New Zealand lags in early detection and treatment of secondary breast cancer.
Claire McLintock was diagnosed with advanced cancer on her elder daughter’s 21st birthday. It had been 14 years since her successful treatment for breast cancer, but then came the constant tummy niggles that she knew needed to be checked out. McLintock is a medical professional, a haematologist specialising in obstetrics. At a scan to check her symptoms, when she saw a large build-up of fluid in her stomach, she realised immediately it was going to be devastating news. The cancer was back and spreading.
“It’s like I’ve got little seedlings of it all over my tummy,” she explains.
Preventing those seedlings from growing any further, so she can live as well and for as long as possible, was now McLintock’s priority. She is fortunate to have connections in the medical world so last year travelled to London, where specialists said her best option was a relatively new drug, Ibrance (palbociclib), taken alongside the oestrogen suppressant letrozole.
“There had been a big clinical trial that showed women with exactly what I’ve got lived 40% longer before the disease progressed when they were taking this combination of drugs,” McLintock says.
At that stage, Ibrance wasn’t registered for use in New Zealand, never mind funded. There was a stressful time trying to access the drug but finally McLintock paid £10,000 for an initial supply and, once back home in Auckland, started to take it.
She and her husband, artist John Reynolds, weren’t sure how they were going to afford Ibrance longer term, with McLintock reluctant to leave her family with mountains of debt. Again, she was fortunate with the people she knows. Her friends organised an epic fundraising art auction that has meant McLintock, 53, has enough money to pay for her medication for the foreseeable future.
“It’s been humbling,” she says. “I keep meeting friends who say, ‘Claire, if you need it again then we’ll do it again.’”
She has been on the drug regime since May last year. While preventing the over-proliferation of cancer cells, Ibrance also lowers the white blood-cell count, leaving patients at higher risk of infection, but so far
she is doing well. She cycles to work to see her patients, often travels in her role as president of the International Society of Thrombosis and Haemostasis, and spends lots of quality time with her daughters, Hart, 22, and Vita, 19.
“I wouldn’t say I’ve slowed down.”
Previous treatments for secondary cancer could involve intensive chemotherapy that left people weak, nauseated and often hospitalised. With the new generation of drugs, patients feel well enough to continue leading the life they had before the diagnosis.
“I’m able to be the person I am,” says McLintock.
She is painfully aware others aren’t as fortunate. Although Ibrance is now registered in this country, it remains unfunded, so patients must pay thousands of dollars a month to extend their time without the cancer progressing. Some travel to Malaysia to buy it more cheaply.
“But, for many, it’s just not on the radar of what they could raise money for,” says Adele Gautier, research and communications manager at the NZ Breast Cancer Foundation.
Ibrance is one of a handful of new drugs the foundation has identified as priorities for funding. It is seen as particularly crucial because the patient group – those with advanced ER+ (oestrogen receptor positive) breast cancer – is large and the drug has been heralded as a game changer.
Last month, 200 people marched on Parliament to petition Pharmac to fund these life-extending cancer medicines.
However, as Gautier points out, Pfizer, the manufacturer of Ibrance, has applied only for first-line funding, meaning even if Pharmac does decide in its favour – and the government agency has a capped budget and pres-
With the new drugs, patients can continue leading the life they had before diagnosis.
sure to fund other drugs – those who have received previous treatments for advanced cancer won’t be eligible for it.
Care for patients with advanced breast cancer generally isn’t good enough, Gautier says. A recent report by the foundation showed that New Zealand’s median survival after a diagnosis is just 16 months, as opposed to two to three years in comparable countries.
Apart from access to innovative new drugs, slow diagnosis and delayed treatment are concerns.
“We hear a lot from patients who go to their GP with a sore back or persistent cough and are treated for sciatica or bronchitis when the first call should have been to refer them to oncology for a check-up,” Gautier says. “Patients tell us it seems so different second time around. They feel the system has given up on them and they feel forgotten and ignored.”
Claire McLintock, right, with daughters Hart and Vita. Above, Adele Gautier.