Blood cancers

Treatment overseas raises difficult questions back home

Haematologists are being warned they could face a “backlash” after the story of a South Australian doctor who travelled across the world for a bone marrow transplant he could not get at home was broadcast on national radio.

Adelaide rheumatologist Dr Mark Awerbuch told the ABC’s Health Report he’d felt abandoned by his medical colleagues after he was unable to access a transplant in his home city of Adelaide, which his haematologist told him was his only hope to cure acute T-cell lymphoblastic leukaemia after chemotherapy failed.

But, doctors considered him an unsuitable candidate due to his age (67), a rare gene mutation and a ‘misdiagnosed’ invasive fungal disease and “didn’t want to waste their resources on somebody who they didn’t think would pull through” Dr Awerbuch told the ABC.

After approaching two interstate hospitals without success, he went to Israel, spending almost $400,000 on a transplant.

While his SA-based haematologist put his chances of survival at 5% Dr Awerbuch is now three years’ cancer-free, but suffers health complications including bronchiectasis, he told the ABC.

The broadcast may ultimately inspire some patients to become more proactive or demanding about their rights to access the treatment, which could put added pressure on haematology units, said Professor Szer, a haematologist at Royal Melbourne Hospital and president of the Worldwide Network for Blood and Marrow Transplantation.

“So it may create…a bit more work for our transplant physicians might need to answer some questions that otherwise might never have been asked,” he told the limbic.

“But I can tell you from our unit’s point of view there will be no change in operating procedure except in an evolutionary sense.”

Professor Szer said medical teams undertake a complex exercise each time they consider whether a patient is suitable for a transplant.

“Does that mean that occasionally patients who might have done OK are not accepted into a transplant program? I guess that does happen from time to time.

On the other hand, we see enough patients who get into a variety of transplant programs that have shocking outcomes….There is almost no worse way to die than after a failed bone marrow transplant.”

He said he was not aware of the reasons Dr Awerbuch was denied a transplant, that decision rests with the transplant team at the Royal Adelaide Hospital.

But he rejected the idea that public funding would have played a role.

“I can tell you with my hand on my heart after doing this for 33 years in Australia the question of public funding has never come up when considering a patient for transplant unless that patient is an overseas patient and non-Medicare covered.”

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