Pancreatic cancer: New Zealand’s first treatment that extends patients’ lives

Miriam Walter was told that she would not survive to see this Christmas when she was diagnosed with incurable pancreatic cancer a year ago.

But thanks to a radically new treatment, which she was the first to benefit from in the country, the 72-year-old is feeling “absolutely fine” and is looking forward to celebrating the summer with her family.

The OncoSil device, developed by an Australian medical technology company, is extending and even saving the lives of patients and has been used successfully at Waikato Hospital three times this year to treat people with locally advanced pancreatic cancer that does not can be operated.

Only 8 percent of pancreatic cancer patients in New Zealand survive more than five years, and only 10 percent are diagnosed early enough for surgery, the only curative treatment.

The disease kills more than 500 kiwis a year and is projected to be the fourth leading cause of death in the country by 2025.

The device, which recently received regulatory approval in New Zealand, makes it possible to inject radiation-containing microparticles directly into the tumor via ultrasound-guided endoscopy, a form of brachytherapy.

The full dose of radiation is released from the particles over 80 days and causes much less damage to surrounding organs than standard radiation therapy, in which a beam of radiation is directed at the cancer from outside the body.

Walter said he went to the doctor when the whites of his eyes turned yellow and he was diagnosed with inoperable pancreatic cancer in early November.

“They told me that without any treatment, I would probably have about three months to live,” he said.

Walter started chemotherapy right away and was on vacation with his family when Waikato Hospital’s clinical director of gastroenterology, Dr. Frank Weilert, called to tell her about OncoSil in January. At the end of that month, he began receiving treatment.

“It was just a better option. It was either that or do nothing and see what the chemotherapy does,” he said.

“He was very proud of the fact that he had mustered the courage to be number one so that others could benefit from it.”

Walter said he suffered no side effects and that scans showed the tumor had shrunk by 73 percent.

Since then, the tumor had remained stable while he continued his chemotherapy treatment.

“Chemotherapy is what keeps me the way I am. I’m absolutely fine. I’m driving, shopping, going to the beach, socializing with my friends,” he said.

“Not everything is pessimism. Life goes on and it is.”

Weilert said that despite the success, surgery was unlikely to be an option for Walter due to his age and other health concerns.

However, two to three months after performing the procedure on two other patients, at least one was being considered for surgery, although it was too early to make a decision, he said.

“It’s obviously very exciting to do something new. It’s more exciting that we’ve already seen good results,” Weilert said.

The history of pancreatic cancer was so “dire” that patients generally had advanced disease and few were offered surgery.

“For pancreatic cancer, this is a really promising technology that will give hope to these patients who have very little hope when they receive this diagnosis. They receive this diagnosis and plan their last Christmas frequently. It is very, very devastating.”

Trials had shown that the treatment shrunk the tumor to an operable size in a quarter of the patients, and 20 percent of the patients had surgery to completely remove the entire tumor, he said.

Weilert, the only doctor in New Zealand using the device, said the new treatment offers the possibility of a cure or at least a life extension for patients who, on average, were given six months to live after diagnosis.

“This gives our patients more hope than we’ve had in recent times with such devastating cancer,” he said.

“The great thing about OncoSil is that it is beta radiation, so it doesn’t emit very far from where the device is shipped, which prevents collateral damage.”

He said the patients treated so far in New Zealand, including Walter, had had few side effects and those who had were compatible with the chemotherapy they were receiving.

Weilert said the device also had the potential to change the current standard of treatment by being given earlier in the treatment process because there was evidence to suggest that it improved the effectiveness of chemotherapy.

Gut Cancer Foundation CEO Liam Willis said that while OncoSil sounded like an interesting concept and appeared to be a novel approach to radiation therapy delivery, it was still an experimental idea that had not been fully reported on.

He said it appeared to be safe and to be promising enough to take it into phase three clinical trials that would determine whether it was better than current chemotherapy and external-beam radiation therapy in people with locally advanced pancreatic cancer.

“The Gut Cancer Foundation does not see this approach as the new standard of care until those studies have been done and the risks and benefits are better understood.”

Patients treated so far had received funding from the company for compassionate reasons, but from now on patients would have to shell out about $ 30,000 for the treatment until the company could get it.