Oxenham is in remission<\/a> \u2013 as close to cancer-free as he can be. <\/p>\nInstead of scans lighting up like a dreaded festive show, they now reveal only innocuous black-and-white body parts. <\/p>\n
![\"Former]()
Former New Zealand Herald photographer Jason Oxenham. Photo \/ Michael Craig<\/p>\n
Oxenham keeps his feet on the ground, playing it cool \u2013 he knows the myeloma can come back. He lets others express the emotion. <\/p>\n
\u201cSome people on the phone were in tears. Just so much joy given for the journey we\u2019ve been on, especially over the trials we had in Shanghai. <\/p>\n
\u201cSo yeah, that was important to me, letting people know, because they\u2019ve been so supportive while we\u2019ve been going through this challenge.\u201d <\/p>\n
The Herald visited Oxenham in August on his return from China, as tests showed his re-engineered immune cells were tearing into the cancer he had lived with for the past five years. <\/p>\n
\u201cLast time we spoke, you know, I wasn\u2019t quite sure if I was prepared to say I\u2019d been an advocate for CAR T[-cell therapy]. <\/p>\n
\u201cMy results are still rolling in, and even weeks and weeks after returning from Shanghai, the numbers are still dropping. The markers in my blood are at zero \u2013 undetectable \u2013 so that\u2019s mind-boggling. <\/p>\n
\u201cSo when people ask me now, I\u2019m prepared to say it\u2019s worth trying if you can afford it. <\/p>\n
\u201cBut we\u2019re in a difficult situation where there\u2019s no funding for this here.\u201d <\/p>\n
For many New Zealand patients with cancers such as multiple myeloma, access to groundbreaking treatments like CAR T-cell therapy remains extremely limited. <\/p>\n
Outside a small number of trials, the only realistic option is to seek treatment overseas \u2013 in countries such as the United States where costs can approach $1 million, or in more affordable countries like Israel, India and China, though the financial outlay still runs well into the hundreds of thousands of dollars. <\/p>\n
Earlier this year, when Oxenham was weighing up his options, he openly questioned whether the monetary risk was worth it, knowing that CAR T-cell therapy does not work for everyone.<\/p>\n
He was aware of other people with myeloma who had travelled overseas seeking the treatment, absorbed the financial burden, but without a successful outcome.<\/p>\n
It was at the insistence of his wife and daughters that they stretch their finite funds and he flew to China. <\/p>\n
\u201cIt\u2019s a shame that patients have to go to such extents \u2013 cashing up KiwiSaver, fundraising, flogging stuff off \u2013 just to stay alive.\u201d <\/p>\n
![\"A]()
A nurse holds Jason Oxenham’s infusion bag of re-engineered T-cells.
\nPhoto \/ Jason Oxenham<\/p>\n
Chimeric Antigen Receptor T-cell therapy \u2013 it sounds like science fiction. <\/p>\n
First, doctors harvest T-cells \u2013 the soldiers of the immune system \u2013 from a patient\u2019s blood. <\/p>\n
Those cells are genetically re-engineered to recognise a specific marker on cancer cells they had previously been blind to, then infused back into the patient\u2019s body. <\/p>\n
It is not like chemotherapy, which is essentially poisoning the body in the hope of killing the disease faster than the patient. <\/p>\n
Instead, it is a targeted response because the immune system now sees the cancer and attacks it directly. <\/p>\n
The development of these types of treatments is a game changer, says Dr Rodger Tiedemann, an associate professor at the University of Auckland. <\/p>\n
\u201cThe immune system is an incredible thing, and once you unleash it in a way that it can recognise the cancer, it can be very, very effective.\u201d <\/p>\n
![\"Dr]()
Dr Rodger Tiedemann, associate professor of medicine at the University of Auckland and consultant haematologist. Photo \/ Jason Oxenham<\/p>\n
Advances in immunotherapy treatments are rapid. <\/p>\n
A new step in CAR T-cell re-engineering involves doing it in the body, eliminating the need to harvest or infuse cells. <\/p>\n
Tiedemann works on bispecific antibodies \u2014 proteins that \u201cglue\u201d a T-cell to a cancer cell, guiding the immune system\u2019s soldiers directly to their targets.<\/p>\n
\u201cIt used to be that new companies were bringing out new drugs or small molecules for cancer treatment. But in myeloma nearly all new treatments are now immunotherapies, and for many patients they have fewer side effects,\u201d explains Tiedemann.<\/p>\n
\u201cThe progress is accelerating, and I don\u2019t see that changing any time soon.\u201d <\/p>\n
CAR T-cell therapies target blood cancers, including lymphoma, myeloma and leukaemia. <\/p>\n
More than 20,000 New Zealanders are living with one of these diseases, including around 3000 people with multiple myeloma. <\/p>\n
Myeloma is incurable and relapsing \u2013 something Oxenham knows all too well. <\/p>\n
Over the past five years, he has undergone repeated rounds of treatment as the disease diminished and then inevitably returned. <\/p>\n
His treatment has included multiple drug regimens, brutal rounds of chemotherapy, and a stem cell transplant. <\/p>\n
\u201cI\u2019ve been on this journey for a while. I\u2019ve been cancer-free before,\u201d remarks Oxenham.<\/p>\n
In New Zealand, there are far fewer publicly funded treatment options than in countries such as Australia and the UK, and patients and clinicians continue to call for improved access. <\/p>\n
The strongest push has been for the drug daratumumab, which is funded in 49 countries but not publicly available here. <\/p>\n
