Medical Isotope Supply Cannot Meet Demand

Nuclear Medicine is the branch of clinical practice that uses specially manufactured radioactive isotopes in the diagnosis of conditions that range in seriousness from difficult to diagnose stress fractures to the spread of cancer cells throughout the body. This specialty branch of medicine is responsible for an estimated 9 million diagnostic examinations and/or treatments per year in the United States alone. Since the isotopes used in these procedures do not occur in nature, they must be manufactured inside nuclear reactors (similar to those used to generate electricity). As you might expect, these reactors aren't found on every street corner. In fact, there are only seven such medical isotope-producing reactors in the entire world (located in Canada, France, Belgium, Germany, South Africa, Argentina, and Australia). Notice that none of them are located within the United States. And why, you might ask, is that such a problem?

The single factor that determines the "shelf-life" of medical isotopes is time. These isotopes have a life span (known as "half-life") that is measured in hours rather than days or weeks. You will have to trust me on this, because the physics and mathematics of why this is the case is rather complicated. But regardless of math and physics, the previously alluded-to problem with the current situation in American health care is the direct result of a world-wide shortage of medical isotopes!

That's right; there isn't enough production capacity in the world to meet the increasing demand for these substances! As a result, should you happen to need certain medical procedures (such as tests to determine the status of your heart) or a treatment for cancer that involves using an isotope, welcome to the world of rationing of health care! In other words, get ready to stand in line.

And why is this be the case in a country that boasts of its high standard of living? Hold you nose and grab a barf-bag before reading the rest of this posting.

It seems that, back in the year 2000, Sandia National Laboratories in New Mexico had requested the U. S. Department of Energy to sign off on a plan that would have funded a small reactor to supply most of the medical isotopes required by the United States rather than risk a future disruption in the international supply of these materials. The then-incumbent Clinton Administration rejected the plan on the grounds that the demand for isotopes could be met by existing reactors, including two new Canadian reactors that were scheduled to be "coming online" in over the nest few years. Care to hazard a guess at what happened next?

Right! Canada abruptly canceled the two "new" reactors that the Department of Energy had been counting on to supply the American market with medical isotopes while, at the same time, the only existing reactor within the United States was taken out of service. Then, on May 15^th of this year, the lone remaining isotope-producing reactor in Canada was shut down due to operating safety concerns. At best, that reactor won't be back in operation for a year.

If you think that I might be over-reacting, how about an opinion from a world-class authority on this subject?

In his September 9, 2009 testimony before the House of Representatives Committee on Energy and Commerce's Subcommittee on Energy and the Environment Steven Larson, Director of Nuclear Medicine at the Memorial Sloan Kettering Cancer Center in New York City made the following statement:

"Demand for nuclear medicine services is stable, with a likely growth rate in utilization of 3-5% per year. Technetium 99m (a widely-used isotope) is crucial to the nation's health care in oncology, cardiology, and neurology. Reliability of supply is a significant problem now and likely to be a problem for the foreseeable future. Total capacity for production is very near current use, and there is little margin for additional production capacity in the event of an interruption of supply."

And what is my point in discussing the above situation?

The United States seems to be Hell-bent on extending government "involvement" (read "regulation") in health care to a historically unprecedented extent. As usual, the government's plans regarding what it will do when it assumes such a role is "long on promises but short on policies."

If the current situation regarding the availability of vital medical isotopes is a harbinger of the future, the nation's citizens should demand that Congress provide a definite plan for health care rather that its usual pie in the sky promises. Based on its past dismal record at predicting an adequate isotope supply, it would be wise to view any promises made by the federal government as just that: mere promises.

After all, it will be you or a member of your family that will suffer the long-term consequences of whatever policy emerges from the ongoing torrent of rhetoric that has become a substitute for debate.