Tony Shepard received devastating news this spring: he had vocal cord cancer. However, he found solace in the fact that there was an 88 percent chance of a cure through chemotherapy and radiation. Unfortunately, this hope began to fade as his oncology practice in Central California started running out of the critical medication he needed. As a result, every treatment session became a game of chance, with the risk of losing his vocal cords and his voice.
Mr. Shepard, a 62-year-old gas station manager in Madera, California, tries to push these fears out of his mind. Facing the reality of the shortage is terrifying, but he has no choice.
The shortage of highly potent cancer drugs in the country has been ongoing for months, leaving patients and doctors with fewer options, delays in treatment, and grim prospects. Doctors are worried about the alternatives to these crucial chemotherapy drugs, as they are often less effective and more toxic. This is particularly concerning for patients with ovarian, testicular, breast, lung, and head and neck cancers.
Unfortunately, there is no indication that the shortage will ease anytime soon. A major drug producer temporarily shut down last year, depleting its stock, and the recent relaxation of restrictions on imported drugs from China hasn’t fully resolved the issue. Some companies project that the shortage will continue into the fall or even longer. Experts and medical organizations have yet to find a solution, leaving doctors to ration the drugs.
In the meantime, doctors are trying to stretch the available supply by extending care intervals and skimming doses. Others are resorting to surgery as a first step, hoping that supplies will become available later on. The American Society of Clinical Oncology now advises doctors to administer the drugs to patients with a chance at a cure, but deny them to patients with recurring or advanced diseases.
The main chemotherapy drugs in shortage, cisplatin and carboplatin, are essential in fighting tumors. However, the manufacturing process requires a stable supply of platinum, a sterile plant, and special controls to protect workers. Only a few companies produce these drugs, making them vulnerable to shortages.
The recent shortage of these drugs occurred after a leading manufacturer, Intas Pharmaceuticals, shut down production due to quality control issues. The effects of their closure have been significant, with academic treatment centers reporting shortages and altering treatments for patients. For example, Mr. Shepard’s odds of a cure without the drugs would drop from 90 percent to 45 percent.
Patients with ovarian cancer face particularly dire circumstances due to the central role the platinum drugs play in their treatment. Their chances of survival would decrease from 30 percent to single digits without these drugs.
The shortage of these drugs is critical and affects hundreds of thousands of Americans. Cancer care groups like the American Society of Clinical Oncology are doing their best to navigate the shortage, but the absence of these crucial chemotherapies will undoubtedly lead to worse outcomes for patients.
The Food and Drug Administration has taken some measures to address the shortage, such as overseeing the testing and release of batches of Intas’ drugs made before the shutdown. They have also allowed Qilu Pharmaceuticals from China to temporarily ship cisplatin to the United States. However, the impact of these imports is yet to be determined.
The scarcity of these drugs is a significant setback in the fight against cancer. While newer treatments like immunotherapy have shown promise, the platinum drugs remain a tried and true method for improving survival rates. Without them, patients are left with limited options and a bleaker future.
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