“People are going to die because of this stalling”

BY JANET GIBSON

One morning every three weeks, Sudbury resident Sam Bruno gets up at 4 a.m. and has a breakfast of sorts – a glass of water. He sits in his favourite chair in his living room watching Home and Garden Television, trying to keep his mind off the disease that defines his life. At 8:30 a.m., he steps inside his silver Volkswagen and drives to the Northeastern Ontario Regional Cancer Centre on Ramsey Lake Road. He registers with the nurse at the front desk and walks into a room filled with chemotherapy recliners.

“It takes an hour-and-a-half to get the drugs into me,” he said. “It’s like the worst case of the flu you’ve ever had minus the sore throat. I can’t even tell you honestly what it’s like because I’ll cry if I do.”

Sam Bruno, 53, was born in Gatchell, a small Italian neighbourhood in Sudbury, five years after his parents emigrated to Canada. He didn’t speak English until he started public school. “It was a good life,” he recalled as he enjoyed a cup of coffee at Frank’s Delicatessen on Durham Street. “It was an incredible life.”

There was no television and no computer games. “We had barrels of friends with very little supervision but loads of common sense,” he said.

Bruno went to St. Anthony’s Catholic School and Lockerby Composite School, then studied business administration at Cambrian College. He made a career in sales, capping it off by working in marketing and sales training at Sealy Canada.

Three years ago, life as he knew it ended – forever. After undergoing a routine colonoscopy, he was stunned to learn he had to have emergency surgery. He had colorectal cancer.

Dr. John Snider cut 13 inches out of Bruno’s large intestine. “They thought they’d got rid of it,” Bruno said. But months later, Dr. Pablo Cano ordered a blood test for Bruno and found the level of CEA was over 100. A normal reading is between 1 and 1.5. Cano urged Bruno to get a PET scan. Like an MRI and a CT scanner, a PET scanner produces images that give doctors a look inside the body. However, a PET scanner is unique in that it tracks a tracer called fluorodeoxyglucose that’s been injected in the bloodstream. The scanner is particularly useful for finding out how much a cancer has spread.

While Ontario residents have ready access to MRIs and CTs, OHIP doesn’t fully fund PET scans. The quickest route for Bruno was to travel to Mississauga, where he paid Carel Imaging, a private clinic, $2,350 to do the scan.

When Cano showed him the picture, Bruno saw the cancer glowing. It was the size of a nickel near the aorta behind his abdomen. “They couldn’t operate on it,” Bruno said.

He was treated with radiation and chemotherapy for three months. He had a second line of chemotherapy, then a third. He’s now on his fourth line, a line that will continue until the day he dies.

Bruno was puzzled about the difficulty in getting a PET scan. It wasn’t only northern Ontario residents who couldn’t get one. No matter where they lived in the province, there were only three ways a cancer patient could get a scan.

They could do as Bruno did and travel to Mississauga, where Carel Imaging has never turned a patient away for lack of money. Or their doctor could refer them to a hospital that is doing clinical trials or taking part in a registry study or apply to the PET Access Program. Recently, Bruno has learned of a fourth route. Ontario residents who have a PET scan done in another province can ask OHIP to reimburse them.

But why won’t OHIP pay for PET scans just as they pay for colonoscopies? Bruno learned others were asking the same question.

The clinical trials, which started when Tony Clement was minister of health, are now in their fifth year. They were only supposed to last for two, said Progressive Conservative deputy leader and health critic, Elizabeth Witmer.

Witmer is calling on the government to set timelines to achieve the same level of access to PET scanning in Ontario as in other Canadian provinces such as Alberta, British Columbia and Quebec.

“I’ve been asking questions of the health minister for quite a few months,” Witmer said. “I’ve had absolutely no response. At the end of the day the government recognizes there’s money involved and they’re not willing to make the investment.”

Laurel Ostfield, press secretary for Minister of Health George Smitherman, said the ministry’s priority is to provide access to MRI and CT scanners. “It’s not likely we’ll broaden access to PET scanners in the short term.”

That leaves Ontario lagging not only behind other provinces but other nations.

“I’m not aware of any other jurisdictions in the developed world that are not making PET scans available,” said Dr. Sandy McEwan, Edmonton oncologist and president of the U.S. Society of Nuclear Medicine.

On April 22, Bruno got a surprise phone call from Princess Margaret Hospital, where he’d applied to take part in the clinical trials. He’d been accepted. The government was going to pay for him to have a PET scan.

“Apparently, I’m now an experiment,” he said.

He calls the inaccessibility to PET scans “infuriating and despicable. “I know for a fact people are going to die because of this stalling.”