A young mother, Akhona Lusawana, shares how a biosimilar drug trial gave her the chance of survival.

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Akhona Lusawana (26) lives in Swaneville, Krugersdorp with her partner Donald and their five-year-old daughter Yamkelani.

Akhona was diagnosed with HER2-positive breast cancer at the age of 24 on 7 May 2015; it was through her sheer persistence of insisting on getting a referral letter from Swaneville Clinic. This is where she was told that the lump in her right breast cannot be cancer as it is too big and her breast wasn’t black nor itchy.

However, after all the diagnostic tests at Helen Joseph Hospital Breast Care Clinic (HJHBCC), it was confirmed that it was indeed breast cancer. Chemotherapy was needed as soon as possible as the cancer was aggressive. “I was so confused. I was young but the info I read on the internet said older women mainly get it,” Akhona explains.

The young mother was counselled and told she would start chemotherapy at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) as HJHBCC doesn’t have the facilities, and that she’ll be phoned with the dates.

But, weeks later she still hadn’t gotten any dates. Many phone calls and visits to both hospitals took place. “I lost hope as my breast was changing and I felt I was dying,” she says.

In July – two months after her diagnosis – the anxious breast cancer patient was told that the type of treatment she needed (Herceptin) was too expensive and the South African government couldn’t afford it.

But, there was a bright light at the end of this dark tunnel. If Akhona agreed to take part in a biosimilar drug trial, a pharmaceutical company would cover all the costs, and her treatment would take place at Wits University Donald Gordon Medical Centre (WDGMC). Young Akhona was overjoyed, and hope filled her heart again.

The trial included: neoadjuvant (before surgery) chemo with either Herceptin or a biosimilar, surgery (lumpectomy and breast reduction) and adjuvant (after surgery) Herceptin or a biosimilar, as well as R250 for reimbursement for out of pocket expenses per visit.

Though, radiation was done at CMJAH, and when Akhona suffered from side effects from the treatment, such as blood in stools, vomiting, headaches, and nose bleeds, she had to be treated at CMJAH.

The first time she went to the breast care clinic at CMJAH, she was told they are closed and she must go to casualty. She then waited for two hours before she was seen to, and then admitted for three days. Akhona was admitted twice throughout her treatment. Any medication needed to treat the side effects of chemo was prescribed by the site doctor of the trial and dispensed by CMJAH’s pharmacy, including tamoxifen which she is still currently taking.

The comparison of the two hospitals is vastly different. “I would be seen to straight away at WDGMC and the nurses would come every few minutes to ask if I am okay. My parents were amazed by how I was treated,” Akhona says. All her check-ups will be done at WDGMC.

If Akhona decided not to take part in the trial, she would’ve been given similar chemotherapy at CMJAH, but wouldn’t have had access to the additional drug (more directed therapy). The site doctor said that these studies save the government more than R100 000 per oncology patient by taking on these expenses, in addition to giving the patient access to a novel agent (drug).

When asked if she understood that this trial was a test to see if the biosimilar drug works the same as Herceptin (killing the cancer), she said yes, and added, “What other option did I have?”

Life has only gotten sweeter for the young mother, she recently obtained a learnership and is studying to be a beauty therapist at The Pyramid Beauty School. “I remember while I was having treatment, some ladies showed us how to put make-up on and take care of ourselves. It made me feel better, so I want to help other women as well,” Akhona says.

This survivor thanks her sponsor, the the staff at Wits Clinical Research, Dr Fourie – for her patience and willingness to help, and the Makgamathe family, whom she worked for as a domestic worker when she was diagnosed, as well as her friends and family (her mom Thelma, her dad Vusumzi and her boyfriend Donald Matshinge).

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