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Polish women die of breast cancer more often because an effective drug used in 14 EU countries, including the Czech Republic and Slovakia, is unavailable in our country.
Dr Bogumiła Czartoryska-Arłukowicz from the Białystok Cancer Center tells about her 39-year-old patient who came to her in the eighth month of pregnancy due to a breast tumor. After the biopsy was performed and the neoplastic disease was confirmed, labor was accelerated. The patient gave birth to a healthy boy. The woman had previously informed her gynecologist that she sensed a lump in her breast. The latter, however, found that such changes are typical in pregnancy. Further examinations of the patient revealed metastases in the bones and liver. It turned out that she suffers from an extremely malignant type of HER2-positive tumor.
Twice as long
HER2 positive is a particularly aggressive form of cancer that grows rapidly and spreads to other parts of the body and is resistant to treatment. It falls on about 20-25 percent. women with breast cancer. Until the drug trastuzumab appeared, patients with advanced HER2-positive breast cancer survived for about two years. A study published in 2001 showed that combining this drug with chemotherapy prolongs the overall survival of patients by an average of 9 months. Since then, this method of treatment has been considered a standard in the US and European Union countries. Now, thanks to the addition of the new drug pertuzumab to this therapy, patients with aggressive metastatic breast cancer live 1,5 years longer, i.e. almost 5 years. During this time, a lot can happen in medicine, which gives patients hope for an even longer life. But not in Poland.
Economical ministry
Polish patients do not even receive the older trastuzumab therapy, which has been recognized as optimal in the world since 2001. The regulations require doctors to first use chemotherapy alone, and only – if it does not bring results – trastuzumab. Polish women also do not have access to a new drug – pertuzumab. It is reimbursed in 14 EU countries, including the Czech Republic and Slovakia. The average price of a monthly therapy is PLN 13. zloty. The Polish health ministry did not agree to its reimbursement. This is outrageous, because the National Health Fund has not used the entire budget for drug reimbursement in the last two years and has saved over PLN 3 billion. According to the law in force, the money saved should be spent on reimbursement of new therapies. However, this did not happen.
The minister determines that the doctor cannot heal
Oncologists emphasize that the minister of health decides what the treatment of patients will look like, but he does not face the patient. It is the doctor who has to tell the patient that there is a drug that would allow him to live five years waiting for further medical advances, but unfortunately not available in Poland. The Polish oncological community considers this drug a breakthrough discovery. – It’s amazing. We are satisfied when the therapy extends the survival by six months or even four months. Here, adding a new drug gives an additional year and a half, so a total of five years – emphasizes prof. Tadeusz Pieńkowski, head of the Oncology and Surgery Clinic at the European Health Center in Otwock. – Meanwhile, although the therapy concerns a particularly poor group of patients, treatment is currently not reimbursed in Poland – says prof. Marek Wojtukiewicz, head of the department of clinical oncology at the Białystok Oncology Center.
Due to the fact that the pharmaceutical company conducted research on the effectiveness of pertuzumab in the hospital where the 39-year-old pregnant woman was admitted, Dr. Czartoryska-Arłukowicz was able to administer it to the patient. – After giving birth to a healthy son, we started administering the drug. Recent tests have shown remission of liver metastases and stabilization of bone metastases. I am happy that I could offer such treatment to the patient. I hope that she will live for over five years, which is very important in her case, because she has a small child – says the doctor. Not all of her fellow oncologists can be so happy and heal the sick to the best of their knowledge.
Targeted therapies
Breast cancer is the most common cancer among women in the world. Statistics show that in Poland one in 12 women will develop this cancer. Most – as much as 80 percent. incidence of breast cancer – occurs in Polish women over 50 In 50 percent patients develop distant metastases. HER2 determination after diagnosis of breast cancer is of key importance for the selection of therapy. The lack of this knowledge results in the choice of the treatment with worse effectiveness. Biological therapies, also known as targeted therapies, have been used in the treatment of breast cancer for several years. All of these treatments can be used alone or in combination depending on the stage and type of cancer. By targeting specific mechanisms of cancer cell activity, biological therapies are effective and less harmful to healthy cells. These drugs can be administered intravenously and orally. Rapid surgical and postoperative treatment can help most patients with early-stage breast cancer.
Text: Halina Pilonis
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