that is dedicated to achieve that mission. It is to bring to Canadians the best technology there is for the early detection of cancer, its recurrence and spread.
Some years ago, Denis Tusar, whose Estonian family came to Canada in 1951, tried to help save the life of a young niece in Estonia who had cancer. Tragically she died because of the unavailability of a needed procedure. This started him on a quest to find out more about what can be done for cancer patients.
"Early detection is vital in the successful treatment of cancer patients," said Tusar. "Surgery, radiation therapy and chemotherapy can all be useless if it's too late and the cancer has taken hold." Tusar found that Canadian cancer doctors rely on CT scans, MRI scans and other imaging procedures - all of them some form of structural imaging - to look for cancer. He also found that these methods are generally from 50 - 70 percent accurate - which means they are wrong from 30 - 50 percent of the time, depending on the type of cancer. They are not good at finding out if cancer has spread to another organ or region of the body. That information is key to successful treatment.
Then Tusar found out about positron emission tomography (PET) scans. Unlike the other scans, which look at the anatomy of the body and try to detect structural abnormalities, PET scans study the disease itself in the suspect area and the whole body. It is up to 35% more accurate in detecting a problem and diagnosing that problem than the structural types of scans.
Tusar also found out that PET scans were not available in Canada. By the late 1990's there were hundreds of PET scanners in the world - most of them in the United States, Europe and Japan- being used for clinical diagnosis of cancer. Although there were two or three PET scanners in Canada, they were being used exclusively for research, and were unsuitable for use in everyday clinical diagnostics. Tusar talked to health authorities and politicians, but no one was interested. Except, that is, for Dr. Simon Sutcliffe, head of the BC Cancer Agency, who said he would support anyone who brought PET scanning to BC.
So Tusar gathered a team around him, formed the IPET company and started the process of designing, equipping, opening and operating the PETSCAN Centre on the University of British Columbia campus - the first and still the only dedicated clinical diagnostic PET facility in Canada for cancer patients. The Centre has now been open for two years and has done close to 1000 scans. In about 50% of the cases, the decision on treatment of the patient - radiation or chemotherapy or surgery - has changed, as a result of the PET scan, and in virtually every case the scan has provided some valuable new information.
What is it about PET scans that make them so different and so good? They work on "functional imaging", a completely different principle than other imaging technologies. It has been known for decades that cancer is a disease that will feed voraciously on glucose. FDG is glucose, labeled with a radioisotope or tracer. FDG injected into the bloodstream will go to and
collect at the site where the disease is active, or "functioning". The concentration of radioactivity is digitized and turned into images of the patient’s body, with the disease site showing up as a "hot" spot. An expert nuclear medicine physician can interpret the images and describe the location, nature and extent of the disease.
Advantages PET scans have are that, apart from the simple injection they are non-invasive (unlike biopsies), they are safe, there are no side effects, and they provide unique accurate information. Futile therapy and ill - advised surgery can be avoided.
The business is of course challenging. PET scans are " outside the system"- that is, no province has yet made PET part of the health care system covered by the provincial health insurance plan (MSP in BC and OHIP in Ontario). Despite its obvious value in the management of cancer patients, no province has yet designated PET scans as medically necessary, which would force them to cover the cost. So, as with many other valuable procedures, the patient has to pay. As already mentioned, the equipment and the FDG are expensive. IPET charges $2,500 for a full body scan, which is at least $1,000 less than the cost of a PET scan at a US hospital.
There is also active dialogue with the respective provincial Ministries of Health that will, in due course lead to coverage by the health insurance
plans.
So Denis Tusar has made a difference. The BC Cancer Agency doctors and surgeons have access to the best technology for their patients. Having proven that it's a viable business Tusar's next step is to bring PET scans
to Toronto and Montreal. The Princess Margaret Hospital in Toronto has an international reputation as a cancer treatment hospital. It is time it had access to the technology its counterpart hospitals in Vancouver, the USA and Europe have.