Call to speed access to innovative advances for all breast cancer patients

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Call to speed access to innovative advances for all

breast cancer patients

Medical Procedure News

Published: Tuesday, 28-Mar-2006

Breast cancer specialists and advocates at the 5th

European Breast Cancer Conference (EBCC-5) called for

patients to have equal and speedy access to new breast

cancer treatments and procedures, as soon as they are

validated by comparative clinical trials.

Doctors and patient groups fear that women across

Europe are not getting timely access to new drugs and

devices that could help prolong their survival and

well-being. Recent advances in intra-operative

radiation therapy and reconstructive surgery to the

breast have been made accessible quickly to women in

the United States, but even getting on to the relevant

clinical trial has proved almost impossible for their

European counterparts.

Last year Italian and English studies demonstrated the

feasibility of intra-operative radio- therapy. They

found that delivering radiation directly to the open

breast during surgery appeared to be potentially as

effective as six weeks of external radiotherapy.

Patients had their breast cancer surgically removed

and their radiotherapy treatment all in one stay in

hospital. The new treatment also limited radiation

exposure to the rest of the patients' skin and other

organs, preventing further tissue damage. However,

there are only a few centres across Europe that can

carry out intra-operative radiotherapy and many

patients cannot benefit from these advances. Patients

are still facing long waiting times and have to travel

long and tiring distances to radiotherapy centres.

The psychological impact of having a breast removed

due to cancer has been well documented. However, new

advances in reconstructive breast surgery can

significantly improve a patient's confidence and

well-being; unfortunately these surgical techniques

are not available to all European patients. Breast

surgeons can now perform a mastectomy that removes the

malignant tumour and surrounding breast tissue whilst

sparing the nipple. Nipple saving surgery can vastly

improve the look and feel of the breast and improve a

patient's self confidence.

Surgeons can now reconstruct a breast immediately

after the cancer is removed using artificial implants

or even the body's own tissue (autologous tissue

reconstruction) or a combination of tissue

reconstruction and implants. Breast reconstruction is

a complex procedure that needs to be performed by a

skilled plastic surgeon, unfortunately not all

patients have access to surgeons who can carry out

these new techniques.

Another topical example of complexity in access to

treatments is the case of the drug trastuzumab

(Herceptin.). Currently the drug is licensed by the

EMEA (European Medicines Agency) for women with

advanced stage breast cancer but not for those with

the early stages of the disease. The recent results of

four large clinical trials showed a significant

reduction in breast cancer recurrence for women with

HER2 positive breast cancer, when given the drug

post-surgery. Breast cancer doctors claim that the

results of the four trials are sufficiently compelling

to recommend adjuvant trastuzumab as a standard option

after surgery in appropriate patients. The lagtime

between the announcement of the results of the

clinical trials and the submission of the applications

by the industry, the lack of clear definition of

'appropriate patients', the diversity of the national

healthcare systems (even within the EU) and their

heterogeneous policies of reimbursement may prevent

hundreds of patients enjoying the benefits of this

drug when they need it.

Dr Alberto Costa, President of the EBCC-5 conference

comments, " Action needs to be taken so that women in

different countries have equal and quick access to new

and better treatments and procedures. It is

regrettable that so many women are still not receiving

the treatment that gives them the best chance of

survival and best quality of life. "

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