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A father-of-two in Iowa fighting one of the world's deadliest cancers was nearly left without his life-saving chemotherapy because of the national drug shortage.

Ryan Dwars, 39, a special education teacher in the state's capital, had been receiving chemotherapy for his stage four pancreatic cancer since December last year.

But just two days before his final four rounds of treatment — and as the light at the end of the tunnel began to beckon — doctors called to say they did not have enough of the chemotherapy drug left for him. 

Mr Dwars was using cisplatin — considered the 'backbone' of chemotherapy — which has been in shortage in the US since February. More than 90 percent of hospitals now have the drug in short supply and are opting for alternatives — with the US having to call on China for aid.





During his stage four pancreatic cancer treatment, Ryan Dwars was informed that his hospital didn't have enough of the chemotherapy drug cisplatin for him. Mr Dwars was able to get access to the medication through the charity Angels for Change but is worried he won't be able to get the drug if he needs more chemo in the future 





Mr Dwars has had several rounds of chemotherapy using the drugs cisplatin and gemcitabine. The drugs have eliminated one of the two tumors on his liver. He plans to start radiation therapy next week and have surgery within a year

Mr Dwars, speaking to DailyMail.com alongside his wife Brooke, said: 'It is just not something that anybody should have to deal with, but especially people that are in a life or death situation.' 

Mrs Dwars added: 'I think it's ridiculous that we live in what everyone says is the greatest country in the world and you're being told that the treatment you're supposed to have isn't available.'

The father-of-two was first diagnosed with pancreatic cancer in 2021 after he began to suffer pain down his left side that radiated to his chest. 

After surgery to remove a tumor on his pancreas and nine rounds of chemotherapy, he went into remission in September of that year.

But after going for check-ups every few months, doctors delivered the news in November last year that the cancer had returned — after scans revealed two masses in his liver.

He was prescribed up to 12 cycles of chemotherapy with the drug cisplatin — each cycle lasting one to three weeks — to treat the cancer.

Early results showed the treatment was going well and the tumors were shrinking, but then in April — just 48 hours before his next cycle — the hospital called and said they had so little cisplatin that they were now having to ration it and his treatment was being cut.

Mr Dwars said, describing the moment the treatment was cut: 'The cisplatin was working. It seemed to have fully knocked out one of my tumors.

'That was why it was so difficult to [see it cut]. Maybe I wouldn't have had strong feelings about it [if it wasn't working].'

'But the fact that it was successful, or seems to be successful, is what makes it more difficult to take.' 





When he was first diagnosed with pancreatic cancer, Mr Dwars was just 36 years old. His uncle was battling the disease simultaneously, and after genetic testing. The cancer returned in November last year when he was 39 years old






'It's hard to not think of it as a death sentence,' Brooke Dwars, wife of Ryan Dwars, told DailyMail.com about her husband's cancer reaching stage IV

Mr Dwars was offered replacement chemotherapy drugs, but he feared they would be much less effective against his tumors.

Then, his aunt connected him to the charity Angels for Change, which is dedicated to getting medications in shortage to patients.

They ensured that he could still get the drug on time and did not miss a single round of chemotherapy.

From next week, Mr Dwars will now start a round of radiation and then have surgery within a year to remove the now one remaining tumor in his liver.

If doctors decide he needs chemotherapy again, however, he fears he will struggle to access the drug.

'Everything is up in the air right now,' Mrs Dwars said.

'If he does the radiation, and then it seems that chemotherapy is the best option moving forward after radiation, I think we will be very leery and extremely cautious about whether there will be cisplatin to be able to give him.'

While the Dwars are thankful to have access to cisplatin, they believe they should not have relied on a charity to get the medication. 

'If there's a drug, whether it's a chemo drug, or Adderall, or Tylenol, if it works, people should be able to get it,' Mrs Dwars said.

Mr Dwars is at higher risk of cancer because he has a mutation on his BRCA2 gene.

This gene normally works to repair damaged DNA. However, mutating can increase the risk of certain cancers, such as breast, ovarian, prostate, and pancreatic cancers. 

BRCA2 mutations respond to some medications better than others, and Mr Dwars' doctors believed his tumor would respond best to a combination of cisplatin and the drug gemcitabine.




The National Cancer Institute estimates that just over 44 percent of pancreatic cancer patients survive more than five years if the condition is still localized to its original area. It has an average survival rate of 12 percent





This shows the number of drugs in shortage by year since January 2001. There have been 47 reports so far in 2023, the American Society of Health-System Pharmacists said





The above graph shows the number of drugs currently in shortage according to the American Society of Health-System Pharmacists






'The cisplatin was working. It seems to have fully knocked out one of my tumors. that's what's difficult too is to know that maybe if it wasn't making as much of an effect on and that was the drug there was a shortage of, maybe I wouldn't have as strong of feelings about it,' Mr Dwars said. 'But the fact that it was or seems to be successful makes it more difficult to take.' 

Pancreatic cancer is the third deadliest form of the disease in the United States, according to the National Cancer Institute. On average, just 12.5 percent survive after five years.

Stage IV is considered the 'distant' stage, meaning that is has spread to other organs in the body.

Just three percent of pancreatic cancer patients diagnosed with this stage live beyond five years.

NCI estimates there will be about 64,000 new cases of pancreatic cancer diagnosed this year, along with more than 50,000 deaths. 

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