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A diagnosis of cancer is scary enough. Now imagine finding out that a key drug you need to treat the cancer isn’t available. That’s happening in San Diego and around the nation because of critical shortages of chemotherapy drugs.
It’s a situation that isn’t likely to be resolved anytime soon.
Day after day at the San Diego Cancer Center in Vista, nurse practitioner Scott Shuford takes care of people who are fighting to stay alive. Shuford thinks the last thing they need is someone with a grave attitude.
So when he visits with his patients, he tries to keep things light.
"So tell me," Shuford said to a woman in treatment, "what’s it like walking around having a plastic tube hanging out your side?
"It’s a mild inconvenience," she replied.
"Ha! It’s mild inconvenience..." Shuford sputtered.
Shuford said he gives his patients a little bit of chemotherapy, and a lot of love. But lately, that little bit of chemotherapy has been hard to come by. That’s because there’s a growing shortage of chemotherapy drugs.
"This problem has just gotten more and more pronounced," Shuford said, "because we’re spending more and more time looking for drugs all over the country, and using different outside vendors, and hoping we’re gonna have enough to keep people on cycle."
Chemotherapy is usually given in cycles. For the treatment to be effective, certain drugs are given at certain times.
"When you can't get a particular drug," Shuford said, "you have to consider going with a completely different regimen, or jury-rigging another regimen, which is not in the patient’s best interest."
Ken Patterson lives in Escondido. He’s one of Shuford’s patients.
Patterson has bladder cancer.
He was being treated with the drug Taxol, and was tolerating it quite well. But one day, he got a call telling him the drug was no longer available. Patterson couldn’t believe it.
"What do you mean I can’t have the drug?" he recalls saying. "It’s workin’ for me. What are we supposed to do now?"
That’s the question a lot of health providers are asking, too.
Daniels says they’ve been struggling to find enough Taxol, as well as other drugs to treat colorectal and breast cancer.
It turns out there are almost a dozen frequently-used cancer drugs that have been hard to get for more than a year.
"There’s been more consolidation in the pharmaceutical industry, so where there might have been three to five manufacturers of a given product, now there’s maybe one, two, three," Daniels pointed out.
And there’s another, more insidious reason: most of the drugs in short supply are generics. Daniels said there’s not much profit in selling generics, so there is little incentive for drug companies to make them.
So that puts both patients and providers in a tough spot.
Nurse practitioner Scott Shuford said it’s just not right.
"Patients with cancer are facing uncertainty in their futures; is this gonna work, is this gonna be effective. They shouldn’t be worried about whether or not we’re gonna have the medication to treat them," Shuford said.
The Obama Administration is looking at the possibility creating a stockpile of chemotherapy drugs. How they can do this when there’s a shortage is an unanswered question.
Congress is considering a bill that would require drug manufacturers to give advance warnings of disruptions in production.
For now, however, cancer patients and providers are left wondering: what will they run out of next?
