For decades, a cancer diagnosis was equated with loss of hope and even described as a death sentence. Advances in drug therapies have changed this.
‘Cancer survivor’ is used to define people who had completed treatment successfully, and it has evolved to mean something more holistic. The National Coalition for Cancer Survivorship and the National Cancer Institute (NCI) in the United States state that ‘a person becomes a survivor from the time of diagnosis and continues to be a survivor for the rest of his/her life’.
In Malaysia, we face two problems. First, unlike similar countries, patients are diagnosed in late stages of cancer. Our national registry shows that more than half of our survivors are diagnosed in advanced stages of cancer (Stage 3 or Stage 4). Second is that diagnosis of most Malaysians now is getting younger, due to better cancer awareness that sees more women going for early screening.
Resources particularly availability of new and innovative treatments, are often focused on early stage cancer patients with a focus on breast cancer as they often have better chances to respond to treatments. However, studies show that offering new and innovative treatments to patients in later stages of the disease may yield equal rewards; which sees them living longer and better lives including some who remain disease-free for their entire survival period.
Patients with breast cancer in early stages (Stage 1 &2) who visit public hospitals have access to a drug therapy called ‘trastuzumab’ which is highly effective for those expressing a specific protein (HER2+). With these drugs, they have better, longer survival and/or cure rates. However, evidence shows now that for those with breast cancer in Stage 3 & 4, trastuzumab also has huge benefits – increasing both survival periods and the quality of life of these patients. Unfortunately it is unavailable for their use.
The Government must consider the value obtained by extending treatment to cancer survivors in late stages as they are enormous. Looking at the cost of treatment alone is not enough as there are savings such as less hospitalisation and care required for the survivor who remains well; the economic productivity of the survivor (and family members) who has the ability to return to work. Providing these drugs can improve the well-being of survivors who will be able to spend more time with their families while leading better quality of life.
Merely asking for funds for the survivors’ treatment may seem unjust to the Ministry of Health, what with our recent economic conditions. The National Cancer Society of Malaysia, alongside other cancer control groups, would like to call on all stakeholders to work together to build new innovative strategies to ensure these patients can be given these innovative, highly effective therapies.
Foundations aiding patients across all cancers should also be roped in to partly fund patient purchase programmes; while pharmaceutical companies can provide assistance programs – in which they too contribute these drugs at subsidised rates.
With stakeholders pitching in with their part, MOH needs to take a small funding step forward in order to ensure that the Malaysian healthcare system; our patients, are provided with the best care to enable longer survival and better quality of life.