By Mark Ebrey, RD2, Taumarunui

New Zealand men are being denied access to a low impact prostate cancer treatment based on an Australian report that actually recommends making LDR brachytherapy a publicly-funded option for some cancer patients.

This revelation comes as Ministry of Health officials respond to an Official Information Act request for the evidence that justified their advice to Health Minister Tony Ryall to reject a call from a Taumarunui man seeking public funding so he can have the treatment.

That evidence was a 2005 report by the Medical Services Advisory Committee (MSAC) of the Department of Health and Ageing in Australia that recommended:

"Following a reassessment of further evidence pertaining to the safety, effectiveness and cost-effectiveness of brachytherapy for the treatment of prostate cancer, interim public funding should continue for patients with prostate cancer meeting the following criteria:

at clinical stages T1 and T2 with Gleason scores of less than or equal to 6, prostate specific antigen (PSA) of less than or equal to 10ng/ml, gland volume less than 40cc and with life expectancy or more than 10 years; and where the treatment is conducted at approved sites."

The Australian Department of Health and Ageing accepted that recommendation on 28 November 2005 and continues to publicly fund the treatment within these guidelines.

Mr Ebrey notes that the MSAC report specifically acknowledges that it had done no research into the cost-benefits associated with the various forms of prostate cancer treatment but had simply compared the actual costs of treatment.

"I can provide categorical evidence that the NZ taxpayer would be better off financially by funding low impact LDR brachytherapy treatment for me, rather than require me to have cheaper upfront treatment that has proven longer term side effects."

In a covering letter with the report the NZ Ministry of Health Acting Deputy Director-General - Sector Capability and Innovation, Dr Ashley Bloomfield, says the five year old report is currently being reviewed by MSAC to take into account any new evidence and his own ministry's expert advisory group for radiation oncology has recommended that the Ministry of Health undertake an economic evaluation of the use of LDR brachytherapy for prostate cancer within the New Zealand context. He told Mr Ebrey that this review will take place later this year.

"This is encouraging news and will hopefully be endorsed by a Prostate Cancer Foundation remit at the forthcoming annual meeting calling on all forms of brachytherapy to be made available in the public health sector.'