Is cancer treatment better in the US?

November 11, 2009 1:09 PM

Looking to help a Canberra, Australia acquaintance recently diagnosed with estrogen-receptor-negative breast cancer, and wondering whether they would receive better treatment from the US. No politics, please.

Someone I know was just diagnosed with breast cancer. It has spread to a lymph node under her armpit. The biopsy report was on Wednesday, and she's having a CAT scan later this week, so I don't know how far it's spread, but she's never had a mammogram, so there's a good chance it's pretty bad.

She has a lot of money. What I'm wondering is, would seeking treatment at a top US cancer hospital appreciably increase her odds of survival? I'm from Australia myself, but I live in the US, and work in medical genetics (the statistics side) so I have an inkling of just how much bigger the research over here is. I guess it comes down to how quickly new treatments are disseminated to the rest of the world.

I'm imagining shipping a biopsy sample to MD Anderson or somewhere like that, to get someone there to study the histology and maybe do some genotyping, and recommend a chemotherapy which could then be applied back in Canberra. Is that crazy or useless?

Please, no politics. I'm currently totally disinterested in comparing the overall value of the US and Australian healthcare systems, though I acknowledge the general contemporary importance of healthcare politics in the US.

posted by Estragon to health & fitness (6 comments total)

I think your friend and her physicians in Canberra could certainly, with enough money, arrange for consultation in-person at MD Anderson and work something out. Enough money makes a lot of very good care possible whenever you are.
posted by fairytale of los angeles at 1:40 PM on November 11

(Even in the US, it seems like relocation and money are often necessary to pursue the best treatments, as famous CS professor Randy Pausch's blog detailed before his death. He went to Anderson in person for nearly two months for his pancreatic cancer, received treatment at Hillman in Pittsburgh, PA in concert with consults at Anderson, entered the Virginia Mason protocol at Virginia Mason, and received the cancer vaccine trial at Johns Hopkins.

Wherever you go, it appears some chasing about and personal visits will be needed to get optimal results. Good luck.)
posted by fairytale of los angeles at 1:47 PM on November 11

It might be better at one of the big oncology centres in Sydney or Melbourne if the American thing doesn't work out. I'd get her on some web forums with her kind of cancer people and see what they're doing in the States. (And of course, you could ring the Cancer Council.)

It may not be that different to what is being proposed here. And here she has all her support and friends... her own bed, toilet and probably her own car... Or if she decided to go to Sydney, she'd be able to travel the relatively short distance (in Australian terms) back and forth as necessary.

As you probably know, cancer treatments... like chemo and radiation, can take a long time over many cycles.

The very best of luck to your friend and your self.
posted by taff at 2:50 PM on November 11

I am only guessing but I imagine up to date protocols are quite similar in Australia and US. However, I would strongly encourage her to discuss, with her oncologist, a consultation (in person or electronically) with one of the US cancer centers ( Andersen/Sloan/etc.). Your point about targeting treatment to her specific genotype is cutting edge. I am positive that if a clinical trial is indicated there are many more available in the US than Aus. This would obviously necessitate temporary relocation and return visits. I hope a trial is not indicated and it is probably much to early in the treatment process. Best of luck to your friend.
PS--A very quick review of breast cancer survival rates in the US and Aus. suggests they are quite comparable. The US has a slightly better survival rate but I am not sure if it holds up when adjusting for lower rates among indigenous, rural and poorer populations.
posted by rmhsinc at 6:47 PM on November 11

I'm sorry your friend is facing breast cancer. I have nothing to add to your question, but wanted to mention knowing someone with estrogen negative receptor, who was her2/neu positive. Herceptin was added to the treatment.

You sound like an awesome friend.
posted by Feisty at 1:26 AM on November 12

Thanks for the answers, everyone. I don't see a clear way forward, yet, but I appreciate all your advice and support.
posted by Estragon at 3:59 AM on November 13