Cuz

“In 2000 figures indicated that liver cancer was the fifth most common malignancy in men and the eighth in women worldwide. An estimated 150 New Zealanders die annually from liver cancer and this number is expected to double over the next 20 years because of the growing health burden from hepatitis C and hepatitis B, which are the most common causes of liver cancer. An estimated 90,000 New Zealanders have hepatitis B and another 50,000 have hepatitis C.”

My darling cousin Evan is one of those New Zealanders currently suffering from liver cancer. His diagnosis was recent but the disease has taken little more than two months to completely ravage his remaining health. As I write this he’s in Brisbane Hospital with little more than a fortnight as his future prospect. My heart is heavy. He’s a baby really, at 52 years old.

He has the most marvellous chuckle my cousin, the kind that lights up the heart, it’s that infectious. It’s the kind of chuckle too that might suggest mischief, but he rarely did, create it or get up to much within boyish reason. He has a way of calling me ‘cuz’ that’s endearing and lovely. It has the same musicality about it that his laughter has, lasting in my memory and warm. He’s my first cousin, the son of my mother’s sister.

“Of the 770 cases of liver cancer seen in my Auckland clinic over the last eight years, 24% were Maori and 23% were Pacific Islanders. In most patients, the cancer was diagnosed late when no therapeutic options were available. Less than 20% of newly diagnosed cases of liver cancer were suitable for curative surgery and the average survival was less than three months,” he said.

Last month, the cancer therapy Nexavar® (sorafenib) initially registered in New Zealand last year for treating advanced kidney cancer was approved by Medsafe for treating patients with liver cancer (hepatocellular carcinoma).

Developed by Bayer Schering Pharma and Onyx Pharmaceuticals, Nexavar is a new class of treatment that belongs to a group known as multikinase inhibitors or targeted therapies. It works by slowing tumour growth and reducing the blood supply of the tumour, helping to keep cancer cells from spreading and growing.

Associate Professor Edward Gane, a liver cancer specialist, said the registration of Nexavar for treating liver cancer was a step forward. It is already approved for liver cancer in Europe and the USA as well as Australia following successful global trial results which Professor Gane was involved in.

An international phase 3 double blind, placebo controlled trial (known as SHARP) evaluated 602 liver cancer patients who had no prior systemic therapy. Nineteen patients took part from New Zealand. The trial demonstrated that Nexavar tablets significantly improved overall survival by 44 percent in patients with inoperable liver cancer versus patients who received placebo.

New Zealand clinics are now participating in another study looking at the benefit of Nexavar when used earlier to prevent recurrence after surgery for liver cancer. Nexavar is also being evaluated by Bayer, international study groups, government agencies and individual investigators as a single agent or combination treatment in a wide range of other cancers.

Nexavar is currently unfunded in New Zealand, but an application for funding will be made to Pharmac.” Pharmac, the Pharmaceutical Management Agency of New Zealand is a part of the New Zealand medicines system and work to improve people’s access to medicine, and to promote their optimal use. Too late perhaps for my darling cousin but I highlight the medical advances here in the hope that they continue. Kia kaha Evan.