Calling the treatment a “paradigm change” and a “big game-changer”, two oncologists hailed the treatment for its survival rate among patients, which allows them to enjoy quality of life and spend many years being productive.
However, the prohibitive costs mean that immunotherapy – or treatment that harnesses a patient’s own immune system to enhance it to fight cancer – remains out of reach for most Malaysians as they are treated at public health facilities.
Dr Tho Lye Mun, clinical oncologist and vice-president of the Lung Cancer Network Malaysia, told an online forum last week that while the five-year survival rate for lung cancer patients in Malaysia stands at 11%, he is now seeing “leaps and bounds” in terms of the ability to treat lung cancer, with patients’ survival rates tripling or quadrupling following treatment such as immunotherapy.
Tho said a study showed that patients who received immunotherapy upfront achieved a 32% survival rate at five years.
“In this age of medical advancement and innovation, cancer is no longer a death sentence,” he said during the talk, titled “No Patient Left Behind: Improving Lung Cancer Care in Malaysia during Covid-19”, organised by the National Cancer Society Malaysia (NCSM).
“We are seeing an innovative approach to cancer treatment emerge, which takes into account the individual’s unique genetics, environment, and lifestyle to personalise the treatment approach.
“We are moving away from a one-size-fits-all model. By studying each patient carefully, we’re able to match the right treatment to each patient and move away from a trial-and-error approach.
“This saves time and costs, as well as reduces side effects. We’re relying a lot less on chemotherapy and shifting towards targeted therapy and immunotherapy.
“These patients are able to maintain a good quality of life and spend many productive years with their loved ones and family, continue to work to provide for the family, and to pay for the medical insurance that will pay for the treatment.”
According to the American Cancer Society, immunotherapy can be done either by stimulating the natural defences of one’s immune system so it works harder or smarter to find and attack cancer cells, or by making substances in a lab that are just like immune system components and using them to help restore or improve how one’s immune system works to find and attack cancer cells.
While he noted that access to innovative treatment such as immunotherapy can be limited, Tho called on the public and private sector to come together and do a “painstaking evaluation” of the cost-benefit of each treatment to make sure it prolongs life, but not at the expense of quality of life.
“We have to come together – health economists, doctors, patient advocates – to really put our heads together to figure out a solution to make these treatments accessible.”
Dr Murallitharan Munisamy pointed out that “very few” patients would be able to benefit from innovative treatments such as immunotherapy in Malaysia.
The managing director of NCSM, Murallitharan said only those with good insurance coverage and those being treated in private hospitals will have access to these treatments.
“Those who are on these treatments do really well and can go back to (their) normal lives – that’s a big game-changer in lung cancer,” he said.
“The five-year survival rate for lung cancer patients in Malaysia is only at 11%; it’s almost a death sentence for (those with) this disease.
“(But) now with these treatments, they are able to live for years, and more importantly, they are productive as individuals, which is equally as important.”
Noting that there is limited access to these treatments in government hospitals, largely due to the cost factor, Murallitharan called on the government to invest in immunotherapy to make it accessible for a larger segment of the population.
However, he stressed that it would require some comprehensive, out-of-the-box thinking.
“We are still stuck with the mindset that cheaper is always better, but we need to move beyond that.
“Instead of thinking of the total gain in terms of the number of people who can benefit from a treatment, we need to think of whether the return that we get from the treatment is more worth it.
“For example, for the same amount of RM30,000 spent, either 1,000 people can benefit from a RM30 treatment; or 100 people can benefit from a RM3,000 treatment that we can get more out of than the RM30 treatment.
“Our clinical colleagues know this – this is the heart of the problem – but unfortunately, we are not the decision-makers.”