Mr. Chairman, members of the committee, on behalf of the Canadian Association of Nuclear Medicine, I would first like to thank you all for giving our organization the opportunity to appear before you to discuss the scarcity of medical isotopes.
It is with mixed feelings and emotions that Dr. Peter Hollet, seated to my right, and I are here before you today as the spokespersons for Canada's doctors specialized in nuclear medicine. I have been working in the field of nuclear medicine for a little more than 30 years. I consider myself to be very privileged for having had this opportunity to practise my specialty for just over 20 years in Belgium, in the United States and, for nearly 6 years, in Canada. During all these years, my colleagues and I practised our profession knowing that we would have the best possible isotopes available to us in order to carry out our diagnoses and treat the patients referred to us every day. This feeling was based primarily on the fact that we knew that Canada had developed a nuclear energy and medical isotope production program unparalleled in the world and that it was in fact the envy of the world.
Since the first dramatic shutdown of the NRU reactor in December of 2007, our association, in cooperation with numerous colleagues, has worked relentlessly to mitigate the effects of the isotope shortage on the well-being of Canadians, and, it must be said, to try to save Canada's credibility on the international scene.
In May of 2008, the working group established by the Ministry of Health, of which we were a part, submitted to the Minister of Health a report detailing the sequence of events of December of 2007, outlining the impact of the reactor shutdown on health care and the weaknesses of the current systems, and, in addition, made recommendations that were both general and specific to prevent any reoccurrence of this type of situation.
We emphasized two basic issues in this report. First of all, we discussed the need to secure a made-in-Canada solution for the supply of isotopes, particularly molybdenum-99 and technetium-99m, by expeditiously commissioning the Maple I and II reactors.
Secondly, we discussed the need to develop and market alternative medical isotopes, particularly positron-emitting isotopes, which can be detected through positron emission tomography, which could partially alleviate the shortage of reactor-produced isotopes.
Over the past 18 months, our community has witnessed five to six significant fluctuations in technetium-99m delivery, forcing us to change drastically our patients' scheduling and our practice, and to reschedule patient examinations. We knew that any further prolonged shortage of isotope procurement would have a dramatic effect on our ability to provide services to our patients.
The announcement last month of the prolonged shutdown of the NRU reactors is a real catastrophe for the two million nuclear medicine patients in Canada, and also for the credibility of Canadian nuclear technology and industry. The chronic and acute shortage of medical isotopes is neither a funny nor sexy story. It is a real drama that we and our patients have to live with on a daily basis.
As physicians, we must practise medical, and not political, correctness. We must provide the very best diagnostic tests and treatments for our patients in Canada and across the world, and we are obligated to be truthful to our patients and ourselves. Our association has never shied away from its mission, responsibilities, or duties. And while we have worked relentlessly with Health Canada to try to mitigate as much as possible this new and prolonged crisis, we have expressed to the government, to our patients, and to the media our grave concern regarding our ability to delivery optimal diagnostic tests and therapeutic procedures. Unfortunately, our concerns have not really been taken seriously, and have even been qualified as ridiculous.
In reality, the current crisis is forcing us to use 20th century medical isotopes, diagnostics, and therapeutics, which are far from ideal. For example, we have used thallium chloride to replace technetium-99m-labeled cardiac tracer in order to make the diagnosis of cardiac disease. Thallium was one of the first isotopes that we used routinely in nuclear medicine in the seventies and eighties. While it represents a short-term alternative, thallium does not have ideal imaging characteristics. It requires drastic changes in patient scheduling and increases by a factor of 1.5 to 2 the radiation exposure of patients. We also have had to replace some of our nuclear medicine tests with radiology procedures that do not provide information on the function of the organs.
I mentioned earlier that I've been privileged to practise nuclear medicine in Europe and the United States. Positron emission tomography, what we also call PET, uses medical isotopes that characterize extremely well the physiology and pathophysiology of the human body, cardiac diseases, and most the cancers and neurological conditions, like Alzheimer's disease. PET education and training was an integral part of my education in Belgium in the eighties. And in 1990, based on the overwhelming evidence of its usefulness for the conditions I mentioned above, the Belgian government decided to provide access to this technology to its ten million citizens at no cost.
Some of the nuclear medicine tests that use technetium-99m can be replaced with the PET procedure. Should Canada have authorized the physicians and scientists to develop and implement this technology in the nineties and at the beginning of this century, we would now be able to provide a 21st century diagnostic tool to all Canadians. To our community, it is inconceivable that Canadians must go to China, Singapore, India, Australia, Kuwait, Europe, South America, and the United States to have unrestricted access to this proven technology and receive adequate treatment with state-of-the-art isotopes. In the eyes of our international colleagues, nuclear medicine in Canada is falling into a third, if not a fourth, world practice.
The absence of PET technology has already taken its toll on Canadians. I must say that I've never seen as many advanced cancers in my career as over the past six years of practice in Canada. Also, it is the first time in my career that I have been.... [Technical Difficulty]