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Esther Hart was seven months pregnant with her first child when she was rushed to hospital with acute stomach pain. Few diagnostic tests could be done without harming the baby, so she was treated for infections and sent home.

After her daughter Sophie was born in December 2003, it took months to convince her doctor there was something seriously wrong. Several trips to the emergency room later, she received a devastating diagnosis Stage four colon cancer. It had already spread to her left ovary, fallopian tube, uterus and liver. The mother of a 5-month-old baby was told she had about two years to live...

The original article can found in the Media Doctor archives.

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This story is about access to new cancer therapies as much as the therapies themselves, but lacks important detail on the main treatment in question, a cancer drug called bevacizumab or Avastin.

While it is excruciating for patients suffering from cancer to be denied what is thought to be an important treatment, it is possible that the Ontario government's decision not to fund the treatment is not due to bureaucratic intransigence, but rather a careful assessment of its therapeutic benefits and harms of that treatment. Unfortunately this story delivers no details on the evidence of benefit or harm, and provides no quantitative evidence of the treatment's effects. It is unusual to see the words 'wonder drug' and 'breakthrough' descriptors in a serious news story about a treatment without any illuminating information of how that quality is assessed.

Stories such as these need to get into the evidence of the treatment's benefit and harm and must go beyond the hope and despair of the suffering cancer patient. They must take some time to examine what the drug's tradeoffs might be in terms of real health outcomes. And there must be some, even minimal discussion about what the alternatives to bevacizumab treatment might be.

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