Cancer patients may face longer delays in treatment if Alberta doesn't build Calgary cyclotron, advocates warn

With construction of the Calgary Cancer Centre well underway, some health advocates say building a cyclotron — to produce radioactive substances used in cancer scans — should move up the government's priority list.

Calgary relies on Edmonton's cyclotron for the medical isotopes used during PET-CT scans, which allow doctors to detect and monitor cancer. But outages and an inconsistent supply have led to testing delays and there are concerns Edmonton's facility won't be able to keep up with growing demand.

Alberta Health Services has had a plan on the books for years to build a facility at the Foothills Medical Centre site. Now, the project is once again on the list of major projects it would like funded by the provincial government.

A 2014 business plan pegged the cost to build one at $36.3 million with yearly operating costs ranging from $5.7 million to $6.8 million. At the time the report was written, the cyclotron was expected to be partially operational by 2019-2020.

"It's very concerning," said Rick Lundy, founder of Open Arms Patient Advocacy Society. He worries the project may eventually drop off the priority list altogether.

"Things that are important, we're putting on the backburner."

He wonders why the province is building a brand new cancer centre but has yet to commit funding to build a facility that would improve access to the potentially life-saving scans.

"Edmonton has one ... and we should have one as well. I think when it comes down to the patient experience, you're going to have a lot of patients upset about this."

'It's long overdue'

According to the Canadian Cancer Society, an estimated 17,000 Albertans were diagnosed with cancer in 2015. Current projections show that number will increase by 66 per cent, to 28,140 diagnoses, by 2030.

"The need is huge," said John Osler, with Concerned Citizens for the Calgary Cancer Centre, which held rallies to get the cancer centre built.

Osler is grateful the long-awaited cancer centre is under construction but says that with the number of cancer patients growing every year, Calgary needs a cyclotron now more than ever.

"This is cutting-edge technology that cancer patients need. And, like a lot of things in the world of cancer patients, it's long overdue."

More scans, fewer delays

In a statement emailed to CBC News, Dr. Sunil Verma, medical director at the Tom Baker Cancer Centre, said the cyclotron "would support the needs of the new Calgary Cancer Centre."

The statement said the city is "well served" by the Edmonton cyclotron but building one in Calgary would come with a number of "benefits," including increasing the number of PET-CT scans by 2,100 per year in southern Alberta.

Dr. Christine P. Molnar, a diagnostic radiologist and nuclear medicine specialist and AHS lead in the Calgary zone, is part of a team that's been working for years to get a cyclotron built in Calgary.

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According to Molnar, the $36-million facility would include a cyclotron and a radio pharmacy lab, where those isotopes would be combined with other agents to create radiopharmaceuticals. The radiopharmaceuticals — used predominantly in cancer diagnosis and treatment — are injected into patients prior to scans.  

That entire process is currently done in Edmonton, and the radiopharmaceuticals are shipped to Calgary daily. But that is not ideal because the products decay by half every two hours.

"When the cyclotron in Edmonton breaks down or when it has to have its regular maintenance, which is four weeks of the year ... then we have to try to get that ...radiopharmaceutical from somewhere out of province. We get it right now from Saskatoon. You can imagine how difficult that is with the long travel time," said Molnar.

"We do our best. But obviously it would be a significant patient care improvement for all of Alberta and particularly for southern Alberta if we had the Calgary cyclotron project so that we'd have two medical cyclotrons in Alberta," she said.  

According to Molnar, the two cyclotrons could act as backups for one another, and avoid future disruptions and testing delays. And the Calgary facility would allow doctors to keep up with the projected increase in demand for cancer diagnosis and treatment.

"We will be able to meet that need. Currently, we cannot, with our limited restricted supply," said Molnar. 

"This is an investment in the future."

At this point, Alberta Health is considering the project — along with many others.

In a statement emailed to CBC News, an Alberta Health spokesperson said the government is committed to ensuring "state-of-the-art' cancer services are "in place when they're needed most."

The department has completed pre-budget consultations and is now reviewing various requests, including the Calgary cyclotron.

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