Natural Resources Committee on June 2nd, 2009

[Serge Dupont]

On the NRU, AECL issued a release just this afternoon indicating that it can provide an update on its work. I don't have the text in front of me, but it's saying it's going to be at least three months. At this time, no further guidance can be provided.

I now have the text in front of me, Mr. Chair, and copies could be made and we could circulate them to the committee.

So as we stand, the timeframe is still at least three months, and there's no further indication of that.

You are quite right, there's no getting around the fact that there will be some periods where there will be some shortage of supply, even with the higher production at Petten. It depends on the others. The Belgian reactor will be coming on stream as well during this period to help alleviate the shortage. But as I mentioned, Mr. Chair, it is going to be how these different schedules relate over the next little while as the NRU is under maintenance.

[Geoff Regan, Liberal, Halifax West, NS]

Yesterday the Minister of Health talked about alternatives, including saying provincial governments and so forth were developing other measures to minimize impact, including alternate isotopes such as thallium. But as I understand it from talking to some of the doctors, the thallium technology, which is 20 years old, is not nearly as useful or as good for most procedures. The benefit of nuclear medicine is it allows the doctors to see how the organs are functioning. With thallium they can get a little bit of an idea but not nearly as good as with normal nuclear isotopes. Is that right?

[Meena Ballantyne]

Mr. Chair, there's consensus in the medical community that Tc-99m is the best there is, and there is no single alternative isotope to Tc-99m.

For cardiac, we have all been working on this issue since December 2007 in the medical community and with the provinces and territories. They have come to the consensus that thallium is a viable alternative for cardiac imaging. It can be used. It's approved. It requires the same cameras as they use with Tc-99m. They're coping by using those. That's part of their contingency planning, to use that as an alternative. It's not perfect, but it is a very viable alternative for the short term.

[The Chair, Conservative, Leon Benoit]

Thank you, Mr. Regan, for your questions, and to you for the answers.

We go now to the Bloc Québécois, Madame Brunelle, for up to seven minutes.

[Paule Brunelle, Bloc, Trois-Rivières, QC]

Thank you, Mr. Chair.

Thank you, madam; thank you, gentlemen.

Mr. Dupont, your presentation makes me even more worried. You say that there are 250 research reactors in the world and that five of them account for 95% of the production. The NRU is one of the biggest, producing 40% of the world's supply. You say that one of the proposals involves the nuclear reactor at McMaster, which is 50 years old. We do not know for how long it can supply us with isotopes.

My question is quite simple. At the moment, is there a reactor producing isotopes anywhere in the world that can, or that could, in the very near future, take the place of the CRL?

[Serge Dupont]

That all depends on how the different countries use their research reactors. The only reactor whose production could be significantly increased at the moment—though perhaps not to the level of our reactor—is the one in Australia. But not in the short term.

In the short term, the most Australia can produce is about a quarter of the capacity of our reactor. By spending more money on it, over several years, Australia could increase that by two or three times. At that point, the increase would start to be significant.

The reactor that is now being built in France could also have significant production capacity around 2015. However, the operator of the reactor, the Commissariat à l'énergie atomique, also has other uses in mind. It was designed for purposes other than just producing molybdenum.

Elsewhere, there are no other reactors designed solely to produce medical isotopes. It would probably not be economic to operate on that basis.

So the short answer is no. There are others that might, over five to seven years, be able to combine to reach more or less the level of production of our reactor.

[Paule Brunelle, Bloc, Trois-Rivières, QC]

So you are telling us that Australia and France might get to that level, but it depends on their willingness to jump into isotope production, if I understand you correctly. Are those issues that Canada could negotiate internationally?

[Serge Dupont]

The dialogue that is going on in the Nuclear Energy Agency, and now in a new group that has been established to deal with this matter, is going to look at the short term as a priority and, in the long term, will make sure that there are no systemic obstacles to finding a new source of supply. All the constraints need to be assessed, whether they be economic or related to transportation. The constraints must absolutely be removed so that the projects can come to fruition. That will certainly be the case in North America.

It is interesting to note that the United States, that uses almost half of the world's medical isotopes, has no production capability at the moment. They make generators, but they do not use any of their reactors for the production of medical isotopes. That is also something that we will bring up.

[Paule Brunelle, Bloc, Trois-Rivières, QC]

How do we explain the fact that, with the government aware for 18 months that the NRU reactor was experiencing serious difficulties and was undergoing technical problems and shutdowns, nothing has been done...? There was a five-stage action plan, but it is not very far along. The answer we get is that the government is going to privatize AECL. How is the privatization of AECL going to provide medical isotopes for our hospitals?

[Serge Dupont]

I think that the minister was clear on that last week, but you can ask her yourself when she comes to see you. The restructuring of Atomic Energy of Canada was not proposed as a solution to the medical isotope situation, but as a response to other imperatives.

