Why Would Cancer Patients Skip Life Saving Pills?

June 26, 2013
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gleevecA medical marvel broke new ground in cancer in 2001 – now there are concerns because some patients aren’t taking advantage of it.

gleevecA medical marvel broke new ground in cancer in 2001 – now there are concerns because some patients aren’t taking advantage of it.

Dr. Brian Druker from Oregon Health and Science University’s Knight Cancer Institute led the development of the first targeted therapy that took on cancer at a genetic level in 2001.The introduction of Imatinib, or Gleevec, for patients with chronic myelogenous leukemia (CML), changed the diagnosis from a terminal illness to a chronic condition for most patients. It was groundbreaking cancer therapy – instead of traditional chemotherapy regimens patients would take a pill to extend and save their lives. Since then many other targeted oral therapies have been developed for other cancers, and more are on the way.

They aren’t perfect. There are side effects, as with any powerful medicine. They are expensive. And there are often special instructions as to whether or how soon you can eat when you take the pill and even what you can eat or drink. Add to that that these drugs give many patients the ability to resume their lives while living with cancer – they move forward to really live, work, and have a future. So some people just forget to take their pills. They are feeling good and busy living.

Gleevec was in the vanguard of oral medicine for cancer, pills one might take for life. New oral therapies are in the pipeline that show promise for chronic lymphocytic leukemia, lymphoma and myeloproliferative conditions. There are “small molecules” for solid cancers too. So with these new pills, sometimes ones the FDA even labels “breakthroughs”, why would some patients not take them as prescribed?

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Giora-at-EHA-2013-for-blogWe got some answers, in a study developed and run by patients themselves, at the recent meeting of the European Hematology Association in Stockholm. The CML Advocates Network, which is made up of patient organizations from 60 countries, conducted a survey of about 2,600 CML patients to query them about their “adherence” to their medicine. My interview with study leader Giora Sharf, an Israeli with CML and on one of the medicines, gives you the study highlights. But basically, some people forget, others are not clear how taking the medicine as prescribed is essential every day, and some hate being reminded with each pill that they have cancer. It’s complicated and, as the study notes, it’s vitally important we all figure out how to promote adherence as the number of people taking oral cancer medicines is about to explode. What tools are needed? What new communication strategies need to be in place so these therapies are used effectively?

The CML Advocates Network, a Patient Power partner, is commended for leading the way in investigating this and the EHA is commended for featuring patient research on their world stage. As for me, I’m on a twice a day pill for myelofibrosis. I take it as soon as I get up, and an alarm triggers my favorite song to play on my phone to remind me at 10 pm every night to take dose number two. I don’t view it as a reminder about cancer. I view it as essential for another day of feeling good. That’s what works for me, and I hope others will also find the right ways to make this work for them.

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As always, I welcome your comments.

Wishing you the best of health!

Andrew