Today
Sometimes Connie Bolle wonders if her husband, Jeff Bolle, would still be alive if things had been different last spring.
After being diagnosed with stage 4 cancer, the high school football coach and guidance counselor began chemotherapy in 2023, but had to abruptly stop it when the medication he was receiving (cisplatin) became difficult to find on the market. shortage of chemotherapy drugs.
“I keep asking myself: 'What if we had achieved cisplatin? Could he have stopped the cancer?” Connie Bolle reflects, “Would he have been able to train even more? Would he have been stronger? Would he have felt better? There is always that question.”
While battling cancer, Jeff Bolle, 60, of Milwaukee, continued to coach the school's football team one last great season, winning the state championship. He had received the diagnosis in 2022: he had bile duct cancer, with a discouraging survival rate. At the time, doctors hoped that surgery and chemotherapy could prolong his life. Before the diagnosis he was in good health, which made everyone optimistic.
He underwent surgery and four rounds of chemotherapy before a shortage of the drug halted his treatment in May 2023, leaving him without two rounds he needed.
As the months passed and the cancer progressed uncontrollably, Jeff Bolle's health worsened. In late September 2023, doctors realized “there really wasn't anything else they could do, which was hard to hear,” Connie Bolle recalls. There was no immunotherapy. There was no other chemotherapy,” she laments.
Jeff Bolle died on December 29, 2023, seven months after losing access to his chemotherapy medications. Last summer he had shared his story to raise awareness about the lack of chemotherapy. He also spoke about his desire to coach at least one more season, something he accomplished and it was even better than he could have imagined: “The Marquette University high school team ended up winning the title of state champion of the first division in football , and they weren't supposed to make it,” says Connie Bolle. “Jeff went to every game.”
Stage 4 cancer diagnosis
When Jeff Bolle felt a twinge of back pain in October 2022, he thought he pulled a muscle while working out. But that same year he was diagnosed with stage 4 bile duct cancer. He had surgery, removed most of the tumor, and began receiving immunotherapy and chemotherapy, even though he knew he would probably never be cured.
“My doctor told me that it was the type of cancerous growth that you will never really get it to go away,” he explained in 2023, “his approach was that they could remove most of the tumor and then use chemotherapy to contain it.”
The Bolles understood it. Still, he was devastating when Jeff stopped treatment due to a shortage of chemotherapy.
“He was never able to take cisplatin again,” Connie Bolle mentioned, “the cancer continued to grow and his bile ducts deteriorated because the disease put even more pressure on them. He was getting very sick. It was horrible”.
Although he felt too weak to work as a counselor, Jeff Bolle continued to coach his team. Before falling ill he went to training on a motorcycle, wearing sleeveless shirts to show off his biceps. He would often head to the gym with the players and challenge them to lift weights. Even sick, Jeff Bolle still came to see them at least several times a week and also to the games.
He eventually required a wheelchair to attend games and sat on the sideline, but coached part of the defense as long as he could. No matter what happened, he always valued watching the recap after the game. In fact, Connie Bolls remembers that during a stay in the intensive care unit, he brought her laptop to analyze one of the games.
Connie Bolle believes he lived to finish the season. “He knew how important he was to his players,” she said, “some of the older guys had been with Jeff for four years.”
The team continued to win, ending with the state championship in November. “I don't know how Jeff did it, because he could barely stand up. At that time, he probably only weighed 140 pounds,” Connie Bolle asserted, “the cold was intense, and he was going up and down the sideline with his walker.”
Chemotherapy shortage
Last year, cancer patients like Jeff Bolle and oncologists were faced with grim news: Many of the chemotherapy drugs used in oncology imaging were becoming harder to find.
The most striking shortage was that of carboplatin and cisplatin, often used in cancers that cannot be cured, William Dahut, chief scientific officer of the American Cancer Society, explained in 2023.
But the shortage of drugs against this disease is not new.
“What we're experiencing now is really the latest of multiple waves of shortages that really go back a decade,” Dr. Mark Fleury, who works on policy development and emerging science at the Cancer Action Network, told Today. of the American Cancer Society.
“We have a lot of drugs that have never really come out of shortage and some that come in and come out again,” he said.
Last summer, NBC News reported that 14 drugs used in cancer treatment were difficult to obtain. As of April 2024, the Food and Drug Administration (FDA) website indicates that 15 oncology agents are currently in short supply.
Asked about the status of the shortage, FDA spokesperson Chanapa Tantibanchachai shared a statement via email: “The FDA recognizes the potential impact that the lack of availability of certain products may have on healthcare providers and patients. Although the agency does not make drugs and cannot require a pharmaceutical company to make them, or to make more of one, or to direct who it chooses to sell it to, the public should be assured that the FDA is working closely with numerous manufacturers and others in the supply chain to understand, mitigate and prevent or reduce the impact of intermittent or reduced availability of certain products.”
FDA Commissioner Robert Califf told NBC News in May 2023 that the main reason for the chemotherapy shortage is that there is not enough profit in the production of these drugs, many of which are generic and off-patent. . “Several companies are going bankrupt or have quality problems due to the difficulty of investing in their technology”said.
About an hour before Jeff Bolle passed away, his dog, Kenzie, jumped on the bed to lie next to him.
Although carboplatin and cisplatin “remain in short supply,” Fleury says that last year the FDA authorized their importation, which helped alleviate the shortage. “We are not seeing the kind of shortages that we saw,” she said, “we call it a shortage, but patients are getting their medications.”
How the shortage of chemodrugs affects
Cancer patients have noticed the shortage. According to an American Cancer Society Cancer Action Network survey published in December, 10% of all cancer patients were affected, but “shortage was not felt equally,” Fleury says.
For example, Medicaid recipients had it worse: 22% reported that cancer drug shortages affected their treatment. Some reported difficulty finding pain relievers or other therapies that were not directly used to treat this disease but were still important, he said.
“People had no idea if they were going to receive the next treatment or not, if the dose was going to be reduced by half,” insists Fleury, “these are drugs that have been the backbone (of cancer care). ) and that in some cases have quite high efficiency. And if they are not available, you enter uncharted territory.”
Although patients faced a high “mental cost,” they also faced “logistical costs,” with some having to drive from one place to another to find treatment.
“Today there are patients who need help,” adds Fleury. “We have to figure out how to better manage the crisis we are in, but also address some of the underlying causes, which keep us in this constant state of crisis.”
Lawmakers have taken some steps to address this problem. While many bills tend to provide short-term solutions, the Senate Finance Committee has been “digging deeper” to address the ongoing shortage, Fleury explains. “The government has an important role in solving this,” she says, but “that doesn't mean the private sector can't.”
A lasting impact
On December 14, 2023, Jeff Bolle was admitted to a hospice facility. Connie Bolle knew she was near the end on December 28, when she agreed to stay in a hospital bed on the first floor because she was too weak to reach her bedroom on the second floor. She died the next day.
“Only one night passed,” he explains, “that was the sign of defeat.”
At his funeral, his players shared what he meant to them. “They said incredible things about the strength, determination and perseverance they learned from Jeff, and about kindness, love and compassion,” says Connie Bolle. She believes her husband would be honored to hear the impact he had on his students. She also believes he would be proud if his story raised awareness about the shortage of cancer treatments.
“He cared a lot about other people not getting the drug,” he says, “even today he would be sad that people are still dealing with this.”
