1. Letter to New Zealanders October 18
2. Response to 60 Minutes Programme, TV3 October 16
   
3. Round the Table with Lyn Swinburne and Raelene Boyle

A Letter to New Zealanders from Libby Burgess, Chair of BCAC

Libby Burgess,
Chair of BCAC

Many of you have contacted us regarding the 60 Minutes programme that aired on TV3 Monday October 16 and we thank all of you for your offers of support and words of encouragement. We salute Christchurch breast cancer patient Mhairi Flett for courageously telling the story of her personal struggle to gain access to treatments that will give her the best chance of being there to support her children as they grow up.  It is wonderful to know that so many people throughout New Zealand share our growing concerns over the widening gap between what is needed by our women with breast cancer and what is provided within our public health system. These discrepancies were made very clear in the 60 Minutes programme and it is with a sense of frustration and outrage that I outline for you here some of the main issues that I see.

The failure to do the decent thing by fully funding Herceptin and investing in our women when their cancer is early and curable brings New Zealand into international disrepute.  Our system for approving funding for new drugs is geared to severely limit expenditure and denies New Zealanders access to many treatments that are standard in the rest of the developed world.  This system is failing all of us. 

We are denied access to other drugs that Australia uses – for example, growth factor treatments that boost the immune system, enabling women to recover quickly during chemotherapy so they can stay with their recommended treatment schedule to give the best chance of fighting the disease.  Growth factors are not provided to most New Zealand women.  We do not have access to a new effective anti-nausea drug that helps Australian women through the ravages of chemotherapy.  Australian oncologists are able to tailor treatment regimes to their patients’ individual needs with a range of chemotherapy drugs that are not funded in New Zealand.

The latest data show that Māori women have a 68% higher death rate from breast cancer than non-Maori.  Wahine Māori are 21% more likely to get breast cancer, often when they are younger and the disease is more aggressive.  While life-saving treatments such as Herceptin remain available only to those able to pay the high price out of their own pockets, access will be worse for Māori women.

Our BreastScreen Aotearoa programme offers free mammograms for women between 45 and 69 so cancers can be detected early.  But only 48% of our women are screened, well below the accepted international target of 70%.  Australia has an efficient programme that is actively promoted in a range of different languages, and 74% of targeted women are screened.  In New Zealand we have workforce problems with the supply of radiographers and radiologists. Many women don’t even know about the programme and those who do may have to wait several months to get an appointment.  We are screening around 20% fewer Māori and Pacifican women than other ethnicities.

Provision of breast reconstruction is standard across the developed world and yet many women awaiting this surgery in New Zealand have been deleted from waiting lists and sent back to their GPs.  Funds for elective surgery have been recently approved but we have yet to see if this will allow reconstructions to resume, especially as they have been given a low priority ranking.

The Medical Council of NZ is proposing to remove breast physicians as a specialty discipline.  These doctors are a key component of the multidisciplinary teams that are known worldwide to bring the best outcomes for breast cancer patients and it is unbelievable that this valuable group should be under threat.

Our public health system provides inadequate counseling and support to cancer patients and their families.   Our doctors have told us they are ashamed that they cannot provide the resources to support their desperate patients through this traumatic time.

To ensure consistency of high quality care around Aotearoa we need up to date clinical guidelines to inform our doctors of how best to treat their patients. 

There is so much that needs to be done to eliminate inequities and bring New Zealand’s standards of detection, treatment and care up to that of other developed countries.

We urge you to join us in our campaign to give hope to our women and their families. Follow this link to our What can I do to help? , a sheet offering some ideas for helping those women who need Herceptin.

Please help us to help our women
Libby Burgess, Chair BCAC

Hope for Life: A Response to 60 Minutes

The 60 Minutes programme that aired on TV3 Monday October 16 presented a shocking reality to many New Zealanders. The treatment our women receive for breast cancer is clearly inferior to that offered in Australia. We have long heard that women in Australia have a 28% better chance of surviving the disease than New Zealand women and this documentary showed us some of the reasons why.

