OTTAWA — The global medical isotope shortage, prompted by the shutdown of Canada’s main nuclear reactor, has dragged on for more than a year now but, rather than dwelling on the difficulties, some nuclear-medicine experts are concerned about the future, and the direction the federal government is taking Canada on the isotope file.
The National Research Universal reactor in Chalk River, Ont., which produces 30 to 40 per cent of the global supply of the most commonly used isotope, was shut down in May 2009 because of a leak. The complex repairs to the 50-year-old reactor are expected to be complete by midsummer — and it can’t come back online soon enough for health-care professionals.
For the past year, they’ve been using alternative medical procedures and juggling appointments for patients, trying to keep waiting lists short. Isotopes, which are used in diagnostic imaging and in cancer treatments, must be used within hours of arriving at a facility because of the radioactive material they contain.
Canada has been relying on imports from the handful of other countries that have reactors, and that’s meant an unsteady supply chain that can easily be disrupted, say by a volcanic ash cloud that wreaks havoc on air transportation.
Dr. Doug Abrams, head of the Canadian Society of Nuclear Medicine, said his field is used to occasional supply disruptions but has never dealt with an extended shortage like this before.
“I think the people on the ground have done a wonderful job,” he said.
The burden of an isotope shortage falls heaviest on the provinces, who deliver health-care, and the frontline workers, but Health Canada was useful in co-ordinating the sharing of information about supplies between jurisdictions, for example, and providing regular updates, said Abrams.
In the coming months, there will likely be quarrels over financial compensation. The federal government is responsible for securing a stable isotope supply for the provinces, and in the absence of that supply, the provinces have had to dig deep in their pockets to cover the costs of importing them, and the increased cost of the isotopes themselves.
Prices jumped worldwide because of the limited supply and they are expected to continue to climb for the foreseeable future.
What the future holds is a cause of some concern to Abrams and others, including Dr. Eric Turcotte, a nuclear-medicine specialist who heads the Molecular Imaging Centre of Sherbrooke in Quebec.
Turcotte was a member of the expert panel appointed by the federal government exactly one year ago this week to advise it on the best options for assuring the country of a stable supply of isotopes.
“I think that the government did a good job in the short-term to help the crisis,” Turcotte said. “My concern is more in the medium and long-term. Are we going in a good direction?”
Building a new reactor to replace the current aging one, which will likely be shut down for good in 2016, was considered the best option by the panel.
The government, however, isn’t going that route and recently announced that $35 million is up for grabs over the next two years for companies developing new sources of isotopes that don’t involve a nuclear reactor.
“All members of the panel were a bit disappointed with the decision of the government,” said Turcotte.
The panel does support developing new technologies, but not to be the primary source of isotopes, he said.
Canada did build replacements for the reactor in Chalk River, but those reactors sit idle because of a string of technical and other problems. They were never licensed to operate and the project was scrapped for good in 2008 by Prime Minister Stephen Harper.
“Canada has some of the greatest minds in the world and we are giving them the tools they need to diversify our sources of medical isotopes and reduce the production of radioactive waste,” Natural Resources Minister Christian Paradis said in a statement to Canwest News Service explaining the government’s decision.
“Simply replacing the NRU would not develop the diversity and redundancy that the panel believed were necessary for security of supply.”
Paradis said the estimated $1 billion cost of a new reactor would be an “irresponsible” investment.
So now, millions of dollars will go into developing what are known as accelerator technologies. Turcotte is worried that after a year or two of work they may not prove to be commercially viable sources of isotopes and Canada will be back at Square 1 with no solid plan for isotope production post-2016.
The Harper government has said it wants out of the reactor business but if there was a change of heart, or, a change in government and a subsequent policy reversal, a new reactor would take at least five years to build.
“We are going against the clock. . . . We don’t have any time to waste,” said Turcotte.
Abrams, head of the nuclear medicine field in Canada, said there is “a lot of controversy” over the government’s approach and focusing on the new technologies only is running a risk.
“If these don’t prove feasible, we haven’t moved any further in any other direction,” he said.
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