Calls to buy cancer scanners grow

Lynette Brown

Cancer doctors and patients say state health services should invest millions in a new type of scanner to improve treatment, save money and spare lives.

Pacific Radiology in Wellington has built one of the new machines by upgrading existing gear.

It cost $1 million, but an off-the-shelf PET (positron emission tomography) scanner costs $3 million. The machine to produce the associated radioactive isotope costs $5 million, although Pacific imports the material from Australia.

PET scanning has been widely available for five years in Australia and longer in Britain and the United States.

An estimated five patients a week from New Zealand fly to Australia for the scans, mostly at their own expense, some financed by their district health board.

The Health Ministry and health boards are investigating the introduction of PET scanning.

Aucklander Lynette Brown, 61, paid for her own PET scan in Melbourne last June. On top of travel and accommodation for her and husband Bob, the scan cost A$1500 ($1650).

Mrs Brown had previously had surgery, chemotherapy and a form of radiation treatment by injection to treat cancer, first diagnosed in 2001, that had started in her bowel and spread to the liver.

After tumours were again detected in her liver last May, her Wellington surgeon, Richard Stubbs, suggested a PET scan.

A traditional CT scan had detected tumours on the right side of the liver, but questions remained about the left. Without a PET scan the plan would have been to proceed with surgery, but tumours on both sides would have been inoperable, requiring too much tissue to be removed.

The PET scan showed tumours only on the right, confirming the decision to have surgery, which she then had.

Mrs Brown is now clear of cancer again and hoping to stay that way.

Her experience convinced her that health boards should buy PET scanners, "because they save unnecessary operations".

Pacific's chairman, radiologist Dr Trevor FitzJohn, said PET scans saved lives, but Mr Stubbs, who operates at the private Wakefield Hospital where Pacific's scanner is sited, was more cautious.

"It's more going to help use resources more efficiently and sensibly," he said.

And it would save some patients the risks and problems of surgery. They could instead go straight on to other treatments or, if the cancer was incurable, on to palliative care.

Mr Stubbs estimated that if all lung cancer patients heading for surgery were scanned, $600,000 a year - enough for 30 heart bypasses - could be saved by avoiding operations shown to be unnecessary.

Health boards should start buying PET scanners "as soon as they can".

The Auckland District Health Board's clinical director of medical oncology, Dr Richard Sullivan, said New Zealand was falling behind other countries by not providing widespread PET scanning.

The country needed two or three scanners and one machine to produce the radioactive material, he said. 
 

PET (Positron Emission Tomography) scans

* A glucose solution containing a tiny amount of radioactive isotope is injected into the blood.
* Cancer cells "grab" the glucose solution.
* Positrons, sub-atomic particles, are emitted from the isotope and detected by a special camera.
* Using CT scanning technology, this allows tumours to be located and sized.
* Used mainly for cancer and less commonly for cardiology and neurology.