PET helps save cancer patients

30.11.2012 — Analysis

To beat cancer, it must be detected early - either in the first or second stage. Thus diagnosis plays a critical role. It has to be perfect and to meet the challenges of time. Today the most modern method is a procedure that uses positron emission tomography. In 2015 the Sverdlovsk region will be able to take advantage of this line of defense.

The task of creating a center of nuclear medicine in Ekaterinburg began on November 16, 2012, when Denis Pasler, the chairman of the regional government, and Denis Butsaev, the general director of PET-Technology, LLC signed a cooperation agreement. "We made a deliberate choice coming to the Sverdlovsk region," claims Butsaev. "This area offers very high-quality cancer care. When health care is inferior, it's not possible to develop new technology. The medical professionals here provide 19,000 outpatient visits per year, which is a very high bar."

The director of the Sverdlovsk regional oncology clinic, Vyacheslav Shamansky, where the nuclear medicine center will be located, noted in an interview with RusBusinessNews that one of the greatest achievements attained by oncologists in the Urals was the number of patients they manage to treat and the number of those who survive the disease. In 12 years they have saved the lives of over 80,000 people, putting the Sverdlovsk region in second place in Russia.

In 2011, 15,429 inhabitants discovered their first cancerous tumor. Of those, 53.2% had their disease detected in the first or second stages, while the average for Russia is 49.8%.

Even greater victories in the fight against cancer would be possible, but according to Shamansky, all too often patients in the early stages of the disease spurn the high-quality treatment available at the clinic, instead turning to folk remedies offered by village healers or simply refusing to take action. They eventually return to see the doctor when the cancer has progressed to the third or fourth stage.

For example, patients with laryngeal cancer often reject medical care. But if it is not treated with radiation in the second stage, surgery will be required, with a possible resulting loss of voice function. "Therefore, our task is to make every effort to explain to the patient that treatment is absolutely essential. But it's even more important to make sure the patient understands that cancer in the first and second stages can be defeated. It's time to debunk the myth that this terrible disease is incurable. Cancer is not necessarily a death sentence," states Shamansky.

He goes on to list a number of factors that exacerbate Russia's cancer woes. First of all - smoking. "Women actively started smoking about 15 years ago. They ended up with cancer and now go to the oncology clinic in droves," complains Shamansky. Low-quality food and polluted air also contribute to the rates of illness. And heredity plays an important role. It has been proven that if a close relative of a woman has breast cancer, her own risk of developing a tumor is also quite high.

Recently, they have been seeing far more patients with skin cancer. This is because Russians are traveling to hot countries with strong sunlight. Shamansky claims that the oncology clinic now operates regularly on patients with melanoma – the most aggressive of all malignant tumors.

The center for positron emission tomography and computed tomography constitutes a breakthrough in early-stage cancer diagnosis. The patient is intravenously injected with a radioactive material that accumulates in metabolically active cells. Since the most active of these are cancer cells, those are then discovered during the computed tomography scan.

This method can detect even very small tumors. It all comes down to the staff's qualifications, because there are different ways to interpret what they are seeing. For example, the place where the tissues are joined that were cut during the operation is also quite metabolically active. There are plans to provide the employees of the Ekaterinburg PET center with instruction abroad.

"There's really not anywhere in Russia to train physicians to work in PET centers. Such sophisticated equipment requires preparation in institutions with lengthy experience and a very highly qualified staff," notes Vyacheslav Shamansky. In the future, there are plans to create an educational cluster at the PET center, where doctors from the regions can study.

Another job for the PET center is to monitor the quality of care. For example, after several rounds of chemotherapy, the medical professionals need to know whether living cells remain in the patient's lymph nodes. The PET procedures will answer these questions, and then for the best results another method of treatment can also be used, such as radiation therapy.

According to the Ministry of Health in the Sverdlovsk region, this area of the country requires roughly 17,000 PET procedures each year. Of those, 7,000 are needed in oncology, 6,000 in cardiology, and 4,000 in neurology.

Each procedure costs between 25,000 and 27,000 rubles. Every year, 6,000 of those procedures will be paid for by the regional budget instead of the patients. Those expenses could run as high as 150-160 million rubles.

There are no doubts about the need to set up a PET center in Ekaterinburg. In all of Russia there are fewer than ten such facilities. Chelyabinsk and Tyumen already have their irons in the fire, and a similar center is soon opening in Ufa. But the standard ratio overseas is one PET center per 500,000 inhabitants. Over 500 PET centers operate in the US and about 300 in Europe.

The Sverdlovsk regional oncology clinic is currently one of the best in the country. Only the clinics in Chelyabinsk, Krasnodar, Kazan, and Ufa boast a comparable level of equipment. More than 600 million rubles was recently spent on machinery, including a new MRI scanner and linear accelerator. "Many clinics only learned about accelerators and how to use them a few years ago. But we started working with our first accelerator 17 years ago and now we have four of them," emphasized Shamansky.

We haven't had any technical problems with them in 13 years - they use what we call pure German engineering. "We have twelve on two floors. The two air conditioners that service them have operated with clock-like precision all these years - regulating the temperature, pressure, humidity, and cleaning the air in five stages. Each day we do 25-30 operations and everything goes smoothly," noted the clinic's director with pride.

The already high-powered Sverdlovsk oncology clinic, strengthened by the PET center, will become the flagship for a system that provides high-quality care to cancer patients. World practice shows that countries that employ this technology see a decrease in mortality, increased life expectancy, and improved economic outcomes. The officials of the Sverdlovsk region have placed this medical project on an equal footing with their efforts to significantly modernize the region's infrastructure, because they understand that without investment in crucial areas of growth, it is not possible to remain one of the leading Russian regions.

Anna Khorkova