Thank you, Madam Chair.
I thank the distinguished members of this committee for giving me the opportunity, as the President of the Quebec Association of Nuclear Medicine Specialists, to appear before you on behalf of my fellow nuclear medicine specialists.
As soon as we learned that the shutdown of Chalk River would continue, we knew that there would be a crisis, because 18 months ago, we had a problem and we knew that it would happen again.
Last week, I heard a heart-breaking story from a young 21-year-old patient suffering from thyroid cancer. She was plainly terrified by the possibility of not getting her iodine-131 treatment for her cancer. She was also worried about the other patients.
In Canada, there are 5,000 new cases of thyroid cancer, 75% of which are women. The chances of surviving for 10 years, if the cancer is properly treated, are more than 95%. If these patients can no longer access this treatment, what will their future be like? This week, we were supposed to receive some iodine-131 from South Africa for treatment purposes. However, there was a problem and we were not able to use it this week. So our cases must wait until next week. Every day, we have to explain to the patients why tests are delayed and why their treatment is delayed.
It is also a fact that one woman out of nine in Canada will develop breast cancer. Today, to treat these patients, we use a nuclear medicine technique called a sentinel lymph node procedure. This consists of giving injections around the tumour, and when the patient arrives in the operating room one hour later, the surgeon tries to detect whether tumour cells have moved to any lymph node. If so, he removes the node, a pathologist studies it, and if there are no malignant cells, the surgery is minimal. If there is a spread, the treatment will be more extensive, sometimes involving a mastectomy, which is a much more radical procedure. If we can no longer get technetium, we can no longer provide this service to our patients, and the surgeon has to find all the lymph nodes in the area, as many as 10 or 20. This has a terrible impact.
The same happens with melanoma or skin cancer, the incidence of which is rapidly increasing. We treat it with the same technique.
As for diabetes patients, the situation is almost turning into a pandemic. These patients are often prone to heart attacks or heart disease, and 15% of them will spontaneously die of their first attack. The cardiac perfusion tests, as Dr. Ruddy and Dr. Beanlands explained, are preventive tests that we carry out for these patients. We even use them at the pre-operative stage for elderly patients before a serious procedure.
This shows you how these tests are used; they cannot be replaced by any other tests.
Patients are really concerned. On a daily basis, with our technicians and our secretaries, we are in the tragic situation of having to explain to the patients that their treatment will be delayed again and again. Patients need to know the truth about the current situation. The government first has to take appropriate steps to help these patients. A patient does not much care what could happen in 3 years, 5 years, 10 years or even in 18 months. The research projects that are being advertised with full page ads in the papers are not what the patients care about. Nor do we, for that matter. Our concern is more immediate, we have to answer the patients' questions and provide them with the treatments and the care that they need.
In Quebec, as soon as we learned about this problem, we worked together with the Quebec government to develop our response to a potential crisis. We are working very closely with Quebec's Department of Health and Social Services and with the Association of Nuclear Medicine Specialists. We have implemented all the measures mentioned by my colleagues from the Heart Institute. Moreover, Quebec has an advantage over the rest of Canada: we have 15 clinical positron emission tomography scanners in our hospitals. They are accessible to all patients in the province, because they are situated in most regions of Quebec. Let me add that this service involves no costs either for hospitals or for patients. We also extended the hours. It does not matter which hospital has the equipment; patients can access it according to their clinical condition. The hospital where I practise in Montreal does not have a positron emission tomography scanner, but every week, I send about 20 patients to another hospital, either to the Montreal General Hospital or to the Maisonneuve-Rosemont Hospital where they can have access to the technology. I think that it is a pity that other Canadians have no access to these essential and very important services.
In France, cancer is the number one priority. They have 80 PET clinics and they are going to open 40 more, for a total of 120. So the situation in Canada is inexplicable. We have not explained the importance of this technology clearly enough to our decision-makers, a technology that also allows us to conserve technetium and use it for other purposes.
For us, this situation was kind of predictable. We are still asking ourselves, with no answers when our patients ask us, what the government did 18 months ago. We keep asking ourselves the question. We read all kinds of things in the newspapers: that the MAPLE reactors are operational, that they are fine. As recently as today, our patients could read that in the Globe and Mail and then they ask us the questions. My answer is that I do not have the expertise to answer. But the government has to be able to answer. They want to know how come they do not have access to technetium when there are people falling all over themselves to publish full pages in newspapers saying that everything is working. I do not have this expertise, and the people do not trust what the government says. The government says that it wants an independent international committee of experts to answer this question.
As to the number of PET tests done in Quebec, it currently stands at about 30,000 per year. So, as Dr. Urbain said about the forecast of 120,000, this might be more or less equivalent to what is likely done everywhere.
We also use sodium fluoride, which we get from the University of Sherbrooke, for the same purposes.
In Quebec, therefore, we fully support the Canadian association's assessment, and we are ready to cooperate along the same lines.
Thank you, Madam Chair.