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Monday, June 20, 2005

Ontario urged to open access to PET scans

From Canadian Press

A group of medical professionals is urging the Ontario government to increase access to the world standard for cancer diagnostic tests so thousands of patients in the province will have improved care and a higher quality of life.

The technology, called positron emission tomography, or PET, is currently restricted in Ontario to a small group of patients enrolled in clinical trials.

But PET scans should be widely available to the thousands of other cancer patients in the province, said Dr. Christopher O'Brien, president of the Ontario Association of Nuclear Medicine.

"It is medically unethical not to fund PET," O'Brien told a news conference Monday.

The diagnostic tool is already funded by British Columbia, Alberta and Quebec, while New Brunswick and Nova Scotia both recently revealed plans to do so.

The 30-year-old technology is also used in the United States, European Union, Chile, India and Israel.

A PET scan accurately diagnoses certain cancers, which helps doctors lay out the best treatment plan for patients, O'Brien said.

"PET imaging certainly improves the quality of life for many patients," said Dr. Sandy McEwan of the Cross Cancer Institute in Edmonton.

But the province must first put the technology through rigorous trials before it can be made accessible to all patients, said David Spencer, a spokesman for Health Minister George Smitherman.

Even though the technology is used in many countries, there is a lack of clinical data to show which cancers PET scans most effectively diagnose, said Terry Sullivan, president and CEO of Cancer Care Ontario.

If a family member got cancer, "you'd want to know that the diagnostic evaluation was backed up by science," Sullivan said.

"The fact is we don't know what are the areas in which this technology has utility in the evaluation of cancers."

Over the next two years, the provincial trials will determine which cancers are best detected by PET scans, and when the technology is best used, he said.

O'Brien argued that calling PET experimental "is just not justified" since it is used so widely.

During a PET scan, a patient is injected with a radio-pharmaceutical, and a camera detects the gamma rays that are emitted, creating an three-dimensional image of body tissue.

For 39-year-old Toronto resident Howard Steinberg, the $2,500 he spent for a PET scan was worth every penny since it saved him from the agony of chemotherapy and surgery.

"That's an understatement," Steinberg said in an interview Monday. "I was able to avert all that."

Earlier this year, Steinberg, who is a survivor of colon cancer, learned at a regular check-up that a computed tomography, or CT, scan revealed two lesions on his liver that doctors concluded were cancer. Patients with colon cancer can often get liver cancer.

Faced with intensive chemotherapy and surgery, Steinberg did some research and decided to pay for a PET scan at a clinic to see the extent of the cancer.

The results showed there was no cancer, and that the CT scan had shown a false positive.

Cautious of the results, his doctors recommended an ultrasound and magnetic resonance imaging. Both determined the cancer wasn't there.

There are five PET scan clinics in the province, and if they were opened up to more than just trial patients, they could do 1,300 scans a year, O'Brien said.

He also complained the trials aren't adequately funded and are moving ahead too slowly.

The province has so far enrolled just 181 patients - far short of the 600 required.


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