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Dozens more caught up in NSW chemo scandal

AAP logoAAP 19/09/2016 Stefanie Menezes

The number of NSW cancer patients given "off-protocol" treatment by cancer specialist Dr John Grygiel is expected to rise, with the latest investigation into his practices identifying 28 more cases.

The inquiry, led by NSW chief cancer officer David Currow, found the bowel cancer patients were given flat doses or "significantly reduced" doses of oral chemo drugs while Dr Grygiel worked as a fly in-fly out clinician in Bathurst, Orange, Cowra, Parkes and Dubbo.

The effect of the under-dosing on individual patient outcomes could not be determined, the report said.

"We can look at whole populations and indicate it is likely that patient care has been affected," Professor Currow said while releasing the report on Tuesday.

"But because no one has studied these doses before it's impossible to quantify."

The findings come six weeks after the first half of Prof Currow's investigation found Dr Grygiel issued flat doses of chemotherapy drugs to 103 head and neck cancer patients - 37 of whom have since died - at Sydney's St Vincent's Hospital.

The senior oncologist practised as a clinician in the state's west between 1989 and 2013 but the report was only able to examine 300 patient records dating back to January, 2006.

Health Minister Jillian Skinner defended the scope of the investigation, saying records had been difficult to obtain because Dr Grygiel was not working with NSW Health.

"The problem was that Dr Grygiel was working as a private doctor, with just a room in the hospital and his prescriptions, as I understand it, went to local pharmacists to be filled, so we don't have all the records," Ms Skinner told reporters outside Orange Hospital on Tuesday.

The investigation will continue if the department gets access to the Pharmaceutical Benefits Scheme records from the commonwealth government, she said.

It's "quite possible" the patient toll could rise by one-third once those records are made available, Prof Currow said.

The inquiry found Dr Grygiel was "not always receptive to questions being raised about issues" with chemotherapy dosing, and once told a questioning pharmacist to "mind their own business".

But it was also critical of the Western NSW Local Health District, adding that governance issues allowed the practice to continue.

The report confirmed that some of the eviQ dosage guidelines do not reflect current medical practice, Dr Grygiel said in a statement on Tuesday.

"This supports my approach and the decisions I took to reduce toxicity," he said.

"I very much regret that debate around adherence to the eviQ guidelines is causing distress to some of my patients and their families, and I would like to assure them that in every case I acted in their best interests."

The report has recommended evaluating every person registered with the NSW Cancer registry and reviewing FIFO clinical service arrangements.

The government will implement all 16 recommendations in full, Ms Skinner said.

Opposition health spokesman Walt Secord has reiterated calls for a special commission of inquiry into the scandal, saying the latest report "resolves nothing".

An extra $1.5 million has been allocated for rural cancer services in western NSW, while new electronic software to track chemotherapy prescribing is being rolled out across public hospitals.

Concerned patients can contact the Cancer Inquiry Line on 6369 8808 or email WNSWLHD-CancerInquiry@health.nsw.gov.au.

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