How Brexit could effect future treatment of cancer patients and supply of radioisotopes

Brexit could result in a “traumatic failure” to deliver medical isotopes on time to cancer patients, MSPs heard today.

Highlands and Islands MSP David Stewart, who is also Scottish labour’s shadow health minister, explained how the UK leaving the European Atomic Energy Community – known as Euratom – as part of Brexit’s Article 50 process could affect patients under-going treatment.

He was speaking at his Members’ Debate in Scottish Parliament.

Medical radioistopes are used in radiotherapy for treatment of cancer and in nuclear medicine for both diagnostic work and therapy.

The principal radioisotope used worldwide is Technetium, derived from a parent element that has a half-life of 66 hours. This element is obtained from a small number of research nuclear reactors – none of which are located in the UK. The Hinkley Point nuclear research facility, planned for 2027, could produce medical isotopes but not until it is ready.

The bulk of the UK’s supply is from the EU, facilitated by Euratom Supply Operation.

“We already have a world shortage of medical isotopes,” said Mr Stewart.

“A key provider, Canada, has just ceased production. The EU is home to four of the top six producers. The distance to Australia and South Africa means they are problematic providers – supply would be limited by the decay of medical isotopes which would occur during transportation.”

Mr Stewart said the key issue was that isotopes have short half-lives. That means they decay rapidly and cannot be stored. This creates an urgent need for constant, reliable and predictable supply. But this has failed in the past and created global shortages. Euratom has a central and crucial leadership role –it supervises the supply chains.

“There was a crisis in 2008 with the closure of the Channel Tunnel. Then again in 2015, industrial action in Calais caused chaos in the transportation of isotopes and therefore the cancellation of treatment in the UK,” he said.

“A clear and present danger to the NHS in Scotland and beyond is the loss of frictionless borders post-Brexit. This could result in a traumatic failure to deliver medical isotopes on time to cancer patients.”

Mr Stewart said that the scale of use is immense and invaluable. In the UK, around 700,000 nuclear medicine procedures are carried out each year, with around 70,000 of those in Scotland. It is essential in diagnosing coronary disease, detecting the spread of cancer to the bones, and biomedical research.

The MSP called for the UK Government to come to an agreement that allows the country to remain a part of Euratom.
He also said that there could be a move to create more cyclotrons in Scotland – this facility (a linear accelerator) produces radioisotopes for PET and CT Scanners.
“There are three in Scotland – Glasgow, Edinburgh and Aberdeen but no spare capacity to other PET Centres such as Dundee,” said Mr Stewart.
“There is a case for a PET Scanner in Inverness, with Highland spending £300K on scans alone. However, a large scale switch is expensive.”