Tag Archives: Cancer

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Nuclear Technology Brings Hope to Patients

MEDICALISOTOPESSaskatchewan cancer patients have been given a new reason to be hopeful thanks to nuclear technology.

The Royal University Hospital in Saskatoon is now receiving on-site medical isotopes thanks to the Fedoruk Centre, a cyclotron and a funding partnership between the province and the feds.

A cyclotron is a particle accelerator and it uses power to make particles radioactive. When these particles collide isotopes are created.

Medical isotopes are safe radioactive particles used to diagnose health conditions.

In total, the nuclear medicine community relies on a wide suite of medical isotopes. There are approximately 200 isotopes available for use. Each isotope has its own characteristics and the ability to provide doctors with a window into what is happening inside the body.

The isotope used to help detect medical issues such as cancer and Parkinson’s through a positron emission tomography (PET)/computerized tomography (CT) scan (PET-CT).

An isotope known as fluorine-18 is attached to a tracer to make a radiopharmaceutical. It is then injected into the patient where it moves throughout the body depending on the tracer.  In Canada, PET/CT scans use the radiopharmaceutical flurodeoxyglucose (FDG).  Approximately 60 minutes after injection, the scanning part of the procedure begins.

“FDG is a sugar and the sugar is burned up by different parts of the body at different rates,” according to Dr. Neil Alexander, executive director of the Fedoruk Centre. “In nuclear medicine, particularly in diagnostics, if you have a sugar it goes around the body and anything burning up the sugar at a great rate lights up on the scan.  As one example, cancer cells burn up sugar at a greater rate than healthy cells, allowing physicians to detect cancers and see how the disease responds to treatment.”

PET/CT scans provide doctors with vital information on the location and extent of cancer within the body. The test also allows doctors to assess the success of treatments; providing patients with a better chance at survival.

Parkinson’s disease diagnosis and research is one of the newest areas for medical isotopes and PET/CT. Early diagnosis in the case of Parkinson’s is an important step to increasing knowledge on how the disease progresses and responds to therapy.  In the case of Parkinson’s patients the scan is looking for a decrease in proteins used in the synapses, or the junctions between nerve cells, in the brain.

Until the cyclotron started producing isotopes, patients requiring a scan in Saskatchewan needed isotopes flown in from Ontario and because the radioactivity is short-lived, meaning FDG cannot be stored, daily shipments were required. The challenges of early morning production added to air transportation often led to delayed starts and cancellations, providing unreliability for patients in need of medical diagnoses.

“Up until now, all of it was coming in from Hamilton and a lot of the material had decayed so they couldn’t process as many patients,” says Alexander.

Producing locally means more reliable health care for patients, cutting wait times and diagnosing more patients sooner. It also means that Saskatchewan medical researchers have a supply readily available to expand their research programs.

CNA2016

Radioactivity Fighting Cancer

Brachytherapy, or internal radiation, is proving successful in treating certain tumors.

Cancer is very complex. Curing patients without causing side effects means that the treatments must be very targeted.

BrachytherapyMen“Not all cancers are the same,” according to Dr. Michael Milosevic, a radiation oncologist at the Princess Margaret Cancer Center in Toronto. “Cancer is not one diagnosis. Each individual cancer is different.”

For patients diagnosed with cancer, surgery, radiation treatment and drug treatment (chemotherapy) are frequently used. External radiation, a beam targeted to a tumor that travels to the tumor from outside of the patient’s body comprises 80-90% of radiation therapies.

Brachytherapy, on the other hand, involves inserting the radiation into the center of the tumor and irradiating the cancer cells from the inside out.  The treatment has proven successful in fighting prostate and cervical cancers.

“With brachytherapy, you can kill the cancer but spare the normal surrounding areas,” says Milosevic. “The likelihood of curing the cancer goes way up and the side effects way down.”

There are two methods of using Brachytherapy-temporary and permanent implants

Temporary implants use special catheters inserted into the tumor. They connect to a machine to deliver the radiation treatments. A temporary implant is a day procedure. The radiation is delivered over a very short period of time, usually a few minutes, and then the catheters are removed.

