Herceptin

Around 25% of breast cancers are HER2 positive, meaning they produce an excess of the HER2 growth signalling protein. Herceptin is a targeted drug which attaches itself to the HER2 protein on the surface of cells, blocking the cells from sending "grow" signals. HER2 positive breast cancer is one of the most aggressive forms of the disease, and tends to affect younger women. At present in New Zealand, women with advanced (terminal) HER2 positive breast cancer are provided with funded access to Herceptin on an “as required” basis to prolong and improve the quality of their lives. However, those women who have early (curable) HER2 positive breast cancer are funded only 9 weeks treatment, with the drug docetaxel. This is a regimen based on the FinHER study of 232 women, 54 of whom were given the 9 week Herceptin/docetaxel treatment. Because the number of women in the FinHER trial was so low, the results have has insufficient statistical power to show whether this treatment prolongs life. However, the world standard of 12 months treatment is based on a number of very large trials involving over twelve thousand women, with consistent outcomes of improved life expectancy. The 12 month treatment has been adopted worldwide because of the strong evidence that provides certainty of a beneficial effect. Despite this, the world approved treatment continues to be denied to New Zealand women, unless they fund it themselves. Herceptin dosage is calculated on weight and for some women costs can reach six figure sums. To illustrate, the quote for my treatment in 2006 was for $127,000, that is, $7,055 every 3 weeks!

At last, however, there is hope for women with HER2 positive breast cancer to be fully funded. The new National government, led by John Key, has undertaken to commence funding 12 months Herceptin treatment for these women outside the Pharmac structure. It will be funded from the Ministry of Health budget. It has been reported in the media that new Health Minister, the Hon. Tony Ryall, has this as one of his priorities within the first 100 days of the National Government being in power. I am confident that many New Zealanders will be watching this closely.

Similarly, other parts of the world will be watching. Thirty four other countries already fund the 12 month course. So within a few weeks we should be able to join those 34 other countries taking a practical and humane approach to women with this form of breast cancer. At last our country is listening to its own medicines regulatory authority, Medsafe. All going well, New Zealand women who have had no way of raising the large funds needed for 12 months treatment, will no longer be guinea pigs. Despite Medsafe, being the first world-wide to approve the 12 month regimen for early HER2 positive breast cancer, Medsafe declined to approve the 9 week course due to the lack of evidence for this shortened treatment. This is not well known. New Zealand women, therefore, have once again been experimented on, particularly those who have no means of raising the funds for a 12 week course. For more information see www.breastcancer.org.nz

Maori Women

Maori women have the highest rate of HER2 positive breast cancer in New Zealand, along with their Pacifican sisters. They also have the highest breast cancer mortality rate. As many are also among the more impoverished members of New Zealand society they are not in a position to raise the necessary funds for 12 months Herceptin treatment. Accordingly, it could be argued that these women have been discriminated against on the basis of race and poverty. Furthermore, I believe this has been another failure of successive governments of New Zealand to uphold their obligations under the Treaty of Waitangi to preserve the rights and privileges (including health and wellbeing) of these people. The mortality rates of Maori women do not indicate this has been a priority. I believe women are taonga (or treasures), and as such, should be treated with appropriate respect and care.

It is to be hoped that the new National Government’s stated intention to fund 12 months of Herceptin treatment for all newly diagnosed early HER2 positive women will go some way to remedying the disparity that has existed for so long.

What you can do if you get a diagnosis of HER2 positive breast cancer

· Get informed by going to Breast cancer Aotearoa Coalition's website www.breastcancer.org.nz
· Get quotes for 12 months treatment from oncologists around the country
· Ask about any trials that may be currently enrolling women with HER2 positive cancer, and then make an informed choice to participate or not
· Gather your support people around you
· Join a HER2 positive blog website e.g.www.31heroes.co.nz, and/or a breast cancer support group
· If you are fundraising, approach info@skipforlife.org.nz , other community organisations might help as well, or form a trust fund for donations, and appoint a media savvy coordinator
· Approach Roche Products (NZ) Ltd for an information pack
· Buy my book, Laugh your tits off!