Nuclear medicine in the bush

16 March 2018

His business now has services in Geraldton, Kalgoorlie, Busselton and Mandurah.

“My dream is to get another site down into Albany and then, radiation physics willing, getting something up into the Pilbara,” Pete said.

TeleMed covers a huge area in Western Australia and nuclear medicine must be transported to each of their four service areas. Isotopes can be transported to Busselton by car, but other areas are a bit more complicated and the best method is by air.

“The weekly, fly-in-fly-out (FIFO), nuclear medicine service to Kalgoorlie has been my Monday ritual for nearly 20 years. Usually out of bed by 3am and home that evening by 9pm, I’m often spent by the end of the day however providing our service to this remote community has been one of the most professionally rewarding experiences of my working life.”

TeleMed has a strong focus on oncology work and heart disease, which Pete says are the two biggest killers in these remote communities.

“We talk about closing that gap or the widening gap but I think with respect to breast and prostate cancer the chasm is just going to get wider between what patients can access in a metro area like Perth versus what they can access in a place like Kalgoorlie.”

Nuclear medicine is the difference between life and death for people in these communities, whether it’s detecting heart issues through imaging or treating cancer.

“Recently in Kalgoorlie we had six patients who had symptoms of coronary artery disease, two had previous heart attacks. We did some stress testing by exercising them on a treadmill or bike, we then injected a radio pharmaceutical and did myocardial profusion scans.”

“After doing reports, two were found to be positive for heart disease. The patients dodged a bullet, we identified the disease and hopefully a heart attack can be avoided and preventative medicine can commence,” Pete explained.

“The isotope we use, Technetium, decays every 6 hours. So we need to buy more than you would have to buy in a metro area for the same application.”

“ANTSO produces the generators, which go to a central pharmacy and they take the generator formula at 2:30am so the Technetium that we need can be produced by 3am.

“Then we take our cold kits, we mix the pharmaceutical to make our radio pharmaceutical, they include this in a canister and they deliver it to the airport.

“They usually get there [to the airport] at about 4am and fill out about one hundred forms, even though we’ve done it over many years.

“The airport dispatch people confirm that I’m flying or my colleague is flying. We used to go up and talk directly to the captain of the plane, but now it’s all done electronically. We confirm with the flight attendants that the isotopes have been loaded into the hold on the con [consignment] note and off we go.”

“At least 5 or 6 times a year, we lose the flight due to bad weather or technical issues, and the patients have to wait. That doesn’t happen in Perth!”

If you would like to find out more about Pete's work visit www.telemed.net.au

ANSTO is also a great resource if you would like to find out more about nuclear medicine, visit www.ansto.gov.au

Dr. Geoff Currie on nuclear medicine

Nuclear medicine changes the lives or saves the life of Australians every day. During the average lifetime, an Australian will have more than 2 nuclear medicine procedures. Some of us many more and some less.

Only a few decades ago, all nuclear medicine services were located in major capital cities in Australia and many Australians simply did not have access to this life saving service. Now, with well-established transport protocols that provide reliable, safe and cost effective transport of radioactive substances across Australia, health and wellbeing is within reach of us all.

Transport of these medicines is essential; via road and by air. Without these transport systems, crucial nuclear medicine services could not be provided to Australians.

The half-life of radionuclides (every half-life sees the amount of useful radiation halve) means that delays or disruptions to transport can render the product useless. Timely and safe delivery sees 665,000 procedures done in Australia every year. ARPANSA, ANSTO and the state licensing authorities have established process for nuclear medicines and other radioactive material that is transported across Australia that ensures safety. It is these processes that would be applied to transport of waste to the facility.