Nigel Hawkes, Health Editor
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Thalidomide, the drug that blighted a generation of children half a century ago, is back on the market in Europe as a powerful cancer treatment.
The European drug agency yesterday gave clearance for thalidomide to be sold on prescription for treating newly diagnosed multiple myeloma.
It has been available, in a limited way, for some years since its powerful effects on cancer and leprosy were identified.
But campaigners, including those damaged by the drug when they were still in the womb, are anxious that its new-found popularity does not lead to more babies being harmed.
Freddie Astbury, the president and founder of the campaign group Thalidomide UK, said that since the drug resurfaced, hundreds of damaged babies had been born in Brazil, where it has been used since 1985 to treat leprosy. There had been no such cases in the US or Europe, he said, but admitted that he was worried by the increased availability of the drug.
“The trouble is that some hospitals in Europe have chosen to get the drug from Brazil, where it is cheaper,” he said.
Thalidomide UK and other patient groups had been working with the European Medicines Agency (EMEA) for more than five years on a plan to control access to the drug once it was licensed, Mr Astbury said.
“We’re never fully going to know how the plan will work until the drug is used on a large number of patients,” he said. “I’d never say there will never be another thalidomide child in Europe, but I think they are the best guidelines we could have achieved.”
The approval given by the EMEA means that the US company Celgene will be the only licence-holder in Europe, and will be responsible for ensuring that the guidelines are observed. No other manufacturers and distributors of thalidomide can now supply the drug across the EU.
Thalidomide was originally marketed in the late 1950s as a treatment for morning sickness in pregnant women. It was only when babies began being born disabled that the dangers became apparent. The catastrophe was a landmark in the development of safer systems for approving drugs.
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A drug commonly used in cancer therapy has been linked to brain changes that may be long-lasting. So-called chemo-brain is the phenomenon of short-term memory loss and difficulty concentrating experienced by many cancer patients. It is usually put down to a combination of tiredness, anxiety and depression. But a new study in the US has shown that one cancer drug, 5-fluorouracil, (5-FU) can cause damage to brain cells that may help explain “chemo-brain”, the Journal of Biology reports.
Blighted lives
— Thalidomide went on sale as a treatment for morning sickness in 1958 in more than 40 countries
— In Britain the most commonly prescribed drug containing thalidomide was Distaval, manufactured by the Distillers Company, now owned by Diageo
— Foetuses are vulnerable to the drug’s effects between 27 and 40 days after conception
— The drug caused deformities in up to 12,000 infants. Of these, 5,000 survived beyond childhood
— The drug was taken off the market in Britain in December 1961, though a government warning was not issued until May 1962
— The first compensation was paid in 1968. In 1973 – after a campaign by David Mason, a victim’s father, and The Sunday Times – the Thalidomide Trust was set up, providing a £20 million fund
— The average compensation paid to a victim is £13,000 per year
Sources: britannica.com; thalidomidesociety.co.uk; thalidomideuk.com; thalidomide.org.uk
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Again, this is something that should only be taken when the patient is _fully_ informed as to the potential consequences.
Unfortunately there will always be people who take advantage of the vulnerable (in this case, as Ms. McGrath has written, in clinical trials).
However if I were dying of cancer, I suspect that I would want to be able to make up my own mind if these risks would outweigh the potential life-saving effects.
Brijit , Paris, France
Human nature is so constituted that some individuals who have inside knowledge about the effects of thalidomide will âalwaysâ deliberately and unnoticeably cause the serious harm thalidomide can âso easilyâ cause.
They do that precisely because the damage is so serious to the mother and to the child
and because they can do that so easily and without being noticed.
It may be that âin clinical trialsâ, thalidomide is shown to be effective against many things.
But âin real lifeâ, it is given to unsuspecting girls.
Or will a utilitarian argue that this should be weighed against the lives which can be saved through thalidomide?
Perhaps, the utilitarian should be reminded of the surprising ignorance among younger doctors about its dangers, especially in countries where it was never an issue.
Utilitarianism is the âethicalâ doctrine that the moral worth of an action is solely determined by its contribution to overall utility in maximising happiness or pleasure as summed among all person
Ivo Cerckel, Siquijor, Philippines
I was diagnosed with KS about ten years ago and traditional chemo was recommended. Having helped others through that nightmare, I did my research and presented a thalidomide protocol to my MD. He agreed and I began the regime, working up to a rather large daily dose. I got my meds from a buyer's club in Brazil.
Nine months (or so) later, I was fine and I remain so. At one point, in the space of four days at a high dose, the raised lesions literally almost disappeared.
Side effects were that I was a bliss ninny and rather poor dinner conversation; ran into mirrors a lot at the gym, was easily fatigued and slept a great deal. Moreover, I had no nausea, no infections, no depressed immune system and normal T4s. I canât say I got much work doneâaside from the gymâbut all in all, I was taking so much I really didnât care.
Certainly if I ever had the misfortune for another cancer diagnosis, thalidomide would be my first choice. It prevents rapid new cell growth and its great for PM naps.
James H Sibal, Kew Gardens, NYC, NY
Should not distinction be made between the optical isomers in that the right handed isomer is pharmcologically active and the left handed isomer is proposed as the the version that caused foetal abnormalities?
Mike Rooke, Durham, UK
My Mother was given Thalidomide 2 years ago, to help fight Myeloma. She suffered side effects which blighted her life, and did not finish the course. This was on a named patient basis.
She was then put on Velcade, of which there has been much talk of it's success, this unfortunately made her paralysed. Velcade was also stopped.
Both treatments probably staved off the Myeloma a little, but her quality of life was nil by the time she died last November. Most of her bones broken by the Myeloma, and her kidney's failing.
I think she would have much preferred quality over quantity. Plus, there is much work to do, as these drugs are not the wonder drugs people seem to think. We were not warned of the side effects. Although one Consultant had warned her not to have any intravenous treatment. [Velcade]
He was right. We will never know how the disease would have progressed without these drugs, but she would have had more time to play with her Grandchildren. And less, being a " Test Subject".
Carolyn McGrath, London,