St James buys €2m scanner to improve cancer therapy

Doctors can now get a detailed picture of patients' tumours through an expensive scanner bought by a private hospital, which can lead to more specific treatment.

Some 20 patients have already used the €2 million scanner called Positron Emission Tomography/Computed Tomography - which shows how tissues are functioning, something not visible on other equipment - over the past three weeks.

The cost of the machine is only part of the major investment by Saint James Hospital. Nuclear medical doctor Mark Anthony Aquilina explained that a special chemical, called a tracer, has to be injected in patients undergoing a scan.

However, these tracers have a shelf life of just a few hours and start deteriorating quickly. The choice is to either produce the chemical in Malta or obtain it from abroad every time a patient requires a scan. The chemical has to be produced in a cyclotron by specialised experts.

The hospital has therefore decided to bring the tracers from Rome every time they are needed.

Dr Aquilina, who has seen thousands of PET scans in more than five years of service at Milan's San Raffaele Hospital, said the ensuring these chemicals arrived on time was a logistical nightmare.

"Everything has to work like clockwork. The tracer is produced at 8.30 a.m. and arrives at Rome's airport at around 11 a.m. We then have to hope there are no delays," he said.

In the meantime, the patient would be waiting at hospital. As soon as the tracer arrives, a 10-minute full body scan is carried out.

Dr Aquilina said because the whole body was scanned, doctors could see whether the cancer had spread. Moreover, the scan would also show how a patient was responding to treatment, possibly leading to a change in therapy.

"We do not solely see a lesion but we can say what it is and whether there are still live cancer cells," he said, adding any changes could be detected early on.

"We can see whether there are cancers in normal-looking cells," he said.

Dr Aquilina said he was conducting a study comparing conventional imaging to PET/CT in the same patient to see how the latter changed the management of the patient. It is estimated that two-thirds of patients diagnosed with cancer require such a scan and the hospital calculates it will be doing some five or six scans a week.

According to statistics from the National Cancer Registry, there were more than 7,000 new cases of cancer between 1996 and 2006.

Although the Nationalist Party had promised PET scan services in its electoral manifesto, Saint James's scanner is the first on the island. And with a price tag of almost €1,700 for each scan, it does not come cheap for patients, although those who have health insurance are covered.

Asked whether there had been any talks with the government about the possibility of using the private hospital's scanner, Saint James head Josie Muscat said there had been "very initial communication".

Contacted yesterday, Stephen Brincat, Boffa Hospital's Oncology Department chairman, said the scanner was a very useful facility and an important tool of investigation, which not only looked at the spread of a cancer but also at how it was responding to treatment. It could therefore also avoid unnecessary treatment.

"If we have a patient with lung cancer and we see it has spread, unnecessary surgery can be avoided," he said.

The PET/CT can also be used for cardiology, neurology and inflammatory pathologies, such as Alzheimer's and Parkinson's disease.

Speaking during the scanner's inauguration last night, Health Parliamentary Secretary Joe Cassar praised the commitment of the private hospital to invest in state-of-the-art technology.

"Investing in the latest technology sends a message that the country is striving towards becoming a centre of excellence in medical treatment; and we as a government believe the private sector has a complementary role in achieving this goal," he said.