For 64-year-old Jenelle Seaman, cancer has become an unwelcome constant in a life spent teaching teenagers science and mathematics and shepherding generations of students through their final years at school.
Diagnosed with stage 3C ovarian cancer in 2010, Seaman has undergone 58 cycles of chemotherapy, major surgery and countless scans. The disease has returned eight times over 16 years.
Now she is among the Australians who could benefit from a major expansion of access to the immunotherapy drug pembrolizumab, sold as Keytruda, which will be subsidised for more cancers on the Pharmaceutical Benefits Scheme from this week.
Seaman, who had never taken a sick day before her diagnosis, has continued working through much of her treatment, determined to remain in the classroom for her students at Sydney’s Redeemer Baptist School.
“My responsibility is to the students, to keep working for the children I teach and the people around me who love me,” she said. “I’m giving them a lesson in life: in perseverance and resilience.”
From Tuesday, Keytruda will be available under a new multi-cancer listing for additional advanced cancers including ovarian cancer, bile duct cancer and the rare skin cancer Merkel cell carcinoma. Until now, access to the drug through the PBS has depended on separate assessments for each cancer indication.
About 700 Australians a year are expected to gain from the expanded listing. Eligible patients will pay $25 per prescription instead of about $14,800 without the PBS subsidy.
Keytruda works by blocking a pathway used by cancer cells to evade the immune system, allowing the body to recognise and attack the cancer.
The government will also subsidise Keytruda in combination with enfortumab vedotin, sold as Padcev, for patients with stage 3 or 4 urothelial cancer, an advanced form of bladder cancer.
More than 490 Australians are expected to benefit from that listing each year, with the PBS reducing the cost from as much as $4800 per script to $25.
Seaman’s cancer first returned in 2014 and has since come back seven more times, despite dozens of rounds of different chemotherapy treatments.
In 2021, her cancer stopped responding to treatment and spread to lymph nodes near her pancreas, leading to invasive surgery and a six-week hospital stay during the COVID pandemic.
“It’s not just the cancer. Most people will never understand the emotional strain, physical toll and financial burden that comes along with it,” she said.
Seaman, who has become an advocate for cancer patients and regularly speaks at oncology conferences, said the prospect of a new treatment offered hope after years of chemotherapy.
“I marvel at the idea of a medicine harnessing someone’s own immune system to fight their cancer,” she said.
“Access to a new therapy is a great source of hope for me and no doubt many other women battling ovarian cancer.”
Being diagnosed with an ultra-rare cancer left Celestino Carosella, from Coburg in Melbourne, facing a disease for which there were almost no proven treatments, forcing him to raid his superannuation to pay thousands of dollars for an immunotherapy drug.
The 59-year-old father is now recovering after genomic testing identified Keytruda as a potential treatment for his cancer, but his campaign for broader access has taken on a deeper meaning after his daughter Jasmine died aged 22 from a rare form of childhood cancer.
He was diagnosed with adrenocortical carcinoma, an aggressive cancer that begins in the adrenal cortex above the kidneys and affects an estimated one person in a million.
“For my type of cancer, once it metastasises there are basically no proven therapies,” he said. “My oncologist looked for clinical trials and did some genomic testing to try and find an answer.”
Carosella took part in two clinical trials, but when the experimental treatments failed to work, his oncologist turned to genomic testing in a last-ditch attempt to identify another option.
The testing indicated his tumour might respond to Keytruda, prompting Carosella to pay about $8000 for each treatment cycle from his superannuation.
His campaign is now as much about his daughter as it is about his own recovery. Jasmine died in December 2024 after battling rhabdomyosarcoma, a rare cancer that forms in skeletal muscle tissue.
“My advocacy is a legacy for my daughter, because she didn’t have that opportunity,” he said.
“She had a passion for wanting to make sure that this would help other kids in the future. All childhood cancers are rare cancers, so this medicine subsidy will benefit young people in particular.”
Health Minister Mark Butler said the expansion would give more Australians access to one of the world’s leading cancer treatments.
“This expanded PBS listing of Keytruda to cover multiple cancers will mean thousands more Australian patients can get the treatment they need faster and at an affordable price,” Butler said.
“Keytruda is one of the most extraordinary drugs available in the country, and now it is listed to help so many more Australian patients.”
Associate Professor Sumitra Ananda, of Peter MacCallum Cancer Centre and Epworth Healthcare, said the expanded listing would give oncologists greater flexibility to make evidence-based treatment decisions.
“Today’s announcement will help make this immunotherapy treatment option more affordable and potentially remove the financial burden that patients with advanced or metastatic cancer may face,” she said.
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Rob Harrisis the national correspondent for The Sydney Morning Herald and The Age based in Canberra. He is a former Europe correspondent.Connect viaemail.
