Nova Scotia agrees to cover man's $900K cancer treatment in Boston
CAR-T therapy is in clinical trials elsewhere in Canada, but is not available in Halifax
Stephen Saunders has just cleared a $900,000 hurdle in his fight to stay alive.
He and his family learned Wednesday that the Nova Scotia government has agreed to pay for CAR-T cell therapy, a treatment that would genetically modify his T-cells so they target and kill his cancer cells.
"There's nothing I can do to say thank you [to] everyone down from the doctors to the government to my daughters," Saunders said. "Even the minister … I want to thank him [because] he was engaged and that's what we need."
The Onslow Mountain man has undergone three lines of chemotherapy and a clinical trial in the past 3½ years. When he relapsed at the end of November, his doctors told him that his last option was CAR-T therapy, a treatment that was only approved by Health Canada in September and just beginning clinical trials in other parts of the country.
At 58 and with four adult children, Saunders said he wanted the treatment.
Funded by other provinces
His medical team recommended he be sent to the Dana-Farber Cancer Centre in Boston, where other Canadians, including 26 adult patients from Ontario, have been treated.
Initially, Saunders was told the treatment for his non-Hodgkin lymphoma would not be funded.
On Dec. 13, the family received a call from Saunders's doctor saying the province had opted not to provide funding. They were told they would receive an official letter providing information for the reasoning at a later date.
The next day, the family received another call saying, in fact, no decision had actually been made. It wasn't yet clear whether the treatment would be funded or not.
"Apparently some wires have gotten crossed somewhere between his medical team and the government," his family posted on Facebook.
"We don't know who informed his doctor we had been denied but apparently this was an error."
The following week, CBC Nova Scotia published a story about Saunders. The family was subsequently told the Health Department would cover the cost of a consultation in Boston, his daughter, Hailey MacDonald said.
She and her father travelled to Boston on Dec. 28 and learned Saunders was "an ideal candidate," MacDonald said.
"Until you hear that from a physician, well, you're always not 100 per cent sure of what is going to be the outcome of that visit," she said. "So when the doctor said that, we felt like we'd jumped another hurdle."
It's also likely what convinced the Health Department to fund the procedure.
No one from that department would speak about Saunders's case, citing privacy issues. But the medical director of the cancer care program said these decisions usually come down to balancing costs with the amount of evidence proving the likelihood of success.
MacDonald said her family is thankful, both to the province but especially to those who wrote to the Health Department on her father's behalf.
It just feels like we've finally been able to help him.- Hailey MacDonald , daughter
"With his life literally on the line, we knew that this was something that had to happen," she said. "It feels really rewarding to have pushed so hard to have been able to come through for dad.
"It just feels like we've finally been able to help him."
Saunders said he knows the treatment itself will be difficult and that it's not a guaranteed cure.
A 2018 clinical trial involving adults with the same type of cancer as Saunders — whose disease also didn't respond to multiple rounds of chemotherapy — showed a 40 per cent complete remission rate.
Treatment next week
Saunders will return to Boston next week to have his T-cells extracted and then modified and multiplied. MacDonald said he'll return at the beginning of February and the new ones will be put into his bloodstream.
At that stage, patients can have severe reactions as their bodies can fight the new T-cells as if they're a foreign invader. Saunders said he expects to spend at least another month in hospital.
"It takes a big team," he said. "And very I'm lucky."