While daratumumab can be accessed privately, it costs around $240,000 in the first year alone \u2013 a price comparable to CAR T-cell treatment in China, which is a one-off cost and helps explain why some patients see overseas therapy as a valid option. <\/p>\n
A spokesperson for Myeloma New Zealand said all blood cancer treatments needed to be well-researched and considered.<\/p>\n
\u201cWe certainly as an organisation can\u2019t recommend anything [CAR T-cell] because they\u2019re all just too new, the data isn\u2019t there and each person is different as well. <\/p>\n
\u201cWith myeloma, people can respond quite differently. You can have quite a different disease, and so what works for one won\u2019t work for another.\u201d <\/p>\n
There is no funded CAR T-cell therapy in New Zealand, but there are moves to change this. <\/p>\n
The Malaghan Institute, which is currently running CAR T-cell clinical trials for lymphoma patients and hopes to expand the approach to diseases such as multiple myeloma, is now building the foundations to deliver the therapy in New Zealand, said general manager Mike Zablocki.<\/p>\n
![\"Malaghan]()
Malaghan Institute general manager Mike Zablocki. Photo \/ Sophie Trigger<\/p>\n
In partnership with Bridgewest Ventures, the institute has established a start-up company, BioOra, which will manufacture and distribute CAR T-cell treatments.<\/p>\n
They were building the infrastructure to make homegrown CAR T-cell therapies possible as well as allowing overseas providers to come in and offer options, he said.<\/p>\n
\u201cWe just want to be able to lower the barriers for CAR T-cell therapies to come here.\u201d<\/p>\n
Introducing CAR T-cell into the health system would mean no direct cost to patients. There would be an upfront cost to the system but it would be offset by downstream savings, he said.<\/p>\n
\u201cBecause the beauty of CAR T-cell therapy, when it works, is that you\u2019re treated and that\u2019s it. You don\u2019t have ongoing hospitalisation costs.\u201d<\/p>\n
In a best-case scenario, Zablocki said CAR T-cell therapy could be available in New Zealand by late 2027, though he acknowledged the timeline depended on factors outside Malaghan\u2019s control.<\/p>\n
![\"In]()
In May, photographer Jason Oxenham examines the space for his upcoming fundraising exhibition Light+Shade. Photo \/ Michael Craig<\/p>\n
Earlier this year, when the Herald published Oxenham\u2019s story about his treatment in Shanghai and the fundraising photography exhibition he organised called Light+Shade, numerous people got in touch to ask about his treatment or share their own experiences. <\/p>\n
He was happy to share his knowledge. Word of mouth and shared stories was one way patients learned about treatments like CAR T-cell therapy. <\/p>\n
\u201cI was really lucky that another friend of mine who battled myeloma \u2013 unfortunately, he\u2019s passed \u2013 but I\u2019ve kept in touch with his wife, sister and family, and they gave me the contact for professor Ho in Shanghai. <\/p>\n
\u201cI\u2019m not sure where I\u2019d be today if I didn\u2019t have that introduction.\u201d <\/p>\n
Compared with when he arrived home after nine weeks in China, Oxenham\u2019s colour is vibrant and his fitness continues to improve. <\/p>\n
He is back on the tools \u2013 taking photos, producing video and doing the creative work that has always been his passion. Before China, Oxenham did not think he would ever have the energy to work professionally again.<\/p>\n
His main focus is to be the best friend, husband and dad, and some mornings he wakes blissfully unaware of the cancer that for years filled his horizon. <\/p>\n
\u201cI feel I\u2019m starting to move away from that intensity, that being hyper-focused on treatment. <\/p>\n
\u201cYou know, I feel like we\u2019ve won the battle. <\/p>\n
\u201cWe might not have won the war, but we\u2019re winning the battle. <\/p>\n
\u201cAnd that\u2019s a pretty good place to be, to be honest.\u201d <\/p>\n
Mike Scott is an award-winning visual journalist with more than two decades\u2019 experience telling stories across multiple media platforms.<\/p>\n
Sign up to The Daily H<\/a>, a free newsletter curated by our editors and delivered straight to your inbox every weekday. <\/p>\n","protected":false},"excerpt":{"rendered":"It was obvious to everyone and everything apart from his immune system. The antibodies tasked with defending his…\n","protected":false},"author":2,"featured_media":192441,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[31],"tags":[74,442,498,499,500,2534,3944,607,22773,501,156,2944,29116,194,2510,25811,111,139,69,76429,119831,13636,49464,119832,3422],"class_list":["post-192440","post","type-post","status-publish","format-standard","has-post-thumbnail","category-arts-and-design","tag-after","tag-arts","tag-arts-and-design","tag-artsanddesign","tag-artsdesign","tag-cancer","tag-car","tag-china","tag-comeback","tag-design","tag-entertainment","tag-inside","tag-jason","tag-kiwi","tag-multiple","tag-myeloma","tag-new-zealand","tag-newzealand","tag-nz","tag-oxenham","tag-oxenhams","tag-photographer","tag-remission","tag-tcell","tag-therapy"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/192440","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=192440"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/192440\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/192441"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=192440"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=192440"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=192440"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}