Cancer - the cost of a life: Patient says system sends have-nots home to die

In a five-part series, the Herald investigates controversies in cancer testing and treatment and reports on the moving stories of people afflicted with cancer. In the fourth part of the series, Herald health reporter Martin Johnston turns his attention to melanoma.

Melanoma patient Leisa Renwick is appalled that New Zealand has developed separate health systems for those who can afford treatments and those who can't.

The 47-year-old Tauranga high school teacher and married mother of three adult children has cashed in her superannuation to help pay for a drug the Government does not fund.

She estimates two years of Keytruda treatment could cost around $300,000, even including a discount from the supplier.

In 2010, Mrs Renwick had a mole removed from her lower back. It was later diagnosed as melanoma and a wider cut was made to make sure of removing any tumour cells. She thought she was fine.

But in May this year she began feeling queasy at school on a Wednesday. On the Thursday a GP found nothing serious. By the Friday her abdomen was swelling. Saturday "I started to look pregnant" and on the Sunday she went to Tauranga Hospital.

"A few days later they said, 'You've got stage 4 melanoma, you are going to die'."

The hospital sent her home with painkillers but also gave her a card for a private cancer centre in Auckland. The cancer centre arranged a test for the gene mutation that can make melanoma susceptible to the drug dabrafenib.

The result was positive and a Tauranga Hospital oncologist got her on to the drug.

The tumours, mainly in her abdomen, had started spreading to her brain, but the drug's effects were dramatic.

"A CT scan at the start of August showed a complete response - all the cancer had gone," says Mrs Renwick.

"In America they call it the Lazarus effect. You are about to die and suddenly the dabrafenib pulls you out of the grave."

When melanoma becomes resistant to dabrafenib, Keytruda is the brightest hope for patients who can pay. Neither drug is funded by Pharmac, but Mrs Renwick managed to get dabrafenib at no charge on a compassionate programme run by its supplier.

She is shocked New Zealand has been divided by costly drugs.

"It seems to me in this country the rich people are able to get treatment and the poor people aren't. They are sent home with lots of pain-killing drugs. They are sent home to die. I think that's really wrong."

"It does come down to how much money you are able [to pay]. Getting sick makes you really value life somehow. I think everyone would be willing to pay to live, but are they able to?"

Although Keytruda doesn't work in everyone, it is a drug the Renwicks could not ignore.

"I'm not ready to go. I've got so much to live for," Mrs Renwick says.

"I have known my husband Wayne since I was 19 and he is still the best man I have ever met. I want to grow old with him. I want to see our children grow to meet their potential and, if it is their wish, to have families of their own."

The Series

Monday: Breast Cancer
Tuesday: Bowel Cancer
Yesterday: Lung Cancer
Today: Melanoma
Friday: Prostate Cancer
Friday: Prostate Cancer