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Friday, January 14, 2005

Physician urges province to provide PET scanning

By Lynn Rees Lambert
Kingston This Week

Cancer patients are being left out of life-enhancing testing because “politicians are masquerading as physicians,” according to a cancer specialist who spoke in Kingston earlier this week.

Dr. David Webster, president of the Ontario Association of Nuclear Medicine, visited Kingston to promote the case for using Positron Emission Tomography (PET) — a tool being used for the management of cancer patients worldwide.

Webster led a public discussion on PET scanning and its role in cancer diagnosis at the Ongwanada Resource Centre auditorium Jan. 12. The event was organized by the Cancer Centre of Southeastern Ontario at Kingston General Hospital and was hosted by the Kingston Prostate Cancer Support Group.

“Beyond our border, it’s become standard care for cancer patients,” says Webster, who is the chief investigator on the PET Clinical Trial at Care Imaging in Mississauga. But, because PET scanning is not funded by OHIP, Webster and others claim cancer patients are not being properly served.

PET scans differ from CT scans, he explains, and are better at diagnosing some types of cancer. “It depends what you’re looking for,” he says.

The Ministry of Health claims there is not enough evidence to support the clinical use of PET scans. Trials are under way to determine the effectiveness of this type of scanning. Webster, however, says the trials — over a 10-year period — are taking too long. While the rest of the world uses the tool, “We’re back playing in the sandbox here.” Aside from the emotional toll on patients, the scans are “more cost efficient” in the management of cancer care.

Webster says there are several scanners in the province but the government allows only 32 patients per year, under extremely restrictive protocol, to make use of them. Dozens of patients head south to clinics in the U.S. to get a PET scan at great expense to the medical system.

“The Ministry of Health won’t tell you how many [patients] they send,” says Webster. The government covers the cost plus travel expenses, as much as $6,000.

“They pay twice as much, at least, for what we could do here.”

After two years of knocking on the door of ministry of health officials, Webster says the government reverts to the “not enough evidence claim.

“But if there isn’t enough evidence, why do they send — and pay for — patients to get the scan in the States?"

Many countries around the world are using PET technology, and some Canadian provinces are now moving toward introduction of clinical PET. Webster and his colleagues are currently lobbying the Ontario government to bring clinical PET services to Ontario patients, while also establishing a world-class PET research infrastructure.

The association claims England is considering scanning approximately 40,000 patients next year while France is installing 75 PET scanners. There were about 650,000 PET scans performed in the U.S. last year, up from 350,000 the previous year.

McMaster University has performed PET scans for over 20 years, at the sole expense of the patient.

Several provinces have already decided to move toward the use of the PET scanners, including Quebec, which, Webster says, was spurred by a highly-publicized litigation case by a lawyer.

“It’s beyond comprehension,” why Ontario isn’t getting behind the technology, says the physician.

The bottom line, he says, “is no one wants to pay for it. That, and game-playing at every level.”

Published with permission from Ms. Lynn Rees Lambert of Kingston This Week.

Dr. Dave Webster is Principal Investigator with IMAGIN’s affiliate, CareImaging. Dr. Webster oversees all aspects of the CareImaging’s clinical trial including the reading of PET scans. He also serves as President of the Ontario Association of Nuclear Medicine


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