On Monday October 16, our government pharmaceutical funding agency PHARMAC once again refused to fund Herceptin for women with early stage HER2 positive breast cancer, a decision made in the face of credible and internationally respected data that proves the drug offers significant survival benefits. New Zealand is now one of only six countries in the OECD who have not funded Herceptin, placing us behind 22 other countries including Australia and the UK, and on a level footing with the Czech and Slovak Republics, Poland, Turkey and South Korea.

The Minister of Health, Pete Hodgson, believes Herceptin is not a good candidate for funding because it is not cost effective – hard words to hear for those women and their families who are affected by HER2 positive breast cancer when they know Herceptin could offer them a 34% better chance of surviving the disease.

The programme compared the treatments two women received on both sides of the Tasman. Australian oncologist Dr Fran Boyle spelled it out very clearly. We have known for many years that a woman with breast cancer stands an almost 30% greater chance of surviving it if she lives in Australia. This gap will widen even further now that she will receive Herceptin, if she has HER2 positive cancer, as well as the other chemotherapy treatments that have been funded there for some time and she will benefit from care managed by a multi-disciplinary team. She may have to pay towards her treatment but it will be nowhere near the estimated $80,000 - $120,000 that a New Zealand woman would have to pay.  Dr Boyle described our breast cancer treatments as being equivalent to those available in Estonia.

New Zealand was the first country in the world to give women the vote.

Now we are one of the last to give our women hope for life.

Round the table with Lyn Swinburne and Raelene Boyle - October 4 2006

Lyn Swinburne and Raelene Boyle

Hope was the key message conveyed at a potluck dinner hosted by Breast Cancer Network NZ (BCN) in Auckland this week. Hope for women with breast cancer, inspired by the power of a unified voice to make a difference.

Breast Cancer Network Australia CEO Lyn Swinburne and her colleague Olympic gold medal winner Raelene Boyle were in Auckland as part of national breast cancer awareness month. Twenty women from BCN, BCSS and BCAC listened to an inspiring talk from Lyn who began by describing her own personal experience with breast cancer and how it motivated
her to found an organisation that now has 18,000 members across Australia, employs 20 people and presents a strong unified voice supporting and speaking out on behalf of all Australian women with breast cancer.

Lyn encountered shortcomings in the Australian health system after her diagnosis in 1993 and so began a campaign to improve options for all women. She held meetings across the country and was astounded by how many women attended and the disappointment and anger many voiced over their own breast cancer experiences. One of the main issues raised then was the lack of services for rural women and this continues to be a focus for BCNA today. Another was the poor communication from physicians during processes of diagnosis and treatment, making an emotional journey all the tougher.

BCNA was founded in 1998 and has gone from strength to strength, now listing an impressive track record of progress. BCNA’s latest achievement was to convene a round table discussion to ensure that funding was put in place as soon as possible for Herceptin. BCNA invited all stakeholders to a meeting – government officials, members from the pharmaceutical benefits advisory group, representatives from Roche (Herceptin manufacturer) and patient advocates. Gathering so many people from a diversity of groups was a feat in itself but the meeting made a positive contribution to the funding process. Herceptin was funded in Australia for women with early HER2 positive breast cancer as of October 1 2006.

BCAC Chair Libby Burgess would like to see a similar round table meeting take place here. ‘This could provide a way forward for New Zealand,’ she said. ‘The round table meeting and the work of BCNA in general shows how diverse groups working together can achieve so much for women with breast cancer.’       

Another recent initiative by BCNA is the establishment of three special project groups to work on major issues. One will explore issues for young women diagnosed with breast cancer; a second will focus on how best to assist women with advanced breast cancer and a third will explore how needs for women living in rural or remote areas can be better served.

Lyn had some final pieces of advice for groups such as BCAC. With so many issues demanding attention, prioritisation for achievement in the short term is good for morale and longevity is important for credibility and success.

‘Let them know that you are not going away,’ Lyn said.

BCAC Steering Group members sing a waiata for Lyn Swinburne