. It took my breath away."

The scan took place on April 27, and revealed a large tumour that had started attaching itself to his brain stem. The next day he was admitted to Frenchay Hospital, where he underwent more tests and had a drain inserted to remove fluid on his brain before undergoing 13 hours of surgery a week later. Mr Harris said: "The neurosurgeon at Frenchay, Mr Porter, told me without an operation I would have two weeks to live. It would have been a painful and unpleasant death. "He told me my brain would have been crushed as the tumour was so big. If I had relied on the NHS I would have died seven weeks before the scan they offered me."

Mr Harris was discharged from hospital on May 17. The surgeon told him that his recovery was remarkable. Mr Harris's wife, Kim, 28, with whom he has a daughter, Gracie, 4, has given up her job to look after him. She said: "For months our lives were on hold. We couldn't do anything and we just didn't know what was wrong. When the scan showed up the problem it was almost relief that it had a name. "Then reality set in that we could be about to lose him. We can't describe how grateful we are."

Last week staff at Park Furnishers were handed a note with their payslips from Deryn Coller, the company director. At the top was written: "Last month you saved someone's life." He also added 20 pounds to everyone's pay to thank them. Alfie Dibble, Mr Harris's manager, said: "Gary is a great bloke and it was never an option not to help him. Everyone feels very emotional about what he's been through and proud to have been able to help." Mr Harris intends to pursue complaints against the doctors he consulted. The GP surgery declined to comment.



For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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