Senator Lyn Allison
Portfolio: Health and Ageing
Related: Status of Women
| Dated: 7 Sep 2005
Location: Parliament
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Matters of public importance - Mifepristone |
Women in France, Sweden and Great Britain, but not Australia, have access to what was described in the 1980s as a new generation of fertility control agents that can cause the interruption of early pregnancy. It works by blocking progesterone, which is a vital hormone in the establishment and maintenance of pregnancy. I am referring to Mifepristone, previously known as RU486, the importation of which was explicitly banned in Australia in 1996 unless it had the approval of the health minister. It seems that we cannot keep heroin or ecstasy out of this country, but we have been very successful in stopping any of this pharmaceutical from coming into the country.
Mifepristone has been used by more than 200,000 women worldwide and has been found to be a safe and effective alternative to surgical abortion in the first nine weeks of pregnancy. It is non-invasive, has less risk of infection and therefore infertility for women, and does not require an anaesthetic. It is 96.9 per cent effective, more private, less costly, provides women with greater control over their fertility and could replace 50 per cent of the current surgical abortions being conducted. It also has fewer side effects and is easier to use than even the morning after pill, which, as we all know, is perfectly legal and available over the counterunless, of course, your pharmacist imposes his or her particular moral judgment on the stocking of emergency contraception, as many do.
Australian women do not have access to Mifepristone, because the anti-reproductive choice, high moral ground defenders of religious views on the matter of abortion held sway in this parliament then, as they probably do now. That is bad enough, but there is another whole group of people out there whose lives and health would be greatly improved by access to this banned pharmaceutical. It would save women who have ectopic pregnancies from the dangerous surgery involved, surgery that often damages fallopian tubes and risks infertility. Three women die every year in Victoria alone from complications that arise from ectopic pregnancies. Physicians can, of course, apply to the Minister for Health and Ageing for an exemption to this ruling, and arrange the importation themselves if the minister agrees. But this process takes a very long time and is useless for women in these circumstances because of the time delay and the fact that they are affected by a life-threatening situation. My main purpose today, however, is to draw attention to the many clinical studies and research that has been done overseas that show that Mifepristone is a promising and viable treatment option for meningioma, some breast cancers, fibroid tumours and uterine and ovarian cancers.
It makes no difference in this country whether the purpose for which Mifepristone is to be used is for interrupting a pregnancy or for treating life-threatening conditions that are not related to pregnancy. Let us look at meningioma. It accounts for 15 per cent of all primary brain tumours and 12 per cent of all spinal cord tumours, and it occurs twice as often in women as it does in men. Meningiomas may enlarge or become symptomatic during pregnancy or the menstrual cycle and are positively associated with breast cancer. These indications suggest that the hormones oestrogen and progesterone influence tumour growth. Many cancers and tumours are known to be hormone sensitive, and oestrogen and testosterone blockers are being used effectively as a treatment on their own or in addition to radiotherapy. This has proven to increase the success of those treatments by 50 to 60 per cent. By binding with progesterone receptors, Mifepristone appears to inhibit the growth of, or actually reduce, meningiomas.
In a study at the University of Southern California in 1994, Mifepristone was found to have some efficacy in the treatment of patients with inoperable meningioma. A year later, a study in Portugal showed that Mifepristone interferes with the steroid action that influences the growth of meningiomas. Patients in the US have testified that Mifepristone helped treat their disease. In Australia, people with cancers and tumours that are progesterone sensitive do not have the same right to medication that can help them as do people with cancers or tumours that are oestrogen or testosterone sensitive.
In Australia, 30,000 hysterectomies are performed every year on women of child-bearing age for a number of reasons, such as fibroid tumours and ovarian and uterine cancer. Studies have shown that Mifepristone is a useful treatment of these conditions in many instances. The use of Mifepristone for endometriosis, which affects thousands of women in Australiabetween 10 and 20 per cent of womenand causes severe pain and, in some cases, infertility, blocks the capacity of endometrial tissue to grow in response to oestrogen and is showing promise in relieving those symptoms. Mifepristone could possibly be used outside the whole question of pregnancy for a very large range of people who are affected by other conditions.
This issue came to light for me when a constituent wrote and said that she had meningioma and had discovered research which showed that people in other countries had access to Mifepristone but that it is not available in Australia. So she did some research into the situation. She has now, through her doctor, applied to the Minister for Health and Ageing for an exemption from the law preventing the use of Mifepristone, and she is awaiting a response from the minister. I do not wish to identify the person for privacy reasons, but I thought it might be useful to identify what she said about her own condition. She said:
although meningioma is a benign tumour, surgical removal is not always viable and may result in significant deficits if it is attempted. Naturally, this depends on the location of the tumour and its involvement with vital structures, nerves and arteries. Surgery on a tumour in the skull-base carries with it the risk of deficits such as loss of eyesight, damage to facial nerves and loss of hearing (in one ear in my case).
My own experience is such that the first neurosurgeon I went to see refused to operate as he said it was too dangerous. The second neurosurgeon I saw said he could operate and, although he uses very advanced surgical techniques, he advised there was a 50% chance I would be left with damage to my eyesight, and possibly damage to some facial nerves. He also advised I most probably would lose all my hearing in one ear. Damage to my eyesight, if it results, could possibly be repaired within 3 months and yet another operation but there was no guarantee it would be successful and there is also a risk that such damage may be permanent.
Of course, this would also result in a lengthy recovery period in the event that such deficits result and the prospect of damage to my eyesight and facial nerves (which carries complications in itself) is not something I would take lightly. Permanent damage would leave me disabled.
That was part of her response to the Therapeutic Goods Administration, which raised some questions once that application had been put in.
Whilst the Senate agreed in 1996not with the support of the Democratsto restrictions being placed on Mifepristone, it is now time for us to revisit that question. I would argue that there is no reason why women in this country should not have access to Mifepristone, or RU486, in whatever circumstances they deem useful; and it is certainly the case that we should lift the restriction for those people for whom cancers and other conditions might be treated.
The request to make this pharmaceutical drug available to people with those conditions is under way. I will be urging the minister to support the application and also to extend it for other conditions. Ectopic pregnancies are one condition which is in urgent need of some action. There is not the time for patients to make individual applications to the minister, as is now required in order to receive this treatment. That is not reasonable. Most countries in the world allow the use of Mifepristone at least for ectopic pregnancies and for cancers, and Australia should revisit this question. I would argue for no restrictions at all on this pharmaceutical, because it is safe, because it has been tested, and because it has been used by so many people over such a long period of time. We should not be bound by some moral view about whether it could be used for abortion or not.
I also make the point that abortion in this country is legal, and there is no reason why there should not be another avenue for nonsurgical abortion made available to women. What we are doing is putting women through unnecessary suffering by adhering to a decision which was made in this place without the knowledge that we now have about the other applications of this drug. I believe this to be a particularly important issue for women, and the Democrats will be strongly campaigning to encourage the minister to do something about this situation.
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Information provided by the Australian Parliamentary Library.
This document is of Draft Status
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