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Roughly two million Americans are expected to receive a cancer diagnosis this year. Some members of this already vulnerable group will wind up facing what physician Andrew Schuman recently called “a tragedy happening in slow motion” — an ongoing, nationwide shortage of critical oncology drugs that routinely save or extend the lives of children and adults.

Speaking at a March 22 Senate hearing on drug shortages, Schuman, a head and neck surgeon at the U.S. Department of Veterans Affairs, described the agonizing decisions that doctors must make when critical medicines are in short supply. “Should our limited vials go to an older woman who was just diagnosed with lung cancer? To a young man who had already been successfully taking it for his testicular cancer? Or a baby with neuroblastoma?” he asked. “As a doctor who has devoted my life to fighting cancer, it is hard to express how horrible it is to face this kind of tragedy.”

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The dilemmas caused by cancer drug shortages are unfortunately nothing new. In the past decade alone, eight of the 10 drugs most commonly used to treat acute lymphoblastic leukemia, the most common kind of childhood cancer type of leukemia, have been temporarily unavailable. The problem has been getting worse: Nationwide shortages of critical drugs increased nearly 30% in 2022, soaring to their highest level in nearly five years, according to a report released by the Senate Homeland Security and Governmental Affairs Committee for the hearing. Oncology drugs currently in short supply include methotrexate, which treats breast and soft tissue cancers; cisplatin, which treats testicular, ovarian, bladder, head and neck, lung, and cervical cancers; fluorouracil, which treats skin cancer; Pluvicto, for prostate cancer; and the injectable bacillus Calmette-Guérin, for bladder cancer.

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