'We Have Two Classes of Cancer Patient: Those with Health Insurance and Those without'; Britain Is at the Forefront of Cancer Research. Yet at the NHS Front Line, Patients Are Being Denied Access to Revolutionary New Drugs on Cost Grounds. Can the War against the Disease, Which Claims 156,000 Britons a Year, Ever Be Won?

By Billen, Andrew | The Evening Standard (London, England), April 25, 2001 | Go to article overview

'We Have Two Classes of Cancer Patient: Those with Health Insurance and Those without'; Britain Is at the Forefront of Cancer Research. Yet at the NHS Front Line, Patients Are Being Denied Access to Revolutionary New Drugs on Cost Grounds. Can the War against the Disease, Which Claims 156,000 Britons a Year, Ever Be Won?


Billen, Andrew, The Evening Standard (London, England)


Byline: ANDREW BILLEN

A DISPATCH from the war against cancer is a report from two utterly different front lines.

From one, the network of labs and universities in which chemists share and feed each other's enthusiasms, there shines a vista of limitless hope leading on to a glorious victory. The other battleground is a willing field.

Here, within demoralised hospital wards and pinched health budgets, 156,000 British citizens yearly die of cancer. A nation in the vanguard of cancer research endures the agony of some of the highest cancer death rates in the western world. Science may indeed produce a cure, or, more accurately, a number of cures accompanied by a series of dramatic new palliative treatments - but Britain may not be willing to pay its price. One London consultant tells me he is not allowed to purchase for his patients the very drug he helped develop. It is the best of times, and it is the worst of times.

At the Cancer Research Campaign's enviable headquarters by Regent's Park , I as Professor Herbie Newell, of Newcastle University's anticancer drug discovery unit, if we are winning the war. His answer is yes, but first he gives me a resume of the battles so far. The military metaphors are not so inappropriate.

The most common weapons used against cancer at the moment are cytotoxic drugs: chemotherapy. The original, first prescribed 50 years ago and still, in derivative form, used today, was nitrogen mustard.

"It is actually derived from mustard gas," Newell says. "Some German doctors in the First World War were examining troops who had been exposed to mustard gas and died. They loo ed at their lymphatic tissue and noticed it was destroyed and concluded that if it wor ed on normal lymphatic tissue, it could wor on tumours of lymphatic tissues, lymphomas."

Chemotherapy wor s, in the same way as radiotherapy does, by stopping cancer cells dividing. The problem is that it also stops healthy cells in the hair, the bone marrow and the lining of the gastrointestinal tract dividing.

Recipients suffer the same horrible side-effects that befell the dying in the trenches 80 years ago. In the Seventies scientists concentrated on improving these cytotoxic drugs and in the Eighties they strove to manufacture less toxic equivalents. In essence, however, the cytotoxic blunderbuss remained in place.

"The important thing is that we are now moving away from this. We now have three examples of drugs that do not wor by that mechanism that have useful anti-tumour activity," he says. These are Rituximab, used to treat lymphomas, Herceptin for some 25 per cent of breast cancers and the as yet unchristened ST1571, which helps chronic myeloid leukaemia and which trials at Newcastle have shown benefits all patients if given at sufficiently high levels. (I shall later meet this pharmaceutical advance party again and discover the progress they are making).

The great thing about them is that they are smart drugs, which target only the unhealthy cells.

"The analogy we like to draw is that when your car breaks down you open up the bonnet to see what's gone wrong. In the past 10 years we have opened up the bonnet on the cancer cell." Whereas previously?

"We were shooting in the dark ."

NEWELL left school at 16 under a cloud he is not particularly anxious to dwell on and went to work with the Marie Curie Memorial Foundation Research Laboratories, where he pursued his love of chemistry without worrying about exams - although he too those, in his own time, later. While he was working for a part-time degree, his mother died of ovarian cancer. But it is during the past 10 years at Newcastle, that he has seen the great leaps in understanding of the disease - in fact the 200 different diseases that group under the term "cancer" at the molecular genetic level. So how good is it going to get? "You have put your finger on it. It is not if. …

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'We Have Two Classes of Cancer Patient: Those with Health Insurance and Those without'; Britain Is at the Forefront of Cancer Research. Yet at the NHS Front Line, Patients Are Being Denied Access to Revolutionary New Drugs on Cost Grounds. Can the War against the Disease, Which Claims 156,000 Britons a Year, Ever Be Won?
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