WHEN Keith Ditchfield was told he had a cancerous tumour on his right kidney his reaction was, unsurprisingly, one of utter devastation.

Yet he said he took for granted that the NHS would do all it could to help him, bringing some comfort that whatever the outlook, he was in the best care.

Keith, 52, soon lost patience, however, when he was told to wait a month for the operation to remove the tumour on the NHS.

He went private and had it removed 10 days more quickly.

But since then Keith, of Whalley Road, Stonyhurst, has developed further tumours in his neck, rib and spine.

He still has renal cancer even though the kidney tumour was removed.

For the neck tumour he went to Germany for cyberknife' surgery, which is not available on the NHS.

He will have to wait until March to see if this has worked but since September he has also been taking a new drug, nexavar, from the same German clinic.

This he said has allowed him to lead a normal life he said - but at a cost. The drug is setting him back about £3,000 a month, which he said he is managing to just about afford through his hotel renovation business.

Keith went to his local NHS primary care trust to ask for funding - but its staff said the drug had not been approved for use on the NHS and it therefore wouldn't fund it.

This is the problem which has dogged the NHS and has led to high-profile battles over treatments such as the breast cancer drug herceptin.

Drugs need to be licensed for sale to prove they are safe and nexavar was given the all-clear by the European Commission in July.

But in England for the drug to be provided on the NHS it has to be given the all clear by the Government's medicines watchdog, the National Institute for Health and Clinical Excellence.

This hasn't happened. A NICE spokeswoman said: "The Department of Health refer our work to us and we haven't been asked to look at that drug yet."

A DoH spokeswoman said: "Sorafenib (nexavar) has not yet been referred to the National Institute for Health and Clinical Excellence.

"However, the government has made it clear to the NHS that a lack of NICE guidance does not mean that a patient cannot be prescribed a treatment."

The decision therefore then rests with East Lancashire NHS Primary Care Trust, the body which decides how much money should be spent on all NHS services in Hyndburn, Ribble Valley, Burnley, Pendle and Rossendale.

This, of course, can lead to PCTs making different decisions which some believe is based on how much cash they have - the dreaded postcode lottery.

It is not know if other PCTs in the country have funded nexavar for patients.

But Keith said: "When you think of what some people are getting on the NHS and all I want to do is prolong my life. It is absolutely ridiculous.

"It is proved to have a benefit for me. It has turned my condition around.

"Just because you live down south where there is more money shouldn't mean that you are left on the side. I am disgusted with the NHS."

The PCT has insisted Keith's case is being assessed on medical and not financial grounds.

A statement to The Lancashire Telegraph said the decision panel received "expert clinical advice" and took into account that Scotland's equivalent on NICE turned down the drug.

In a letter to Keith the PCT said there had to be "cost effective prescribing of the drug". PCT staff had also considered the view of Keith's oncologist, Professor Robert Hawkins of Christie Hospital, Manchester. In a letter to the PCT Prof Hawkins said it was "hard to attribute" Keith's improved health to the cyberknife or the nexavar.

But he also wrote: "Whatever the precise interpretation, the combination of treatment is clearly helping to control his disease and obviously it is appropriate to carry on with this regime."

Keith is now appealing for the second time. His case has echoes of that of Pauline Altham, 62, of Goosebutts Lane, Clitheroe. She this month won her third appeal to have costly liver cancer drug cetuximab prescribed on the NHS.

Others may not be so lucky as NICE this week turned down cetuximab once more - meaning it remains up to PCTs to decide whether to fund it.

And it has brought back unpleasant memories for Barrie Hilton, whose wife Michelle spent 18 months fighting for Herceptin to prolong her life. By the time the 37-year-old mum-of-two won her case she was too weak to take it and died in 2001. It was approved for advanced breast cancer last June.

Barrie, 52, of Buncer Lane, Blackburn, said: "It is all about money and needs a good shaking somewhere. I think NICE has a lot to answer for in lots of ways.

"I thought it was independent from the Government but it doesn't seem to be that way if they have to wait to be referred drugs.

"It is all red tape. People die before they review the treatment."