Thursday, June 30, 2011

Medicine science, emotion, politics and money

The saga of Avastin, a drug used to help in end stage breast cancer, is a salutary warning on the pitfalls that can arise when a promising new "breakthrough" in cancer treatment collides with the reality of hard science, economics, politics and emotion.

Avastin is a relatively new medication for the treatment of solid tumours and is quite successful, in combination with other forms of treatment, when dealing with colon cancer. Avastin is in a unique class of medications, and targets the blood supply that these solid cancers "hijack" and stimulate as they grow and spread around the body.  It is also a very expensive drug and costs around $100,000 per year to treat patients.

The research was initially trialled, as usual,  on mouse models and was dramatically successful: however, when tried out in humans the results were not quite as spectacular - in fact, experts now tell us that the overall survival of people treated with Avastin is not increased at all; and the side effect profile of the drug is not patient friendly either.

Because of its initial promise in prolonging life in stage IV breast cancer, the FDA in America fast tracked it, and it has become widely used for these patients. Now, the FDA has reversed that decision in a 6 - 0 verdict, despite the drug maker and patients making a last ditch attempt to sway the verdict. This decsion has come at a time in US politics where one side is trying to introduce universal Health Care, and the other is saying that the Government is withdrawing a drug based on cost with comments such as "I shudder at the thought of a government panel assigning a value to a day of a person's life,"

Medicine can be quite messy and is not the clean cut, black and white process many of us would like it to be. When money, emotion, politics, power, and science collide, then yet again it is often the weak and the vulnerable who get crushed. My advice: make sure that the person who looks after your health is a good person who is on top of his or her game: and trust them! Your job is to live every moment of your life as well as you can until you draw your last breath: and don't die wondering.
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