Access to PET scan - Australia


Cancer care treatment warning
Julie Robotham Medical Editor
June 18, 2007

THE care of cancer patients is being compromised by inadequate access to a
more accurate form of cancer scan, specialist doctors say.

Lack of Medicare funding for positron emission tomography (PET) - despite
findings from the federal government's own research that the technique
represents a quantum leap in cancer detection - meant seriously ill North
Shore patients had to travel across Sydney for scans now regarded as
essential, said Chris Arthur, director of area cancer services for
Northern Sydney Central Coast Health.

"We believe it's basic management to have PET scanners," Dr Arthur said.
Travel - to the Royal Prince Alfred or Liverpool hospitals - was "an added
burden for someone who's suffering with cancer," he said.

He added this also made it harder for doctors to plan optimal radiotherapy
treatment without immediate access to computerised scans. These scans have
been formally restricted since 2000, when the government sidestepped an
expert committee's advice that the technology was already proven, and
instead opted for a five-year, Medicare-funded trial limited to just eight
hospitals nationwide.

That trial, which ended last year, found the new scan identifies the
spread of cancer better than existing techniques and, for many people,
changes treatment recommendations.

In bowel cancer, the scan identified additional disease spread in 48 per
cent of patients and altered the course of treatment for two-thirds of
those. It found further metastases in 68 per cent of women with a relapse
of ovarian cancer, according to results presented at the Australian and
New Zealand Society of Nuclear Medicine conference in Adelaide last month.

The scan involves injecting patients with a radioisotope, which is
metabolised differently by cancer cells, allowing them to show up clearly
in three-dimensional images.

Dr Arthur said the Royal North Shore Hospital might consider buying a PET
machine from its own budget. "If we can't get a new machine we might get a
second-hand one," he said. But the hospital would still need funding for
the scans, which cost about $900 each.

Documents obtained under freedom of information laws by a Tasmanian
specialist, Rob Ware, show bureaucrats in 1999 circumvented usual
procedures for allocating Medicare subsidies because of the cost

But funding for an additional scanner - outside trial arrangements - was
announced in September 2004, weeks before the federal election, at
Westmead Hospital. The announcement came just after the local Liberal MP,
Ross Cameron, who later lost his Parramatta seat, admitted being
unfaithful to his wife.

At the time, the federal Health Minister, Tony Abbott, whose Warringah
electorate is served by the Royal North Shore, said the scan was,
"particularly valuable in detecting and diagnosing cancers ? that evade
other forms of diagnostic imaging". Mr Abbott's spokeswoman said at the
weekend there would be no immediate shift on funding.