9:01am Friday 4th April 2014
By Jeremy Culley
TEN years ago, Chris Evans could have had just weeks to live.
The 32-year-old suffers from chronic myeloid leukaemia (CML), which was almost a death sentence.
Doctors were usually restricted to making patients’ remaining days as comfortable as possible — with most sufferers of the rare cancer living for just three to five years after diagnosis.
Now, though, a small unit tucked away on the edge of the Royal Bolton Hospital’s A Ward is making miracles happen.
This fatal strand of leukaemia, or blood cancer, is now kept under control, indefinitely, by one tablet.
Provided patients take one every day, their previously fatal condition is controlled. They will always have leukaemia but, in theory, its symptoms should never rear their head again.
The wonder pill called Imatinib is the first — and still the only — targeted cancer treatment in use.
Its impact since being incorporated by the NHS about 10 years ago has been profound.
Dr Clare Barnes is a consultant haematologist on the haematology unit at the hospital.
She is one of six permanent staff members assigned to the unit and they deal with patients with all types of leukaemia, including about two to three a year, on average, with CML.
She said: “Before Imatinib came along, we were breaking bad news to every patient we saw. People in Chris’s position would have had a bone marrow transplant, provided a donor was available.
“It was really horrible thinking back when we had to break the news to people that they would be having this treatment.
“But then this came along and now people are in remission very quickly, and the leukaemia won’t come back if they keep taking the tablet.”
Mr Evans, from Harwood, who was diagnosed with CML in 2011, but was in remission by the following year, escaped the agony of a bone marrow transplant.
Now, he is raising funds for Leukaemia and Lymphoma Research by running the Manchester 10K on May 18 and went to great lengths to thanks the unit’s staff.
Mr Evans, who works for a car valeting company, said: “The NHS gets mixed press but these staff did a fantastic job. It was a shock to be told you’ve got something like this, and it takes you a while before you settle down.
“This tablet is brilliant, though, and the side effects are very mild. I still have check-ups and blood tests every four months, but I am fine.”
The unit in A Ward at the Royal Bolton Hospital is inconspicuous, at the end of a very long corridor and signed only by a blood donation notice.
But its fantastic work, treating about 120 patients each week, is undoubted.
Louise Merrick, a clinical nurse specialising in haematology, said: “We are a small unit here and deal mostly with walk-in patients and check-ups.
“The importance of our screening programmes cannot be overstated, it is amazing what you pick up from them these days.
“On average we get two or three cases of CML every year.
“The number of people suffering from the condition is rising all the while, but that is actually a good thing — it means more conditions are being managed.”
Developed by British biochemist Nicholas Lydon for Swiss firm Novartis in the late-1990s, Imatinib is special as it is a targeted cancer drug, the only one of its kind.
Rather than destroying cancerous cells, as chemotherapy does, Imatinib corrects the genetic change that has caused the cancer in the first place. This means that a previously fatal cancer has been converted into a manageable condition.
Dr Barnes added: “It is the first drug of its kind and it has made an amazing difference.
“There are other drugs with targeted therapies, but nothing as effective or comprehensive as this.
“The long-term effectiveness of the drug is not known because it is so new, but so far it has been very successful.
“Some people are resistant to it, so they have to have second or third generation drugs instead.”
The haematology team also deals with chronic lymphocytic leukaemia, although the older people typically diagnosed with it often die of something else as it develops very slowly.
More sobering for Dr Barnes and Ms Merrick are patients diagnosed with acute myeloid leukaemia, an aggressive, usually fatal blood cancer and acute lymphocytic leukaemia, the most common cancer among children.
Sufferers have a “great chance of survival” as children are “more resilient” than adults, according to Dr Barnes.
She added: “There are always tests being done to see if other drugs are effective and can be brought in.
“Obviously we hope more can come along because Imatinib has totally transformed the outlook we give to patients.
“It has had a remarkable impact.”
Mr Evans is younger than most people with CML — typically in their 60s or 70s — and presented symptoms very late.
It is often picked up through blood tests for other illnesses, but Mr Evans started feeling ill before it was detected.
But for Imatinib, he could well be dead already.
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