Jamie Scott, a 49-year-old NHS communications worker diagnosed with ocular melanoma in 2011, is facing challenges securing access to a potentially life-extending treatment for her cancer that has spread to her liver. Despite surgery to remove her eye, the metastatic nature of the disease means she now requires chemosaturation therapy, also known as percutaneous hepatic perfusion, a specialised high-dose chemotherapy administered directly to the liver. This treatment has been approved for NHS use under “special arrangements” by the National Institute for Health and Care Excellence (NICE) since April 2021 but is not routinely available on the NHS. Jamie has been told she cannot access it through NHS channels and must independently raise the £120,000 required for treatment, a financial hurdle she describes as overwhelming and desperate.

Chemosaturation therapy isolates the liver during treatment, allowing larger doses of chemotherapy to be delivered with fewer systemic side effects compared to conventional chemotherapy. International data and expert opinions indicate that this approach controls tumours in nearly nine out of ten patients with ocular melanoma metastasised to the liver, with some patients achieving survival over multiple years. Retired liver surgeon Dr Neil Pearce emphasises that the procedure is usually well-tolerated with short recovery times, meaning patients can quickly return to their lives and families. However, UK patients face a stark disparity as they are often excluded from NHS funding for the treatment, having to self-fund or seek treatment abroad, whereas international patients can travel to the UK to access it.

The charity Ocular Melanoma UK (OMUK), which supports patients with this rare and aggressive cancer, is campaigning for urgent NHS action to enable patient access to chemosaturation therapy. OMUK highlights that around 600 people are diagnosed with ocular melanoma annually in the UK, with up to half developing secondary liver disease, which is often incurable without effective liver-directed treatments. The charity points to NICE’s recommendation that the treatment should be made available under “special arrangements” while further evidence on its clinical and cost effectiveness is gathered. Nonetheless, concerns about treatment complications have contributed to hesitancy in commissioning the therapy routinely on the NHS.

Jo Gumbs, chief executive of OMUK, sharply criticises NHS England for failing to act, stating that patients with one of the least survivable cancers are being forced into fundraising to access the only treatment proven to extend life. She has called on the Secretary of State for Health and Social Care to intervene before more lives are lost needlessly. Meanwhile, Jamie Scott’s situation epitomises the tragic consequences of this systemic gap in care—she expressed deep hopelessness, acknowledging that without the treatment or enrolment in a clinical trial, she is “waiting to die.”

Existing treatment options for advanced ocular melanoma metastatic to the liver, as outlined by Macmillan Cancer Support and international cancer centres like Memorial Sloan Kettering and Massachusetts General Hospital, include liver-directed therapies such as liver resection, radiofrequency ablation, chemoembolisation, and chemosaturation. These therapies aim to prolong survival and improve quality of life, with chemosaturation offering a particularly targeted and intensive option for patients with liver metastases. The Massachusetts General Hospital programme, for instance, administers the FDA-approved liver-focused chemotherapy in multiple cycles to enhance therapeutic response while minimising systemic toxicity, underscoring the evolving landscape of care for this challenging disease.

Despite the medical promise of chemosaturation, the UK’s uneven access to this treatment reflects broader issues in rare cancer management and NHS funding structures. The fact that patients who have contributed to the NHS, like Jamie Scott, must now raise hundreds of thousands of pounds to afford standard-of-care therapies spotlights a critical healthcare inequity. Experts and advocates continue to campaign for changes to NHS policies to ensure equitable and timely treatment access for patients with rare cancers such as ocular melanoma, aiming to prevent further tragic delays and improve survival outcomes across the country.

📌 Reference Map:

  • Paragraph 1 – [1] (The Independent), [2] (Telford Live)
  • Paragraph 2 – [1] (The Independent), [3] (OMUK), [6] (Massachusetts General Hospital)
  • Paragraph 3 – [1] (The Independent), [3] (OMUK), [4] (Standard)
  • Paragraph 4 – [1] (The Independent), [3] (OMUK)
  • Paragraph 5 – [5] (Macmillan Cancer Support), [6] (Massachusetts General Hospital), [7] (Memorial Sloan Kettering)
  • Paragraph 6 – [1] (The Independent), [3] (OMUK), [4] (Standard)

Source: Noah Wire Services