With word that the shutdown of the Chalk River nuclear reactor could be a long one, doctors across Canada are hoarding their dwindling supplies of medical isotopes while preparing for what it will mean for patients when they very shortly run out.
Clinics and hospitals in Saskatchewan are already having to postpone bone scans and other tests because of the shortage. The Saskatoon Health Region says it will have to reschedule about 70 "non-urgent" bone scans for people who had appointments between May 25 and May 29.
Health regions across British Columbia, meanwhile, say they have agreed to share supplies of isotopes so that emergency cases can be given top priority over elective tests.
It's expected that in other parts of the country, tests that require the isotopes will now be prioritized, with only the most vital tests going ahead until the shortage ends.
The problem-plagued reactor at Chalk River, Ont., was shut down May 15 after a power outage in parts of eastern Ontario and western Quebec. A heavy water leak was detected the following day.
Officials said at first that the reactor would be out of service for more than a month while repair options are considered. But last week, an executive with Atomic Energy of Canada said the shutdown could be even longer.
Chalk River's NRU reactor supplies up to half of the world's supply of isotopes used to detect cancer and heart ailments.
Because the isotopes needed for the diagnostic tests has a half life of just 66 hours, supply disruptions like this one have a quick impact. The last of the reserve of isotopes was used up over the weekend. Doctors are now scrambling to arrange supply from the world's four other isotope-producing reactors.
The Chalk River facility makes a third of the world's supply of medical isotopes, such as molybdenum-99, or Mo-99. The isotope is a small quantity of radioactive material that is mixed with different solutions and injected into patients, where they give off energy that is read by special cameras for use in diagnostic tests.
A nuclear medicine scan differs from radiography, ultrasound or other diagnostic tests because it can detect changes in the functions of an organ, not just its physical characteristics. It often identifies abnormalities at very early stages of disease, before other diagnostic tests.
The 52-year-old reactor was closed back in November 2007 after the Canadian Nuclear Safety Commission discovered insufficient emergency services. The shutdown lasted nearly a month and sparked a crisis in the federal government and a worldwide medical shortage.
The NRU is the world's oldest nuclear reactor, as it went online in 1958. France's Areva Group is bidding against Crown-owned AECL and the U.S. firm Westinghouse Electric Co., to build two nuclear reactors in Ontario. The province is expected to award the reactor contract this summer.
Areva, meanwhile, has offered to help the federal government through the NRU shutdown. Areva told Natural Resources Minister Lisa Raitt and Health Minister Leona Aglukkaq its engineers can help AECL repair the reactor, and offered to find European reactors that can make the isotopes.
"Areva is ready to provide all the support that you will deem necessary to reduce the health impact of the current isotope shortage," wrote Armand Laferrere, president of Areva Canada.
"We will, as requested by you, facilitate contacts with European isotope producers. We are also ready to assist technically in the NRU repairs."
