Canadians concerned about the state of their health are increasingly turning to what is considered the cutting edge in diagnostic testing \u2014 the PET scan \u2014 even though they probably will be paying for the expensive test out of their own pockets.
PET stands for \u201cpositron emission tomography,\u201d and the scans are used for early detection and measurement of cancers, heart disease and neurological disorders relating to epilepsy and Alzheimer\u2019s, Huntington\u2019s and Parkinson\u2019s. PET scans can often detect cancers and other problems before they are evident through other tests, and can give physicians valuable information that can be used to decide on appropriate treatments. PET scans, which take about two hours to perform, often can spare patients painful, invasive tests and exploratory surgeries, and can determine the extent of a disease or whether cancer has spread to other parts of the body after treatment. The scan is able to inspect most organs of the body in a single examination, replacing multiple tests.
\u201cThe PET scan is the gold standard for cancer detection and staging,\u201d says Zoltan Nagy, Vancouver-based director of the Canadian Medical Clinics Association.<\/b> \u201cIt is particularly valuable in evaluating cancer of the colon, rectum and breast, and lymphoma and melanoma.\u201d
Despite the benefits of PET scans, Nagy says, Canada is \u201clight years\u201d behind other countries in availability. British Columbia and Quebec are the only provinces in which patients can obtain financial assistance through provincial health programs to pay for the scans, although there are usually long waiting lists in the public system. In Ontario, the government is conducting a clinical trial program on the efficacy of PET scans; availability is restricted to patients with relatively advanced cancers of specific types, including lung, melanoma, lymphoma, colorectal and breast. There are long lineups for the few publicly accessible machines. In the other provinces, PET scans aren\u2019t available, although people are traveling to out-of-province clinics for the scans.
There are four private PET scan clinics in Canada \u2014 one in Vancouver, another in Mississauga, Ont., and two in Montreal. Rather than navigating the public health system, many Canadians are taking their health care into their own hands by paying the $2,300-$3,000 cost of a scan at a private clinic. They may receive tax credits when they file their income tax returns, as the scan is an eligible expense for the medical tax credit, and those fortunate enough to have a generous private health-care plan may be reimbursed. Most private clinics require a doctor\u2019s referral before they will scan a patient.
Snowbirds who winter abroad frequently obtain PET scans in states such as Florida, Arizona or Texas, says Grant Fairley, marketing director of VIP Docs Inc.<\/b> of Burlington, Ont. VIP Docs helps Canadians connect with doctors and other suppliers of private health care, both inside and outside Canada. Fairley says demand for PET scans has increased every year since the company opened in 1999, but adds that many doctors in Canada are still not familiar with the scan, even though it\u2019s widely used in the U.S. and Europe.
There are more than 750 PET scanners in use internationally, with most of these in the U.S., where about one million PET scans are performed annually. For the cost of a vacation, Canadians usually can obtain a scan at a private clinic within 48 hours in Canada or the U.S., and get results within one or two days, Fairley says. Once they know the nature and severity of their disease, they can make informed decisions on treatment.
\u201cIdeally, I would like to see Canadians accessing treatments through the health-care system, but there is a severe shortage of \u2018doctor minutes\u2019 available in this country,\u201d Fairley says. \u201cA Canadian who pays to go to a private clinic in the U.S. or Canada is making room for someone else in Canada\u2019s public health care system, so it\u2019s win-win.\u201d
In many cases, Canadian doctors fail to inform patients about the technology, says Brian Moss, who is in charge of sales and marketing at CareImaging<\/b>, a private clinic in Mississauga that offers PET scans. He says the Ontario government is creating life-threatening delays with its research trials and inefficiencies with its narrow definition of who currently qualifies for the scans. Some observers speculate the lengthy clinical trials could be a stalling tactic to avoid investing in the costly technology.
@page_break@\u201cA lot of people could benefit, but they don\u2019t meet the strict criteria the government has established to obtain a scan in this province,\u201d says Moss. \u201cWe are prevented from advertising to let people know the scans are available on a private basis, even though world data shows PET scans are standard procedure for cancer patients in the U.S. There have been cases in which U.S. doctors have been sued for malpractice for failure to recommend a PET scan.\u201d
David Olinoski, president of CareImaging, says the PET scan is more diagnostically accurate than magnetic resonance imaging (MRI), CAT scans or ultrasound tests, which can detect an unusual mass but can\u2019t tell if a tumour is malignant or growing, except by obtaining another image at a later stage and comparing the dimensions of the mass. A PET scan can measure metabolic activity, and can uncover abnormalities in organ and tissue function, as well as in blood flow.
The patient is injected intravenously with a small amount of sugar water containing radioactive material. The sugar is distributed by the blood throughout the body, and the PET scanner records signals emitted from diseased sites, which consume the sugar at an abnormal rate. A computer reconstructs the signals into three-dimensional pictures of the body and then a nuclear medicine physician analyses the image. Physicians then can decide on the next stage of treatment.
Olinoski says 65% of patients receiving PET scans in the U.S. have had their treatment adjusted according to the data revealed by the scan. He does not expect PET scans to be financed by Ontario\u2019s health system until at least 2011. By then, he says, there will have been many unnecessary deaths. \tIE<\/b>
Finding VIP care in North America<\/b>
VIP Docs Inc. is a service that helps Canadians find doctors and services outside the provincial health-care system, either in Canada or internationally.
\u201cThere is a finite number of doctor minutes available in any city, state or country, and doctor minutes are the most valuable commodity in health care,\u201d says Grant Fairley, marketing director of VIP Docs, which has offices in Burlington and Windsor, Ont., and helps individuals and firms find solutions to health-care needs.
He says the PET scan is most commonly sought out by people with cancer \u201cwho want to find out what\u2019s going on right away.\u201d VIP also helps people looking for other services, such as elective hip or knee replacements, and can help them avoid lengthy waits in the public system \u2014 if they are willing to pay for private care.
For those who want a PET scan immediately but don\u2019t have the cash handy, the funds often can be borrowed. Toronto-based Medicard Finance Inc. offers unsecured loans for medical, dental and veterinary procedures and products, with interest rates starting at 9.95%, depending on the applicant\u2019s credit rating.
Medicard president Ann Kaplan says demand for diagnostic procedures such as PET scans is growing at a rate of about 10% a year. Loan applications can be submitted online and approved in 20 minutes, she says. <\/b>
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