3 Jan 2011

Chemotherapy scrapped for some types of cancer

9:56 pm on 3 January 2011

The Government says officials are investigating ways to improve cancer treatment after revelations that some patients in the central North Island are being denied chemotherapy.

MidCentral Health, which runs the regional cancer service, is cutting chemotherapy for people with some types of cancer until it can fill two specialist vacancies in its team of five.

The DHB has told the Whanganui, Hawke's Bay, Taranaki and Tairawhiti boards that it will no longer offer chemotherapy for 14 types of cancer that are least susceptible to chemotherapy.

It says it's critical that patients most likely to benefit from chemotherapy are first in line, so it will no longer accept referrals for patients who are less likely to benefit from the treatments.

Instead of being put on waiting lists they will be referred back to their own doctors.

Health Minister Tony Ryall says he's concerned about the situation, but MidCentral Health is hopeful of recruiting extra specialists soon.

Mr Ryall says the ministry is also working with doctors and Health Workforce New Zealand to make better use of cancer networks nationally.

He says chemotherapy clinics have boosted capacity by 25%, to just over 57,000 sessions in the past two years - mainly due to patients getting extra courses of chemotherapy and the introduction of new drugs.

The Cancer Society says New Zealand is competing with other countries for cancer specialists.

Chief executive Dalton Kelly says most regions are struggling to recruit specialists and risk burning out the ones they have.

About 18,000 people are diagnosed with cancer each year, but there are only 60 oncologists in the country.

The waiting list for chemotherapy at Capital & Coast DHB has reached 100 at times, as the board tries to replace a doctor who left almost two years ago.

'Worldwide' shortage

Medical Association chairman Peter Foley told Summer Report the shortage of oncologists is part of a larger crisis in medical recruitment in this country.

Dr Foley said the people who will miss out on chemotherapy are suffering from cancers that are least likely to respond to the treatment.

Professor Des Gorman also says the shortage of cancer specialists in the central North Island reflects a worldwide problem.

He told Summer Report it can be hard to attract oncologists to New Zealand because other countries with shortages are also vying for them.

He said medical services in New Zealand are too widely distributed, given the size of the population, and it may be wise to centralise some cancer treatment services in main centres.

Labour view

Labour says some cancer patients are being refused treatment in order to make waiting times look better, and accuses Mr Ryall of mismanaging the situation.

Health spokesperson Ruth Dyson says National criticised the previous Government for sending patients to Australia for treatment when waiting lists got too long.

She says that while it's claimed that these particular patients are less likely to benefit from chemotherapy, they would be treated if they lived in another region.

What types won't qualify

Patients with these cancers will not get chemotherapy at MidCentral:

- adenocarcinoma of the prostate (95% of prostate cancers are in this category)

- hepatocellular carcinoma (the most common type of liver cancer)

- all cholangiocarcinomas (cancer of the bile ducts that drain bile from the liver into the small intestine)

- all melanoma

- all squamous and basal cell skin carcinomas (non-melanoma skin cancers)

- all adult soft-tissue sarcoma (cancers of the connective tissue like muscles)

- all carcinoma of unknown primary origin (unless clinical presentation suggests a potentially chemo-sensitive primary tumour somewhere in the body)

- seven other types in cases of relapse, unless there has been a clinicially appropriate disease-free interval (usually a minimum of 12 months).