24 September 2022
An impossible choice between life and death. To pay or not to pay for cancer treatment?
Paul Cherry has lived in both Mount Maunganui and in Asia as an operations manager in the Kiwifruit industry, spending 12 years in Japan and a further five years in China training operations staff in fruit quality, storage, and shipping.
It was in Japan that a prerequisite of the job was a yearly medical.
“It was quite the health MOT,” says Paul. “They scheduled us in for a full day of health testing, every year. It would be non-negotiable and believe me, no rock was left unturned. This changed when I went to China as the health testing was so laborious, I chose to do it when I was home for annual leave.
“After getting used to the yearly health checks through my employer I continued to be relatively vigilant at going to the doctor for check-ups after retiring back to New Zealand. But at no point do I recall being offered a PSA blood test over those years. It wasn’t until I retired in 2012, I complained to my GP about getting up too much at night that he carried out a digital exam and discovered something was amiss. The resulting PSA testing by his urologist then showed some elevation which increased significantly over 2013 and ended with me undergoing a radical proctectomy and follow up radiation treatment in August of that year. The diagnosis was that the cancer was incurable.” Whilst we now had our own Health Insurance by this time, replacing the company package, there were a number of exemptions, one of which was prostate cancer.
Toward the end of 2015 Paul started to experience symptoms again and his PSA levels began to elevate. Various treatment options were discussed whilst monitoring through his urologist. This continued until mid-2019 when his level rapidly rose to about 175 over a short period (normal results are <4 ng/ml) and subsequent scans detected significant metastases and a referral to an oncologist.
“At this point I was put on Zoladex, which bought my PSA back to undetectable levels. Subsequent conversations with my oncologist suggested that while the Zoladex was working for now, it wasn’t an exact science for how long it would work for. I was given three drug options to consider adding into the mix, all of which were non-funded. Sitting down with Robyn, my wife, we looked at the survival, quality of life gains and the ability of the drug to halt the progression of the metastases and made the call to start enzalutamide at a cost of $5,500 every 28 days,” says Paul. “It’s a heavy financial burden and I’m very grateful for Robyn’s unwavering support throughout.”
To date, the Cherry’s have spent $212,000 on enzalutamide.
“The biggest stress I have currently, is how can I keep funding it? It’s keeping my cancer at bay but when I run out of money, the outlook is not good,” says Paul. “I understand the challenges Pharmac face with funding and making sure every New Zealander has access to the medications they need. Increasing medicines funding to Pharmac needs to be a much higher priority for Government. But if they can’t deliver more funding then I believe they could help New Zealand men, like myself, with the costs we are paying. For example, they could make non-funded cancer medicines exempt from GST, part-fund treatments or offer other tax breaks to help ease the financial burden.”
“Taking the GST off enzalutamide would give me another two months of treatment, part-funding of even $1,000 would give me almost 2 ½ months extra,” adds Paul. “It would make all the difference.”
The GST off enzalutamide would give me another two months of treatment, part-funding of even $1,000 would give me almost 2 ½ months extra,” adds Paul. “It would make all the difference.”
According to Peter Dickens, CEO of the Prostate Cancer Foundation, with limited funded treatment options available to New Zealand men suffering from prostate cancer, many are faced with the stark reality of finding money for treatment or face a significantly reduced survival rate.
“Without treatment the prognosis is likely to be poor, treatments that are readily available in Australia and other OECD countries, are simply not being subsidised here. The treatment recommended by Paul’s oncologist, enzalutamide, is not even registered. This meant Paul and his urologist needed to obtain approval from Medsafe to allow him access to the lifesaving medication – and at an unfunded cost to Paul of $5,500 per month,” says Peter.
“Enzalutamide has been proven to treat prostate disease earlier and provide significant survival and quality of life gains, it significantly extends metastasis-free survival and reduces the risk of developing distant metastases or death by 72%. The fact that New Zealand men are being denied access to this life saving drug is a travesty. Paul is in the fortunate position of being able to fund his treatment for now, but many prostate cancer patients are not as fortunate and are dying earlier as a result.”
PCFNZ is committed to advocating for New Zealand men living with prostate cancer, to ensure they get better health outcomes. By supporting Blue September, PCFNZ’s primary fundraising event, you will be supporting the 1 in 8 Kiwi men affected by prostate cancer. ‘Do Something Blue’ to help a mate through during the month of September and help give a voice to New Zealand men living with prostate cancer – www.blueseptember.org.nz.
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PCFNZ plays a vital role in raising awareness of prostate cancer in Aotearoa New Zealand. It has 45 support networks across New Zealand providing valuable support and resources to men with prostate cancer and their families. Every year PCFNZ commits significant funds to New Zealand-based research on finding better diagnosis and treatment options for prostate cancer. The Foundation is 100% funded by donors and receives no direct government funding.
PCFNZ is supporting Kristine Hayward’s petition calling for an early prostate detection strategy, to sign the petition click here. Kristine’s husband died of prostate cancer, and she believes, “testing is unfunded, disorganised, and inequitable. Inequities in testing allow too many men to die, with Māori and rural men disproportionately affected. We need a structured, population-based testing approach for early detection of prostate cancer in men over 50 (40 with a family history), just as we have with breast cancer.”
For further comment or to arrange an interview contact: Sandy Trigg 021 231 9406 firstname.lastname@example.org