As to the question of the last 18 months, once the failure of the MAPLE reactors was clear, in May 2008, the only way to ensure the supply of medical isotopes for the foreseeable future was to begin work on the NRU reactor in order that its licence could be extended. Money was made available to Atomic Energy of Canada for the purpose, and work was begun with the Canadian Nuclear Safety Commission.

At the moment, we are faced with an operational problem, a leak clearly requiring major repairs. That means that the commitment that we have already begun in an attempt to see what is possible internationally becomes very important. Of course, we have to look at more long-term solutions. That is all being done in parallel with the work on the NRU reactor: the world supply in the broadest sense and the consideration of longer-term solutions.

[Paule Brunelle, Bloc, Trois-Rivières, QC]

Are there international discussions? Can memorandums of understanding be signed or negotiated? Could it have been done sooner? The situation has been known for 18 months, after all. Could we have moved more quickly, or would that all have been useless because Canada is too big a producer, with 40% of the world's production? Perhaps it cannot be done elsewhere and we will have to do research and come up with alternative solutions before we can proceed. We cannot get what does not exist anywhere else.

[Serge Dupont]

International discussions began well before now, I feel, well before the last service interruption in our reactor. In fact, the first discussions, in a major forum at the Nuclear Energy Agency, took place when the Dutch reactor was shut down and our reactor was filling the global demand.

At that time, there was a realization that effort was needed to better organize the schedules of the various reactors for better coordination of the supply, and also to come to an international agreement to remove obstacles anywhere in the market to new forms of medium- and long-term supply.

[The Chair, Conservative, Leon Benoit]

Merci, Madame Brunelle. Your time is up.

Mr. Cullen, for up to seven minutes. Go ahead, please.

[Nathan Cullen, NDP, Skeena—Bulkley Valley, BC]

Thank you, Chair, and thank you to our guests.

I want to take us back to 2007. Mr. Dupont, in 2007, when Chalk River first went down, how many of the world's reactors were also out of commission at the time?

[Tom Wallace, Director General, Electricity Resources Branch, Department of Natural Resources]

I believe all of them were operating at the time. The other four were operating, is my understanding. I'd have to go back and check the historical records--

[Nathan Cullen, NDP, Skeena—Bulkley Valley, BC]

It's my recollection as well. So in 2007, when Chalk River went down the first time, the other four reactors around the world were operating and supplying isotopes. What confuses me is that when Chalk River went down in 2007, I can recall the minister and several ministers in the House of Commons saying we need to reopen it, fire Linda Keen, because this is a life and death situation for Canadians.

Advance forward to 2009 and we have four out of four other reactors shut down. Chalk River goes down and the minister strikes a committee to report back to Canadians in the fall, a committee to which she hasn't named anyone yet, and part of their mandate is to assess dangers of delayed action and reaction.

The confusion I have, and I think many Canadians have, in terms of the concern over the surgeries they need and in terms of the diagnoses they need, is that an alternative has been suggested today, again, repeated also in the House, that thallium might make up the shortage.

Ms. Ballantyne, could you tell us what percentage of all the treatments we currently and in the past have used these other isotopes for that can thallium replace?

[Meena Ballantyne]

I'd be happy to, Mr. Chair.

Thallium, as I said, in the cardiovascular heart scans make up about 50% of Tc-99m use. The medical community and the provinces and territories, as part of their contingency planning, have agreed that thallium can be a viable source for most of that 50%.

[Nathan Cullen, NDP, Skeena—Bulkley Valley, BC]

Right. So that's with respect to heart disease and diagnosing heart disease. I want to get over to cancer for a moment and detecting early onset of cancer, which I think you would agree is one of the most critical things that can happen in the life of a cancer patient: they get accurate and early detection of a disease.

What percentage of all the cancer diagnoses can be taken over by thallium?

[Meena Ballantyne]

None. Thallium does not do anything for cancer; it's only for heart disease. But there are other isotopes, such as sodium fluoride for bone scanning, to see how the cancer tumour has grown and if it's spread to the bone.

[Nathan Cullen, NDP, Skeena—Bulkley Valley, BC]

What are our current supplies of these other alternatives for Canadian hospitals right now?

[Meena Ballantyne]

Right now, thallium is available—

[Nathan Cullen, NDP, Skeena—Bulkley Valley, BC]

Sorry, the other ones, in terms of cancer.

[Meena Ballantyne]

For cancer, we have provided regulatory approval for patients and doctors in the provinces and territories to use those through our clinical trial applications.

[Nathan Cullen, NDP, Skeena—Bulkley Valley, BC]

Let me be more specific. I'm trying to understand right now, on the shelves in our hospitals and cancer treatment centres, what's the supply of alternatives for the isotope?

[Meena Ballantyne]

My understanding is that there is not an issue, there's not a shortage of supply of sodium fluoride. We'll go back and check and I can confirm with the committee. This is a practice of medicine. It depends on the patient, it depends on the facility, whether they have access to PET scanners or not. All those decisions are being taken by the doctors who are working extremely hard to make sure the patients' needs are met.