The Chronicle Herald: Keeping cancer patients close to home during COVID-19 with best-in-class cancer detection tool

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Neuroendocrine cancer survivor Sharon Needham (left) with her QEII oncologist, Dr. Daniel Rayson (middle), and QEII radiologist, Dr. Steven Burrell (right). The trio are working with the QEII Foundation and its donors to address an urgent cancer care need.

Originally published as a sponsored article on thechronicleherald.ca.

It took seven years for Halifax resident and cancer survivor Sharon Needham to receive the correct diagnosis for the neuroendocrine tumour found in her left lung.

The misdiagnosis happened because neuroendocrine cancer often mimics the symptoms of other illnesses and, most importantly, because she was one of many Canadians who didn’t have access to a gallium-68 DOTATATE diagnostic scan.

Gallium-68 DOTATATE — a radioactive tracer injected immediately before a PET-CT imaging scan — is one of the best tools for both diagnosing neuroendocrine cancer and determining its response to cancer treatments. While it wasn’t readily available to Sharon and her care team for her initial diagnosis, it has since played a critical role in her cancer journey following major lung surgery in 2015.

Two years post-surgery in 2017, Sharon was among the first in Canada to travel to Quebec and access gallium-68 DOTATATE in a clinical trial. But now the ongoing COVID-19 pandemic means she and other patients are no longer able to travel to receive these already-limited scans.

This is why the QEII Foundation is on a mission to raise $200,000 to bring Atlantic Canada’s first gallium-68 DOTATATE tracer to the QEII Health Sciences Centre, giving patients and survivors, like Sharon, the most accurate picture of where their cancer journey stands.

“When you’ve had cancer but then have new symptoms that mimic your cancer, you panic,” Sharon says. “So to be able to have a test that shows you’re in the all-clear, or finds cancer and gives you the ability to treat it earlier, well, that is just amazing.”

Gallium scanner comparison
These are PET-CT scans of the same neuroendocrine cancer patient. The one on the left uses the current detection methods available in Atlantic Canada, while the right scan uses the gallium-68 DOTATATE tracer. The gallium-68 DOTATATE scan (right) is able to detect the neuroendocrine tumour sites with unparalleled accuracy, and this accuracy means a targeted treatment plan can be immediately put in place to address the needs of the patient. - Photo Contributed.

FASTER, MORE ACCURATE SCANS

In the surveillance that Sharon has undergone since her 2015 lung surgery, she says scans have repeatedly come back inconclusive, leaving her with no way of knowing whether she was truly cancer-free.

These results are why her doctor, QEII oncologist and head of Medical Oncology Dr. Daniel Rayson, recommended she be enrolled in the Quebec gallium-68 DOTATATE clinical trial.

“This test is so much better than anything we’ve had before, to diagnose and monitor patients with neuroendocrine tumours,” says Dr. Rayson. “This is a game-changer.”

The gallium-68 DOTATATE tracer also lessens the number of required scans – from three separate appointments to one — and reduces the scan time itself, making the testing process easier on patients. 

Dr. Steven Burrell, QEII radiologist and head of Nuclear Medicine, says it cuts scanning time from four hours to about 20 minutes, and its crisp accuracy means patients get a proper diagnosis quickly and are then able to undergo the most effective therapy for their cancer.

“Having the most accurate imaging is critical to most appropriately assess the state of a patient’s cancer, which then drives the therapy and whether it’s successful,” Dr. Burrell says.

Sharon says the experience of receiving accurate imaging in 2017 is easy to describe. It allowed her to see that the areas shown in the previous inconclusive CT scan weren’t concerning at all.

“In short, this test finally gave me peace of mind,” she says.

QEII oncologist Dr. Daniel Rayson describes the gallium-68 DOTATATE tracer as a “game-changer.”
QEII oncologist Dr. Daniel Rayson describes the gallium-68 DOTATATE tracer as a “game-changer.”

‘WE WOULD BE LEADING THE COUNTRY’

Access to gallium-68 DOTATATE is incredibly limited across Canada; available at only a few health centres and, in most cases, only as a clinical trial.

Sharon says this is why local access is so important, as it would allow Atlantic Canadian patients to remain at home while undergoing surveillance — a benefit that’s especially top-of-mind during COVID-19. Sharon says local access would also mean the right diagnosis could happen sooner for patients.

“A lot of neuroendocrine patients are Stage 4 by the time of their diagnosis,” says Sharon. “To use this as a screening tool and have this cancer diagnosed sooner would be huge. We would be leading the country on this.”

Dr. Rayson says local access is important also outside of the pandemic, as only a limited number of neuroendocrine cancer patients have been involved with the Quebec clinical trial. Having this gold-standard technology locally would mean optimized outcomes for a greater number of neuroendocrine cancer patients.

“Gallium scanning has been available in many parts of the world for a good number of years, though access has remained limited across Canada. Bringing this here would mean the QEII is leading the way,” he says. “The fact that Halifax will soon stand among the first in the country to be able to provide this to patients is a great thing.”

The QEII Foundation is on a mission to raise $200,000 to bring Atlantic Canada’s first gallium-68 DOTATATE tracer to the QEII. To learn more about gallium-68 DOTATATE or to donate today, visit QE2Foundation.ca/gallium.

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