Discovery Health to cover new liver cancer treatment

Source: Sirtex

The medical aid reviewed the clinical evidence base and approved reimbursement for SIR Spheres® Y-90 resin microspheres, a device that was developed by the Australian company Sirtex Medical Limited, which is now available in South Africa.

Better access to treatment

The announcement came within the same week that minister of health, Dr Aaron Motsoaledi, spoke about the “exploding prevalence of cancer around the world and in our country”. He also lambasted pharmaceutical companies over the prohibitive costs of cancer drugs in his budget speech, saying that action needs to be taken to increase access to treatment for cancer patients.

Discovery is the only medical aid to include the treatment in its benefits so far, but no doubt the other medical aids will follow suit.

Overcome hurdle

Interventional radiologist, Dr Gareth Bydawell, has performed multiple radioembolisation procedures at Entabeni Hospital in Durban since 2012, but patient numbers have been limited due to a high rate of reimbursement rejection by medical aids.

“It is such a relief that we’ve overcome that hurdle because this treatment can improve the lives of so many people. The procedure targets primary and metastatic liver cancer and can offer significant symptom relief and survival benefit. Being able to offer a patient more time is priceless.”

Selective internal radiation therapy

SIR Spheres are a form of selective internal radiation therapy, or SIRT, a non-surgical procedure in which an interventional radiologist uses a flexible tube or catheter directed through an incision in the patient’s groin to deliver millions of the radioactive microspheres directly into the hepatic artery that feeds the liver tumours.

The microspheres containing radioactive yttrium-90, are small enough to be delivered straight into the tumours, but big enough that they ultimately become trapped in the small vessels that keep the tumours alive, where they then deliver high doses of beta radiation to the cancer cells.

Because this is delivered internally and directly to the trouble spots, patients can receive radiation doses that are much higher than what is possible with conventional external beam radiation. Patients suffer fewer and milder side effects, and in some cases the treatment may cause tumours to shrink sufficiently that previously inoperable cancers may become eligible for potentially curative surgery.

Retards tumour growth

Local oncologists also welcome the news. “This technology allows us to administer high doses of radiation directly to liver tumours without affecting other organs,” says Dr Waldemar Szpak, radiation oncologist at Rainbow Oncology Centre in Durban.

“The recent trial showed that this treatment keeps liver tumours in check for almost eight months longer than regular chemotherapy alone when it was used early in the treatment of patients with metastatic colorectal cancer that had spread only or mainly to the liver,” he says.

Cancer statistics

Primary liver cancer is the tenth most common form of cancer in South Africa, with 2,000 new cases diagnosed annually, according to Globocan data for 2012, the latest year reported. Colorectal cancer is number five, with 4,700 new cases every year, and if it spreads, or metastasizes, it most often spreads to the liver. Liver tumours will eventually cause the death of the majority of patients.