The Guardian reports that people with a severe drink-related liver disease are to be considered for transplant for the first time, reopening the debate over whether people who are thought to bring ill health on themselves deserve expensive treatment.
The new scheme concerns those with severe alcohol associated hepatitis (SAAH) who have been excluded from consideration because the prognosis was so poor. There is sometimes not sufficient time to judge the prospects of them giving up alcohol and they often suffer infection and bleeding as well as having deep jaundice and mental confusion.
The patients the doctors are looking to treat in the pilot scheme must be relatively young – between 18 and 40 – seeing a doctor for the first time with liver disease, and being diagnosed with a drink problem for the first time.
Research suggesting that such patients may escape a rapid death through such intervention persuaded the NHS to set up a trial involve 20 patients who may take up to two years to recruit – a small proportion of those with the disease.
The move comes amid mounting concern over rises in deaths from alcohol-related liver disease. The Office for National Statistics revealed in February that in England and Wales these had gone up from 3,269 in 2002 to 4,265 in 2012, a rise of 18%. The biggest increase – a third – was seen in people over 60.
The latest rethink was prompted by a study by a French and Belgian team published in the New England Journal of Medicine in November 2011 which reported encouraging results among SAAH patients. It found early transplantation worked in some targeted patients, with six-month survival rates of 77% among 26 who had transplantation compared with 23% among patients who did not.
Meanwhile, the BBS has reported that half of people with lung cancer die within six months of diagnosis, following a report from Macmillan Cancer Support which looked at variations in cancer survival rates.
While breast cancer and prostate cancer have a five-year survival rate of more than 80%, lung cancer’s is around 10%.
Ciaran Devane, chief executive of Macmillan Cancer Support, said the findings revealed “stark variations”.
“Cancer is not just one disease, and therefore there is no one-size-fits-all approach to treatment and aftercare.