BrachytherapyWomenPermanent implants directly insert small radioactive “seeds,” each about the size of a grain of rice, into the tumor. In the case of prostate cancer treatment, about 100 seeds are placed into the prostate gland, usually when the patient is asleep.  The seeds remain in the prostate gland for the remainder of the patient’s life and give off a continuous flow of radiation that is highest immediately after insertion and declines to zero over a few months.

The uses for brachytherapy continue to develop. It has proven useful in treating some breast, head and neck cancers. Perhaps one of the biggest developments, as Dr. Milosevic points out, is the shift to magnetic resonance imaging (MRI). The Princess Margaret Cancer Centre  is home to three MRI units that help to deliver brachytherapy.

“With Brachytherapy you put the radiation in the center of the tumor so you can kill the cancer but spare the normal surrounding areas. The likelihood of curing goes way up and side effects go down.”

CNA2015

Radiopharmaceuticals and Disease Diagnosis

Nuclear medicine, already well-established in cancer diagnostics and treatment, has started to play a role in other diseases, like Alzheimer’s.

Doctors are using medications that contain radioactive materials so they can get an inside look at how your body operates. Patients receive these radiopharmaceuticals by injection, or by inhaling or swallowing the medication.

pharmaceuticalslabRADIO

As oncologist Sandy McEwan explains, “It circulates and binds at the site of the target and then we measure the distribution of the injection in space or time to understand what changes or functions are occurring.”

Dr. McEwan is a professor and chair of the department of oncology at the University of Alberta’s Cross Cancer Institute in Edmonton. He is also a member of the Canadian Nuclear Safety Commission, the independent nuclear regulator.

Dr. McEwan says advances in nuclear medicine are growing thanks to strong and active research and development.

The U.S. Food and Drug Administration (FDA) recently approved the use of radiopharmaceuticals to help evaluate patients for Alzheimer’s disease and dementia.

Advances are also being made in other areas such as cancer behaviours, according to Dr. McEwan.

“Tumors tend to use more glucose or sugar than regular cells,” Dr. McEwan says. “Using radiopharmaceuticals, doctors can measure how much glucose is being used by a tumor. The more sugar used by the cancerous cell, the worse the tumor is.”

These new medicines aren’t just used for diagnoses. Their very nature allows doctors to tailor them to individual patients.

“It’s personalized medicine,” says Dr. McEwan. “The right dose of the right drug, at the right time, for the right patient.”

Nuclear R&D Uncategorized

A Sunny View of Risk

By John Stewart
Director, Policy and Research
Canadian Nuclear Association

Blue-eyed John Stewart
Blue-eyed John Stewart

Like many blue-eyed, middle-aged men who’ve been hiking, cycling, canoeing and kayaking since childhood, I have basal cell carcinoma, in the form of little low-grade cancerous spots on my skin.

Exposure to non-sun radiation is one of the main risk factors. It’s apparently #2 after too much sunshine – and not counting being blue-eyed, middle-aged, and male, none of which I can be expected to avoid, at least not at this point.

So how come the medical advice I get doesn’t say anything about avoiding licensed nuclear facilities? My doctors know what I do for a living, but none of them tell me to stay clear of Chalk River, Blind River, Kincardine, Port Hope, Darlington or Pickering.

Instead, the advice I get from them is 90% about hats, shirts, glasses and sunscreen (fair enough). About 5% is about avoiding tanning beds and sun lamps (no problem). About 3% is about staying in the shade (ha!). And the remaining 2% is about taking vitamin D so I won’t mind sitting in the shade for the rest of my life.

Why nothing about the nuclear industry? Because emissions from nuclear facilities are so low, they don’t matter.

The non-sun radiation sources that health care organizations talk about include anything other than nuclear power plants, including:

  • Cancer treatment itself (radiation to treat a first cancer might cause a second cancer)
  • Naturally occurring radon gas in my basement
  • Weapons testing programs that occurred before I was born.

Why nothing about the nuclear industry? Again: emissions from nuclear facilities are so low, they don’t matter.

CNA Responds Nuclear Energy Nuclear News

Gentilly-2 Movie Makes Fiction Out of Fact

It was reported last week that the recently elected Parti Quebecois intends to shut down Quebec’s reactor, Gentilly-2. Nothing is official until the new government makes it so, but comments from PQ spokesperson, Éric Gamache, have caught some attention.

