KEY POINTS:
Cancer doctors are pushing for New Zealand to introduce a new kind of x-ray scanning, which they say improves the treatment of patients, saves money, and can help sufferers avoid the stress of unnecessary surgery.
PET (positron emission tomography) scanners, a specialised form of CT scanner, are widely used overseas, but New Zealand patients have only minimal access.
Some consider this another example of New Zealand falling behind Western medical standards.
PET scanning is far more sensitive than CT or MRI scans in detecting cancers. Auckland City Hospital radiation oncologist Associate Professor Graham Stevens, who helped organise a symposium to highlight the need for the scanners in New Zealand, said 30 per cent of patients who had a PET scan had their treatment changed as a direct result.
"In many cases this saves the patient from major surgery that is carried out currently, but which is in fact of no benefit to the patient. This is a tragic situation that is repeated daily in New Zealand hospitals, as PET scans are not readily available in New Zealand."
Up to 200 patients a year are sent to Australia for the scans and a small number are scanned at Pacific Radiology in Wellington, but its capacity is restricted by the need to import the required radioactive isotope for the scans from Australia; the material breaks down rapidly.
Dr Stevens said most of the 4000 to 6000 New Zealand cancer patients a year who might benefit from PET scanning were denied this investigation.
He and colleagues want the public health system to buy a scanner for Auckland and a "cyclotron" machine to produce the isotope, and a second scanner for Wellington or Christchurch - at a cost of about $16 million.
They won support from the Health Ministry's new technology group for one scanner and cyclotron, but this was over-ruled by district health board chief executives.
The chief executives said the benefits did not justify the costs, but their written decision indicates a possible willingness to pay for more of the scans without buying a scanner.
Their spokesman, Murray Georgel, said they would not review their decision for at least two years and wanted rules written quickly on who could have the scans.
The chief executive of private hospital group MercyAscot, Andrew Wong, interpreted the decision as an opening for the private sector. His company is considering buying a PET scanner for the cancer centre it is planning for its Mercy site in Epsom, Auckland.
"We have every intention of establishing a comprehensive cancer centre," he said. "We can't see how we can have one without a PET [scanner]. Currently we are working with our partners as to how this can be achieved. The key at the moment is the cyclotron."
New Zealand could only justify having one cyclotron, whoever owned it, and public-private joint ownership was a possibility.
"There are a number of interested parties looking at how a cyclotron could be funded," he said.
How it works
* PET (positron emission tomography) is a specialised form of CT scanning.
* It is used mainly for cancer patients, but also in cardiology and neurology.
* A glucose solution containing a tiny amount of radioactive isotope is injected into the patient.
* Cancer cells take up the solution and emit sub-atomic positron particles, which are detected by the scanning machine.
