New drug to aid SA fight against asbestos-linked cancer

In the late 1970s, South Africa was the world’s biggest asbestos-miner, but, more than three decades later, the country still suffered the legacy of these activities.Working with asbestos could lead to the development of a rare form of cancer, called mesothelioma, which targets the lining of the chest. Currently, South Africa has one of the highest mesothelioma incidence rates in the world – sixth times higher than the UK – but treatment options were mainly limited to surgical removal.

However, the South African Medicines Control Council (MCC) recently approved the registration of a new drug, called Almita (Pemetrexed), developed by pharmaceutical company Lilly.

Speaking at a media conference on treatment options for mesothelioma, head of the oncology department at Grootte Schuur Hospital, in Cape Town, Raymond Abratt said that official data showed that South Africa could expect to treat between 400 and 500 patients living with mesothelioma this year. But he said that the registry was not active and that this number could be even higher.

He explained that mesothelioma developed 20 or more years after first exposure to asbestos, a group of minerals that occur naturally as masses of strong, flexible fibres, while the peak incidence was between 35 years and 45 years after exposure. And, with South Africa being the biggest producer of blue asbestos in 1977, it was expected that the mesothelioma “epidemic” would continue for at least the lifetime of the large numbers of people exposed to blue asbestos.

The male:female ratio was 2,5:1, and Abratt attributed the high incidence rate among woman and children affected to asbestos brought home in the hair and clothes of miners. “The closure of the last mine is, therefore, not the end of the problem. There are 82 asbestos mine dumps in the Northern Cape.”

Meanwhile, Lilly’s treatment had been successfully used on a patient suffering from mesothelium.

Dr Daniel Osei-fofie, a medical doctor practising in Kimberley, told the meeting that he started trial treatments with Anvil (Pemetrexed) in February 2005. The new drug was used on a 54-year old man, who worked on a Northern Cape asbestos-mine, for six years. He reported that the patient had returned to work in February this year – after five treatments.

“Previously we couldn’t offer much to these patients,” he said.

Before the advances in treatment, people with mesothelioma lived on average six to eight months after diagnosis. However, with the new treatment, which was used in combination with another common chemotherapy agent in patients who had not received prior chemotherapy and who were not candidates for surgery, the average survival time had been increased to just over a year, and, after a year, about 50% of patients were still living.

DWIGHT SMITH (NEWSCASTER): Two members of parliament are calling on the federal government to stop promoting asbestos in developing countries. Most of the asbestos mined in Canada is exported, often to countries that either don’t follow or aren’t aware of the need for safety precautions. Asbestos is a carcinogen. Its tiny fibres can spend up to three decades incubating in the lungs before they cause cancer or other illnesses. As Alison Myers reports, the two MPs are coming at the issue from differing politics but similar personal histories.

ALISON MYERS (REPORTER): Pat Martin is well aware of what inhaling asbestos can do. The NDP Member of Parliament for Manitoba worked in asbestos mines in the Yukon when he was a teenager. Decades later, the tiny fibres have now scarred his lungs and forced him to get regular chest x-rays to check his condition. Martin wants Canada’s asbestos industry shut down. Perhaps a more realistic goal, he says, would be to end the Canadian government’s lobby to convince other countries that the product is safe.

PAT MARTIN (N.D.P. ETHICS COMMISSIONER): Other developed nations are banning asbestos. Canada is still spending a fortune trying to promote what they call safe uses of asbestos. The rest of the world doesn’t believe that there are safe uses.

ALISON MYERS (REPORTER): Exports of asbestos have dropped significantly over the past decade, by more than 200 million dollars. Asbestos is still mined in Quebec, and politicians from that province continue to pressure Ottawa to help the industry stay on its feet. The federal government has organised international conferences to promote asbestos, and paid for junkets for foreign journalists, something Agriculture Minister Chuck Strahl wants to see come to an end.

CHUCK STRAHL (AGRICULTURE MINISTER): I don’t think the government of Canada has a business in promoting the product. This is a case where, you know, we’ll let the industry flog their own product, and I’d just as soon we got out of it.

ALISON MYERS (REPORTER): The Conservative MP says he hopes to make that argument to his colleagues. Like Martin, Strahl worked with asbestos when he was young.

Since then, he’s developed mesothelioma, the incurable cancer that is undoubtably

(sic) caused by exposure to asbestos. Alison Myers, CBC News, Vancouver.

DWIGHT SMITH (NEWSCASTER): As part of “Dying for a Job”, CBC Radio’s ongoing series on workplace safety, Alison Myers will bring you a closer look at this story on The House, with her documentary “A Long Goodbye”. That’s right after the nine o’clock news.