Herceptin guidelines welcomed in region

HEALTH trusts in East Anglia have welcomed final guidance on use of the breast cancer drug Herceptin - but say they are already funding the treatment.

The Government's health watchdog will issue the guidelines today, saying primary care trusts (PCTs) are now obliged to fund the use of the drug.

The move has been hailed as marking the end to the postcode lottery of the treatment, which saw former nurse Barbara Clark take her PCT to court after being told she would have to pay privately for the drug.

In Suffolk, women have already been prescribed Herceptin, which costs around £20,000 per patient, as the trusts have been funding it where there is a “clinical need”.

The final guidance confirms draft rules issued in June, which recommend Herceptin for early stage HER2-positive breast cancer, except where there are concerns about a woman's heart function.

It means there is now official guidance on the drug instead of PCTs choosing whether or not to fund it.

Nice chief executive Andrew Dillon said: “Our assessment of Herceptin shows that it is clinically and cost effective for women with HER2-positive early breast cancer.”

Jan Rowsell, spokeswoman for Suffolk East PCTs, said yesterday: “We have been funding Herceptin all along. We have followed Mid Anglia Cancer Network guidelines, which said wherever there is a clinical need for Herceptin to be used to the benefit of the patient then there is an expectation for the PCT to do so.”

She said this meant the change in the ruling would have little impact on the number of women given the drug but it would ensure there was greater clarity surrounding its use.

Dr David Kanka, consultant in public health at Suffolk West PCT, said: “We are already treating women with early stage HER2-positive breast cancer in accordance with guidelines agreed with local cancer specialists within the West Anglia Cancer Network.

“These guidelines will be reviewed in the next three months when we have seen the full Nice guidelines issued today.”

Waveney PCT's current policy also already meets NICE guidelines.

However, Paul Breame, head of medicines' management at Tendring Primary Care Trust, said: “The trust is unable to assess the effects on services or finance until we have full details of the court ruling and subsequent guidance from the Department of Health and National Institute for Clinical Excellence.

“Nobody in the trust currently has knowledge or details of that ruling but the trust will be following the guidance when issued by these bodies.”

Colchester PCT and Braintree, Witham and Halstead Care Trust, and Chelmsford PCT, already provide Herceptin to some patients.

Meanwhile, Dr Sarah Rawlings, from Breakthrough Breast Cancer - the charity EADT readers raised £100,000 for through our Ray of Hope appeal - said it was delighted at the issuing of the guidance.

“We have at last come to the end of a long journey to ensure access to this vital drug for women who could benefit and we hope that today's announcement reassures those PCTs who initially reserved their decision to prescribe the drug until final guidance was issued,” she said.

n Herceptin (Trastuzumab) is effective on the HER2-positive type of breast cancer, where tumours have too much of the HER2 protein.

n This affects around 20% to 25% of women newly-diagnosed with the disease.

n It is believed Herceptin has up to three different types of activity - it may block tumour cell growth, may target the cell for destruction by the immune system, and may work with chemotherapy.

n The drug can result in the development of some heart problems, while severe allergic reactions and lung problems have been observed. Rarely, these have been fatal.

n The Department of Health last year said Herceptin would lead to the lives of around 1,000 women a year to be saved.

A SUFFOLK mother-of-three has welcomed the ruling on Herceptin and spoken of her experiences of the drug.

Tammy Nunn, from Woodbridge, is currently on a course of the breast cancer treatment, which she has been given every three weeks since May.

It comes after she went through three lots of surgery - a lumpectomy, an operation to remove four lymph nodes and some more breast tissue, and a mastectomy - and then chemotherapy.

The 43-year-old said: “I think it was difficult when it wasn't under the guidelines as people had to fight for it.

“When I was told I would be given Herceptin I was quite surprised. I thought why should one person have the opportunity to have it and not another. I wondered what was so special about me.”

Tammy, who has a 15-year-old daughter and seven-year-old twins, was diagnosed with HER-2 positive breast cancer a year ago.

Last November, she had her head shaved to raise money for the EADT's Ray of Hope appeal ahead of starting chemotherapy.

She has now had the all-clear for the last year and has had four treatments of Herceptin so far.

She said: “It is injected in the same way as the chemotherapy and really I have had no side effects whatsoever, although I sometimes get a sniffly nose and I think it can result in slight flu symptoms.

“I had no problems with the chemotherapy either so I think I have been lucky.

“I assume it is doing me good. The only thing is that it can cause damage to your heart muscles so I have a scan every 12 weeks to check my heart is doing ok.”