This has always been the PQ party’s position on Gentilly-2 (G2), so why the stir now?

Timing is everything. A movie called “Gentilly Or Not To Be,” based on a report by the Quebec government’s Agence de la santé et des services sociaux de la Mauricie et du Centre-du-Québec aired last night on Télé-Québec.

The G2 movie uses this report as the basis for their claim that ‘the rate of childhood cancers in the area around the plant is 27% higher than in the rest of Québec.’

To be clear, this is the film maker’s interpretation of the data.

The director of the public health agency that authored the report, physician Gilles W. Grenier, clearly acknowledges the limitations of the municipal data, the very small numbers involved, random variables, the difficulty in interpreting the statistics to determine significance, the need for more detailed study and so on — so the 27% claim is simply not credible.

In fact, according to the CNSC, the Regional Public Health Directorate confirms cancer rates are normal around Gentilly-2. The fluctuations recorded by the documentary filmmakers for the years 2000–2004 are normal, temporary and related to cases located in a relatively remote area from the plant. In fact, such fluctuations are regularly observed in the population and should not be interpreted blindly and recklessly.

To quote Dr. Grenier, when he spoke with the CBC on September 11,

“We’ve been monitoring cancer rates and birth-defect rates for 20 years in a 20-kilometre radius around the reactor, and in all that period, in the zone from five to 10 kilometres out, we’ve never seen a rise in cancer cases against the Quebec average.”

The film also references a German study that alleges increased leukemia risk for people living near nuclear power stations. This is false. The authors of the study and the German Commission on Radiological Protection have determined that the presence of clusters (or concentrations) of leukemia cases near some German nuclear power plants had nothing to do with the radioactive releases. In fact, some years clusters are observed in different regions of Germany whether they have nuclear power plants or not.

Also worth noting, recent British and French studies used the same methodology as the German childhood leukemia study and did not find any increase in risk in their populations.

To be or not to be

The film’s title is a clever play on the opening lines of Hamlet’s soliloquy and clearly signals the intention of the movie, which is to ask the question: do we need nuclear energy?

…Whether ’tis Nobler in the mind to suffer
The Slings and Arrows of outrageous Fortune,
Or to take Arms against a Sea of troubles…

But who is Hamlet in this scenario, really? What outrageous fortune is it to have a reliable, clean energy source like nuclear? In 2012, nuclear power from G2 helped avoid almost 3.5 million tonnes CO2 emissions in Quebec. The province is fortunate to have immense hydro power but that’s not the case for all provinces or countries.

This is another issue the film failed to address. Nuclear power is a vital part of Canada’s clean energy mix. It accounts for 15% of all electricity generated across the country and almost 60% in Ontario alone. Nuclear is a strong reliable source of base load power that is enabling Ontario to quit coal by 2014 and get renewable sources like wind and solar on the grid. Nuclear power generation can enable Canada to reduce its greenhouse gas emissions by reducing dependence on burning fossil fuels, like coal, oil and gas. An energy mix that includes nuclear means a cleaner, greener future.

The film makers feel they are taking arms against a sea of trouble. A sea filled with supposed increased childhood cancer rates and misunderstandings about the safety of this energy source.

People who work at nuclear facilities live near them too. They are knowledgeable about the technology and the science. They understand how safe it is, how responsibly power generation by-products and used-fuel are handled.

They are 800 strong at G2. Ask yourself, would 800 people collectively decide to put their health and their families’ health in harm’s way if there was indeed such a huge risk, as the film makers say?

We don’t think so either.

 

Additional Reading

The Canadian Nuclear Safety Commission sent a letter from President Dr. Michael Binder to the editor of Le Nouvelliste, a QC paper that has been covering the issue recently. They completely debunk the claims in the film. If you’re still worried, we recommend you read the letter and sleep better tonight.

More from the CNSC on this issue:  Similar to the letter above but with more myth busting facts!

Radiation and health is a complicated issue for us regular folks. AECL, one of the best sources for accurate information about nuclear, has compiled this information and list of resources.

Nuclear Energy Nuclear Medicine Statistics

Nuclear Power Plants and Childhood Leukaemia–End of the Debate?

