Two young cancer survivors joined me this month at a Canberra roundtable led by Breast Cancer Network Australia to share a confronting reality with the health minister.
Both had relied on a hormone drug during their own chemotherapy to preserve their fertility and spoke passionately about how vital this protection was for them. Speaking from that experience, they described the devastating impact on young people currently receiving cancer treatment, who faced the prospect of losing access to that same medicine, with no certainty over whether an alternative would have funding when they needed it.
That was the reality for young women with cancer after AstraZeneca announced it would withdraw Zoladex, a hormone drug used during chemotherapy to protect fertility, from the Australian market, giving patients and doctors only months’ notice.
This week, that uncertainty eased. Following an emergency hearing, the government’s independent medicines advisers, the Pharmaceutical Benefits Advisory Committee, recommended a new drug called triptorelin for fast-tracked, subsidised listing as an ongoing alternative to Zoladex, with funding for the same range of cancer and gynaecological patients expected within weeks. This is the outcome we have fought for on the behalf of young women who have spent this year worrying about their access to fertility-protecting treatment,
Young cancer patients can be confident in the use of triptorelin, which is endorsed by the World Health Organisation, as it’s a well-established treatment with extensive safety and efficiency data from years of use in clinical practice.
Zoladex is used broadly across cancer and gynaecological care, including during chemotherapy to temporarily suppress ovarian function, protecting against fertility loss and early menopause. When AstraZeneca cited commercial reasons for the withdrawal, more than 40,000 people signed a petition calling on the company to reconsider, and it agreed to keep supplying the drug for free while a longer-term fix was found. But having access to a medicine, then having that access thrown into doubt, even temporarily, is cruel. And the implications reach far beyond one drug or one company.
For more than two decades, Canteen has fought to make sure adolescents and young adults with cancer get hospital care designed around their age group’s medical and psychological needs. That work led to Australia’s Youth Cancer Services, where fertility preservation has always been a key focus, because survivors of adolescent and young adult cancers face far higher rates of infertility, early menopause, and low testosterone than young people without a cancer history and are significantly less likely to have children.
As the organisation leading Australia’s Youth Cancer Service, I can tell you fertility preservation isn’t an optional extra. It’s a right, and a core part of quality cancer care and survivorship. Around 1,300 young Australians are diagnosed with cancer each year, and more than 6,000 are living with the disease, at the exact age when they’re building relationships, finishing study, starting careers and, for many, thinking seriously for the first time about having children. For these young people, having children isn’t a minor consideration weighed against survival. It’s one of the outcomes that determines whether survival feels like getting a life back.
That’s what made the roundtable matter.
Survivor Holly spoke about how critical Zoladex was to her fertility preservation, telling the room that “the best possible care isn’t a privilege, it’s a basic right.” Destinee shared how the drug had protected the future she’d always pictured for herself. Minister Butler listened, acknowledged AstraZeneca’s move was unprecedented, and was clear that government needs stronger rules to stop pharmaceutical companies leaving patients in limbo again.
The PBAC’s backing of triptorelin is proof of what’s possible when patients, clinicians and government put pressure on together.
But resolving this one case doesn’t fix the system that let it happen in the first place. Three things need to change. The definition of “discontinuing” a medicine must explicitly include delisting, and the notice period needs to go from six months to a full year. The definition of a “critical” medicine needs to change too, with patients and consumers involved in setting it. And communication needs to be clearer and more direct, so patients and families are never again left finding out after the fact.
A young life shaped by cancer doesn’t have to be defined by it – including the chance to become a parent, if that’s what a young person wants.
Canteen’s goal is simple: every young person should have access to fertility treatment and fertility optimisation from the point of diagnosis. This outcome shows what’s possible when patients, clinicians and government act together.
Canteen will keep bringing young people’s voices to the table, to advocate for every young person facing cancer to have guaranteed, ongoing access to the fertility treatments that protect their future. Not because a company chose to offer it, but because the system guarantees it.