PITTSBURGH (KDKA) — What if there’s a shortage of a drug you need?

That’s the situation Steve Cummings faced. He was in the middle of treatment for colon cancer when suddenly one of the three drugs he was taking by vein was not available.

“[The doctor] said, ‘You’re going to have to start taking tablets instead of the I.V.,’ and I looked at the amount of tablets — a whole cup full, 37 tablets,” he said.

“You have to take them within an hour or two, so you have to take like 10 at a time or five at a time, and you just choke on them after a while.”

“There’s nothing you can say except ‘We can’t get the drug.’

“It’s not that we don’t try, not that we won’t pay for it, but nobody has it,” Dr. Jane Raymond, a cancer specialist at Allegheny General Hospital, said.

Cancer drugs, anesthetics for surgery, certain I.V. medicines and drugs stocked on crash carts for emergencies are among those in short supply.

“We have to verify sometimes before a patient starts on a course especially for chemotherapy to make sure we have a full course available for them,” Laura Mark, the pharmacy director at Allegheny General Hospital, said.

“It’s sort of become part of our culture. We’ve been dealing with this for probably two years.”

A lack of raw materials, discontinuation of older, off-patent drugs in favor of newer more profitable ones and drug recalls are contributing to the problem.

“Most of the problems we’re having now just boil down to the fact that manufacturers don’t get paid enough for these generic drugs to make it worth their while,” Dr. Raymond explained. “They’d rather concentrate on the new drugs where they can get a lot of reimbursement.”

Substitutions are being made with similar medications, like buying brand name instead of generic or using different formulations — pills instead of I.V., for instance.

But sometimes the prices are higher and it can be hard in certain situations where a standard treatment is known to work.

“There are some cancers, for example, testicular cancer, where bleomycin is one of the standard drugs. And that’s not available, so do you substitute a different drug? Do you try different chemotherapy combinations? Maybe those aren’t quite as effective. And that is really, really difficult,” Dr. Raymond says.

As for Steve, he had to take the cups full of pills and hopes for the best.

“I don’t envy anybody having to do it. I hope I don’t have to do it again.”

This year, there’s a shortage of 232 medicines, up from 70 in 2006.

President Obama recently signed an executive order for drug companies to report impending shortages to the FDA, for the FDA to assemble teams to review ramped up manufacturing and for the Justice Department to investigate cases of price gouging.

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