A common claim by opponents of nuclear power is that nuclear power plants are directly linked to higher rates of childhood leukemia. For example, Greenpeace frequently references such claims on their website and branded publications such as here, here, and here. It appears that in some cases, the research on which these claims are based has been misunderstood:

A good example is this 2010 Greenpeace story, quoting a report according to which a 2008 study published in the journal Radiation Protection Dosimetry supports the claim of increased cancer rates around nuclear power plants because of radioactive emissions from these facilities.

In fact, the study does no such thing. Instead, the authors note that childhood leukemia rates around nuclear power plants are generally not higher than elsewhere, with three notable exceptions: Sellafied and Dounreay in the UK, and Krümmel in Germany. But rather than attributing those slightly increased rates of childhood leukemia to radiation from these sites, the authors state that they find the hypothesis that cases of childhood leukemia may be linked to a yet unidentified infectious agent most convincing. After all, if radiation were the cause, then one would expect to find higher rates around most nuclear sites, not just 3 out of 49 in total.

Examples where anti-nuclear activists seem to have misread scientific studies on the effects of nuclear radiation abound, and are too numerous to detail in a single blog post. In too many cases, the studies say the polar opposite of what is claimed they say.

However, there is one prominent exception: the famous 2007 KiKK study (Epidemiologische Studie zu Kinderkrebs in der Umgebung von Kernkraftwerken). This study, sponsored by the German Federal Office for Radiation Protection (BfS), did indeed make the argument that

there is a correlation between the distance of the home from the nearest NPP [nuclear power plant] at the time of the diagnosis and the risk of developing cancer (or leukaemia) before the 5th birthday.

However, the authors of the study have been quite clear that they do not attribute these findings to radiation from the nuclear facilities:

This study is not able to state which biological risk factors could explain this relationship. (p. 19)

Furthermore,

Exposure to ionising radiation was not measured or modelled. (p. 19)

And

This study can not conclusively clarify whether confounders, selection or random influences play a role (…).

In 2008 the authors published a follow-up paper, where they confirm their findings, but once more point out that

The result was not to be expected under current radiation-epidemiological knowledge. Considering that there is no evidence of relevant accidents and that possible confounders could not be identified, the observed positive distance trend remains unexplained.

In short, they found something, but have no idea how to explain it.

To make the claim, as many in the anti-nuclear community have since done, that the KiKK study shows nuclear power plants are responsible for increased childhood leukaemia rates in their vicinity is simply not supported by the KiKK study itself.

But nonetheless, the findings were interesting enough for the German Commission for Radiation protection to do a systematic assessment of the KiKK study. Some of the findings were nothing short but astonishing. Apparently, it was found

an increased leukaemia risk for children who lived in areas in which nuclear power plants were planned but never built. (p. 29)

Even more surprisingly,

the risk was similar to that found in the vicinity of existing nuclear power plants. (p. 29)

Since nuclear power plants that have not yet been built can hardly pose a radiation risk to the public, the authors conclude that, maybe,

nuclear power plants may tend to be built in areas which, for reasons that have not yet been understood, have a higher risk of childhood leukaemia. (p. 29)

Why sites that would be good locations for nuclear power plants tend to be associated with higher rates of childhood leukemia will probably remain a scientific puzzle for years to come. One thing, however, seems to be clear: it’s not the nuclear power plants.

Researchers in other countries have come to the same conclusion. For example, the UK Committee on Medical Aspects of Radiation in the Environment (COMARE) has studied various aspects of radiation health effects since 1985, and published 14 comprehensive reports by now, including one on childhood leukaemia around nuclear power plants in Great Britain.

While stressing – with good reason – that it is necessary to continuously monitor for any possible negative health effects from nuclear power plants, the authors state unambiguously there is

no evidence that there is an increased risk of childhood leukaemia and other cancers in the vicinity of NPPs due to radiation effects.

As for Canada, the situation is no different: a systematic review of current data and scientific research by the Durham Region Health Department found that cancer rates around two of Canada’s major nuclear sites in Ontario

did not indicate a pattern to suggest that the Pickering NGS [nuclear generating station] and the Darlington NGS were causing health effects in the population.

It really couldn’t be any clearer: nuclear power plants in Canada, the UK, and Germany do not cause childhood leukaemia or other cancers.