A sweeping survey of more than 30 academic cancer centres across the United States has found that every single facility is experiencing shortages of at least one life-saving anti-cancer therapy. The findings paint a troubling picture of a healthcare system struggling to meet the needs of hundreds of thousands of patients at a time when cancer remains the second-leading cause of death in the country, with the American Cancer Society projecting more than 626,000 deaths this year alone.
A System Under Strain
The survey reveals that over 20 per cent of the centres surveyed are currently without five or more different cancer medications, all of which are used to treat some of the most deadly forms of the disease, including testicular, bladder, uterine, ovarian, lung and breast cancer.
The shortages are not limited to niche therapies. Some of the most critical drugs affected include carboplatin, widely used in ovarian cancer treatment, ifosfamide, a mainstay in lung cancer care, and cisplatin, which targets bladder cancer. These medications also play vital roles in treating a range of other cancer types, meaning the shortfall ripples across many areas of oncology.
The figures are stark: 94 per cent of centres reported a shortage of multi-use ifosfamide, 71 per cent lacked sufficient carboplatin, and 16 per cent had no adequate supply of cisplatin. Meanwhile, the bladder cancer immunotherapy Bacillus Calmette-Guérin was in short supply for more than half of those surveyed.
“It is disheartening that we remain in the same situation, including recurring or continued shortages of some drugs, despite years of raising the alarm,” said Dr Crystal Denlinger, CEO of the non-profit National Comprehensive Cancer Network.
The Human Cost of Delays
While cancer centres have developed workarounds to keep patient care and clinical trials moving forward, these mitigation efforts come at a price. According to the survey, 61 per cent of centres had to implement special strategies simply to keep patients on their recommended drug doses.
Even more concerning, 90 per cent of centres reported needing to obtain multiple authorisations from health insurance companies for each patient — a process that adds administrative burden and can delay the start of treatment at a time when speed matters most.
Shortages take time and attention away from direct patient care, and they add stress to an already burdened system, Dr Denlinger noted. For the nurses, doctors and pharmacists working on the front line, the constant juggling of supply and demand is both professionally exhausting and emotionally draining.
Efforts to Address the Crisis
Several legislative proposals have been introduced in Congress to tackle the shortages, though none have yet passed into law. The Trump administration told The New York Times in June that the Department of Health and Human Services was actively working to ease the burden and was considering temporarily allowing imports of medications from companies that do not typically supply the US market.
The FDA confirmed it is aware of the shortages affecting ifosfamide and has expressed concerns regarding the supply of both cisplatin and carboplatin. The agency said it is working closely with manufacturers and other stakeholders to mitigate the impact and support patient access to treatment.
“This includes engaging with manufacturers to understand supply constraints, identifying opportunities to increase available supply and helping to facilitate actions that may alleviate the shortage as quickly as possible, including potential temporary importation, where appropriate, to help bridge supply gaps,” an agency spokesperson wrote in a statement. “In addition, the FDA exercised regulatory discretion to import ifosfamide to help with additional supply.”
The non-profit has also identified broader solutions that could help combat shortages in the long term, including updating federal drug production policy to improve supply stability and providing incentives for domestic drug manufacturing. Researchers have additionally pointed to the development of new cancer vaccines as a promising avenue, noting that such advances could not only help address supply issues but also personalise treatments for individual patients.
Looking Ahead
Although cancer rates have dipped in the US in recent years, experts warn that the outlook is not without complications. Obesity rates are expected to rise, and obesity is a well-established risk factor for developing the disease. Environmental pollution, alcohol consumption, smoking and genetic predisposition also continue to contribute to new cases.
The drug shortage crisis therefore intersects with broader public health challenges, making a coordinated national response all the more urgent.
Why it Matters
The shortage of cancer drugs in the United States is not an abstract policy problem — it directly affects the lives of people battling some of the most aggressive and common forms of cancer. When centres cannot access essential therapies, patients may face delays in treatment, reduced doses, or uncertain outcomes. With more than 626,000 Americans expected to die from cancer this year, any disruption to the supply chain carries serious consequences. The findings from this survey should serve as a wake-up call for policymakers, manufacturers and healthcare leaders alike: ensuring a reliable supply of life-saving medications is not optional. It is a fundamental obligation of a healthcare system that values every patient it serves.
