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| | | | |  | Warren Kotler, who has lived with Stage 4 breast cancer for eight years, says he wants to have the option of taking a new but expensive drug that has only approved for female patients in Canada.(Turgut Yeter/CBC News) | | | Men get breast cancer too. But they can't always access new drugs
Breast cancer is widely researched, but some men suffering from the illness say they can’t benefit | Jennifer Yoon | Warren Kotler has outlived his prognosis.
Eight years ago, Kotler was told he had three to five years to live. The diagnosis: Stage 4 metastatic breast cancer. It's a common illness among women, but a rare one among men, who account for only one per cent of cases.
Kotler, 61, has received a mix of drug treatments and several courses of radiation therapy. His quality of life is excellent, he said: he got married two years ago. He travels often. He regularly goes on long bike rides.
Despite that, the Toronto man knows the cancer could eventually outsmart his treatments. The plan he and his medical team developed: "Stick around long enough. There's new drugs that are going to be coming on, and hopefully those will be of benefit," Kotler said.
This summer, his oncologist suggested a new drug: capivasertib, sold as Truqap. Clinical studies suggest the drug, which was approved in Canada in January 2024, could hold off the cancer from progressing for several months for patients with a type of advanced breast cancer known as HR positive, HER2-negative. These cancers respond to hormone-therapy drugs and do not have abnormal levels of the protein HER2, which can accelerate tumour growth. The drug stops the cancer from growing by blocking AKT – one of the enzymes needed for cell growth.
But Truqap is expensive. Canada's Drug Agency says it costs around $10,000 for a 28-day supply. And while Kotler is able to get provincial help for some of his other pricey drugs through Ontario's Trillium Drug Program, Truqap is not covered by the program.
Kotler's medical team has asked the drug manufacturer to cover the cost of the drug on a compassionate basis through a patient support program it runs. AstraZeneca said it cannot.
The reason? Health Canada has only approved the drug for women. | | |  | Warren Kotler has been able to outlive his prognosis by several years, after receiving a mix of drug treatments and several courses of radiation therapy. But he says he's always afraid the cancer will outsmart his treatments. (Submitted by Warren Kotler) | | | Too few men in study, says Health Canada
Some other jurisdictions — the United States and the European Union — have approved the use of the drug for both men and women following a clinical trial.
When CBC News asked Health Canada about the decision, the department pointed to its regulatory decision summary for the drug, which says too few men were involved in the Phase 3 clinical study: seven out of around 700 participants. For those men, the drug appeared to stop the cancer from getting worse for about two months – compared to around seven months for the entire study population. Health Canada raised concerns over the toxicity of the drug, including side effects like diarrhea, rash and nausea.
While side effects are a part of many treatments, there is a weighing of risk and benefit — and whether medications used at the end stages of cancer meaningfully improve survival and quality of life. A group of cancer doctors in North America say medications with marginal benefits are being overused for patients who are nearing the end of their lives. They say ultimately whether a patient decides if a drug is worth taking is a deeply personal choice, and one that should come after an honest conversation about the reality of what a drug can do.
But for Truqap, Canada's Drug Agency, an independent non-profit organization that provides objective evidence to healthcare decision-makers, came to a different conclusion than Health Canada.
In a reimbursement review for Truqap, its expert review committee said the drug should be reimbursed for all adult patients — with conditions. The proportion of men in the study, it said, reflects the rate of breast cancer among men, and because there were so few men involved in the study, it was impossible to say for sure the drug would be less effective in male patients.
For Kotler, who is no stranger to the side effects of cancer drugs, it's about having the option.
"In terms of quality of life, absolutely, I want to make an informed choice," he said.
"I don't have a choice with Truqap. It's not available to me."
Read more at this link from CBC Health Reporter Jennifer Yoon on why some doctors say male breast cancer patients should be able to access certain drugs. | | | Cross-Canada health news from CBC |  | 'We have a new start,' doctor says after Canadian Medical Association apology to Indigenous Peoples | CBC British Columbia | | | | | How DeMar DeRozan changed the conversation around mental health in basketball | The Current | | | | | A Halifax woman has spent years fighting for out-of-province care. Now she's ready to end her life | CBC Nova Scotia | | | | |  | Multiple RSV vaccines for adults are rolling out in the months ahead, along with two monoclonal antibody shots to provide protection for infants. Yet accessing the various shots will depend on where you live, with some provinces covering certain options and not others. (Matt Rourke/The Associated Press) | | | Canada approved multiple RSV shots to ward off infections this fall — here's how to get them | | | Respiratory syncytial virus, or RSV, which usually causes the common cold — can be a major driver of severe illness in vulnerable groups.
Chief among them are babies. RSV is the leading cause of respiratory infections and hospitalizations among Canadian infants, health professionals say.
The good news is Canada is among the countries offering a broader slate of protective products to ward off RSV infections this fall and winter.
Multiple RSV vaccines for adults are rolling out in the months ahead, along with two monoclonal antibody shots to protect infants.
Read more from CBC Health and Medical Reporter Lauren Pelley on how to access the various shots will depend on where you live, with some provinces covering certain options and not others. | | |  | | Sudden Cardiac Arrest | | 2:03 | | | | | How one family's fatal history of sudden cardiac arrest could help save others | THE NATIONAL | After Lauren Philion lost a brother and a sister to sudden cardiac arrest, and almost died herself, extensive study of her family's history has helped lead Canadian researchers to a discovery they hope will help save lives. CBC Health's Mike Crawley reports. | | | | | THE BIG NUMBER | 79% | | | Driving is the most common way to commute to work, Statistics Canada reported this week.
The agency's analysts crunched responses from more than 360,000 adults who completed the 2016 long-form census. About 79 per cent of people gave private motorized vehicles like a car as their most common mode, followed by public transit at nearly 14 per cent, walking, almost 6 per cent, and cycling, 1.5 per cent.
Walking and cycling, known as active commuting, are associated with health benefits from getting the heart pumping. They also pointed to economic and environmental benefits of taking steps or cranking pedals.
Workers in trades, transportation, natural resources, and manufacturing occupations were least likely to commute actively.
Walking and cycling were more likely among people working in art, culture, recreation and sport.
The report's authors suggest there are occupational and sex differences in modes of commute that may have important implications for public health, as well as workplace policies like flexible work hours or creating change rooms, and transportation planning.
In August, Statistics Canada reported the average Canadian now spends 26.4 minutes travelling to work, just above the previous high of 26.3 minutes in May 2016.
When it comes to active transportation, the national average was six per cent — a figure that's remained essentially unchanged since 2021.
| | | | | Stories we found interesting this week | | | U.S. overdose deaths plummet, saving thousands of lives | NPR | | | | | | | The secret to getting men to wear hearing aids | The Atlantic | | | | | | |  | New episode drops Sept. 19
Iron deficiency is relatively straightforward to treat, yet a significant percentage of Canadian women and girls live with the condition. Dr. Michelle Sholzberg, a hematologist at St. Michael’s Hospital and director of hematology at the University of Toronto's department of medicine explains how to diagnose iron deficiency and maintain our iron stores.
Play on CBC Listen | | | |  | New episode airs Sept. 21
Queen’s University is zeroing in on the family doctor crisis with a first-of-its-kind medical school in Canada. The six-year program partners with a nearby hospital network to recruit and train students with the sole intention of graduating family doctors. It integrates classroom learning and high-tech patient simulation at Lakeridge Health with placements in the community. But can it prepare students for the daily realities of being a family doctor?
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