Action plan for medical isotopes needed

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The Article

The NRU nuclear reactor at Chalk River in eastern Ontario is really quite remarkable. It’s the world’s oldest nuclear reactor (commissioned in 1957) and its largest supplier of medical isotopes, producing 50 per cent of the radioactive materials needed for nuclear medicine procedures. Over 52 years, the NRU’s record of service is, apparently, excellent.

All of this proves a key point—when it comes to atomic science, Canadian technology rules.

But with every shutdown, leak and repair, that legacy is faltering. Last week, the NRU was shut down after it was found to be leaking radioactive water. The official line is that it won’t be producing isotopes for “more than a month,” but the reality is it may take that long just to determine the problem. Some experts estimate it could take eight months to make the repairs. Others say this may be the end of the road for the reactor.

The shutdown threatens the approximately 5,000 medical procedures performed each day on Canadians, and the president of the Canadian Association of Nuclear Medicine estimates 80 per cent of patients will have their diagnoses and treatments rescheduled or cancelled.

In Alberta, the shortages will first impact smaller centres like Medicine Hat and Lethbridge. Acute cancer and heart patients may have to travel to Edmonton or Calgary for treatment, thereby creating further delays for patients in those centres and more inconvenience for those who are already ill.

We’ve been here before: Just five months ago, another radioactive leak forced a shutdown. Around 18 months ago, there was a lengthy (and unexpected) shutdown that resulted in a critical shortage of isotopes and negatively affected the health care of tens of thousands of patients in North America. These events made the term “medical isotope” a household name in Canada.

So why are we here again? We saw how fragile the system was and identified the need to have a contingency plan to ensure medical treatments can continue during a short-term shutdown.

Yet, here we are—no isotopes, no guarantee of isotopes from other producers and no long-term contingency plans. It defies common sense.

The former long-term plan went up in smoke. Two reactors (Maple 1 and Maple 2) were built in 1996 and were expected to replace the NRU by 2000. Eight years later, they still weren’t ready. They were $500 million over budget and had a worrisome flaw—they didn’t work. In May, 2008, the government put the reactors out of their misery. So much for Plan B.

No wonder the U. S. is currently investigating a way to secure its own isotope supply. A reactor at the University of Missouri could be producing isotopes within two years. If they agree to sell isotopes to Canada, the price tag will be steep and the costs of medical procedures could skyrocket.

Canadians who require these materials are likely becoming quite fearful about the present and future of cancer diagnoses and treatments. They don’t want to see an inactive or indifferent government that isn’t making headway to a solution. And no Canadian wants a solution that raises the costs of isotopes and treatments, thereby forcing our already overburdened health-care system to pay for our government’s lack of foresight in the area of nuclear technology.

It’s time to think outside of the box. The Task Force on Alternatives for Medical Isotope Production recently suggested it may be possible to create radioisotopes with a linear accelerator.

Accelerators would cost between $50 million to $125 million each and could be built and functional in three to four years (compared to about $5 billion and five or more years for a reactor). They would utilize natural or depleted uranium that is better for the environment, and doesn’t pose a safety or security risk to the public. It’s estimated that six accelerators would be needed to maintain Canada’s current capacity.

More work is required before this technology can became a reality, but the unique approach is more evidence that Canada can be/still is a world leader in nuclear medicine and technology. The demand for nuclear medicine is only going to increase over time and, without a reliable source of isotopes, Canada is already at risk of losing its leadership role. It’s time for Canadians to demand the government produce a plan of action—and the cash to back it up.

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Joel Johannesen
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