3 Jul 2015

Ashya King is back – but was it right for him to go?

Poor Ashya King has returned to Britain. Clearly at the time of his disappearance last August, there had been a well-documented breakdown in communication between the doctors and his parents. They fled to Spain, in part, because doctors here didn’t recommended proton beam therapy (PBT) to treat his cancer.

There are big advantages to PBT because it can deliver localised doses of radiation – reducing damage to other parts of the body. This is especially important in for children, because they’re small and their organs are still developing.

But Ashya’s cancer – a medulloblastoma – requires the whole brain and spine to be treated, whether with protons or otherwise. PBT may have caused marginally less damage to his brain and certainly would have avoided damage to his heart (which can cause problems for child cancer patients later in life).

But time is everything with medullablastoma. The longer the time between surgery to remove the tumour and radiotherapy the greater the risk of later relapse. And that’s crucial because children whose cancer comes back have a much lower chance of surviving.

SPAIN-BRITAIN-HEALTH-CHILD

Ashya King at a party on 15 June 2013

PBT is not available (yet) in the UK, and NHS patients have to travel to America. Ashya’s doctors decided that the travel delay could reduce Ashya’s chance of surviving at all – making the problems PBT might help avoid later in life less relevant.

Ashya’s cancer was treated last year. This type of brain cancer is only considered “cured” if it does not reappear within five years.

His father, Brett King, refused to allow his son to have chemotherapy while in Prague. Chemotherapy is dreadful and it’s hard to criticise any parent who wouldn’t want to see their child go through it.

But without the drugs, the chance of his cancer coming back is now between 8 or 10 per cent greater than it would have been.

Ashya’s parents were faced with awful decisions – and the actions that were taken were made with the very best of intentions.

Perhaps the only good thing about the sad story of Ashya King is that it raised the profile of childhood cancers in the UK. We’re one of the worst rich nations at diagnosing and treating childhood cancers like Ashya’s early – with some of the lowest survival rates to go with it.

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2 reader comments

  1. Philip Edwards says:

    Tom,

    Neocons tell us there’s no need to worry:

    Put the profit motive into health care and everything will be alright, according to them.

    Well it will, won’t it……………………….?

  2. Tom Slaney says:

    By not having chemotherapy Ashya’s long term survival has been reduced from about 75 – 80% to about 55 – 60%

    Survival for childhood cancers such as leukaemia (the most common childhood cancer) are much the same in the UK as the rest of the developed world.
    Latest survival figures for childhood leukaemia – 5 year survival (percentages)
    Canada 90.6
    USA. 87.6
    France 89.1
    Germany. 91.8
    UK. 89.1
    Australia 88.6

    What is your source/ evidence for the statement that we are one of the worst developed countries for diagnosing and treating childhood cancers?
    Are you extrapolating from some adult cancers such as lung cancer perhaps?

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