[Lani]

and having seen some of the old hospital buildings still in use and realiziing how few buildings are airconditioned I developed my worries.
I would think the Herceptin is kept refrigerated and delivered in refrigerated trucks and/or in styrofoam containers with ice as it is in the rest of the world , but was concerned what happened after the herceptin was mixed.

I think you made your point exceedingly well regarding the bean-counters and what they define as cost-effective, not taking the human suffering into account. Economists like to utilize cost-benefit analysis but if they truly did so they must put into the accounting the household help that would need to be hired for any children for household cleaning (God knows men tend to be rather useless in this regard) if the patient died, the time lost from work of the husband, the loss to the labor force if the woman worked.

GDP (a measure of all the goods and services produced and traded by a country) neglects the value of mothers' milk and housework, neither of which are charged for by most women.

A recent (published within the past week) paper on the amount of time taken off from work by those treated for cancer already showed a large financial (detrimental) impact on society.

And it is important to remember that the treatment of each patient allows lessons to be learned (even without formal participation in a clinical trial and even if only for one treating oncologist) about what worked/what didn't which advances the fight against the disease.

Are the local trusts made up of elected or appointed individuals. Maybe some should be selected who lost their mothers early in their lives!