WATERLOO REGION — Another life-extending drug for kidney cancer patients was recently approved for provincial funding, but advocates say there are still far too many limitations to drug therapy in Ontario and across Canada.

“It depends on where you live as to whether you get access to the drug or when you get access,” said Dr. James Gowing, a Cambridge cancer specialist and co-chair of the Cancer Advocacy Coalition of Canada.

Torisel — a drug that targets kidney cancer and has been proven to extend life for advanced patients with a poor prognosis — was approved by Health Canada in 2007. Ontario now joins British Columbia, Saskatchewan, Newfoundland and Labrador, and Nova Scotia in covering the medicine. Access to other cancer-fighting drugs is also often hampered by government red tape, whether strictly limiting funded treatment courses or outright denial.

“That shouldn’t be in a country like Canada. It’s time for them to get together,” Gowing said.

Other widely prescribed treatments for kidney cancer, Nexavar and Sutent, are also not available in all provinces. Afinitor was recently approved federally, but has not yet been added to provincial drug plans.

The slow approval for government funding is compounded by the fact the drugs are only available as a first-line treatment, which means they are only paid for when used as a patient’s first medication.

No drugs are approved for the second-line treatment of kidney cancer, said Deb Maskens, co-founder of Kidney Cancer Canada. That means there are no options when the first drug fails.

“That’s really our next battle,” said Maskens, who lives in Guelph and has kidney cancer. “If one drug stops working, we want the ability to switch to another.”

Gowing said limiting a cancer drug to first-line treatment is problematic because it’s not effective in all patients. New cancer drugs target specific proteins that play a role in the metabolic pathways that cause cell division, and cancer appears when an overactive protein causes cells to multiply quickly.

More research must be done, he said, to identify the troublesome proteins, or markers, in different types of cancer to determine which drug will work for a patient.

“We need to know who to give it to and who not to give it to,” Gowing said. “That would cut back on the overall cost if you only treat the people who benefit.”

Only in the last decade has there been any effective treatment to kidney cancer, which doesn’t respond to conventional treatments like chemotherapy and radiation.

“Because it is a rare cancer, the research has not been there,” Gowing said.

An estimated 4,800 Canadians will be diagnosed with kidney cancer this year and 1,650 will die, according to the Canadian Cancer Society.

Kidney cancer accounts for only a small portion of cancer deaths in Canada, about two per cent. However, the prognosis is poor for people with the disease, as about one out of four cases are diagnosed when the cancer is advanced and often has spread to other parts of the body. The five-year survival rate for metastatic cancer is less than 10 per cent.

Despite the limitations for cancer drug therapy in the country, Gowing is pleased to hear another drug is available.

“Any new drug is always good news for cancer patients.”

Maskens, too, is pleased Torisel is now covered in Ontario 2 ½ years since being approved federally, especially since other provinces are waiting to make their decision based on what happened here.

“This has been a long-fought battle,” Maskens said. “Every time we get a drug reimbursed, it’s a major celebration.”

People with private insurance can get a cancer drug once it’s approved by Health Canada, but those depending on the public plan have to wait. New cancer drugs are pricey, costing as much as $6,000 a month.

For many people with advanced kidney cancer, Maskens said, this newly funded drug offers the chance at a longer life.

“This announcement brings a tremendous amount of hope.”

jweidner@therecord.com