POTENTIALLY life-saving treatment over prostate and neuroendocrine cancers is having to be conducted south of the border, because Scotland has not got the facilities to deal with it, it has emerged.
In June, last year, the Scottish Government announced that new prostate-specific membrane antigen (PSMA) scanning technology would be funded by NHS Scotland, and provided at four centres across Scotland.
The advanced scans, which use radioactive dye to light up specific regions in the body was expected to be operational by spring of last year.
Prostate Scotland welcomed the move at the time saying that PSMA scanning in Scotland for men with prostate cancer was a “step forward in helping determine whether prostate cancer has spread or re-occurred”.
But in a letter, the health minister Jeane Freeman has confirmed that the scanning facilities are not yet in place.
And she has admitted that currently patients requiring these types of advance scans may be referred to other sites in England.
MSP Murdo Fraser, the former deputy leader of the Scottish Conservative Party described the lack of available treatment as “an utter disgrace”.
He is calling urgent action after one patient from Perthshire, told of his despair of the current situation, saying: “I feel as if my life is like waiting on a time bomb.
He added: “It is ridiculous expecting someone to have to travel down to London to get a scan, when there should be an available machine in Scotland.
“I would have to travel to London by a sleeper train as I will be getting radiotherapy for the cancer so can’t travel by plane. The cost of the train journey plus a taxi to the hospital and back to the rail station will be around £500 – it is scandalous.
“I paid my taxes when I worked and looked after my parents when they were older, as I was able to, but now you feel so let down by the system when you’re told the only place you can get a PSMA scan is down in London. This disgraceful matter needs highlighted to let all Scottish men know the situation.”
Prostate Cancer is the most common cancer in men in Scotland- with one in ten at risk. Around 3,400 men are diagnosed with prostate cancer every year in Scotland.
The Scottish Government announced said the new technology which provides a more accurate scan for advanced prostate cancer would improve detection.
Funded by NHS Scotland, it was to be provided at four centres across the country – NHS Greater Glasgow and Clyde, NHS Tayside, NHS Lothian and NHS Grampian.
The PMSA scans would allow for a more accurate diagnosis of possible prostate cancer relapse, where the disease spreads after initial treatment.
It would allow clinicians to identify exactly where any follow-up tumours are located, ensuring appropriate treatment.
An initial investment of £2 million was made in the service, with contracts awarded to allow the procurement of the equipment required.
Making the announcement during men’s health week, Ms Freeman said: “Prostate cancer is the most common male cancer in Scotland, so it’s vital that we ensure that the best treatment is available.
“This equipment will allow clinicians to get quick and accurate information about whether advanced prostate cancer has spread to another part of the body. If there is no spread, the patient can be reassured, and if there are additional tumours, the medical team can put the right treatment in place.”
There are currently five PET/CT scanners in Scotland, including two in Glasgow, and one each in Edinburgh, Aberdeen and Dundee. But Ms Freeman said that certain types of cancer require scans using different radiopharmaceuticals that are not routinely available in Scotland at present.
“Currently patients requiring these particular types of scans may be referred to other sites in England,” she said.
She said the installation of the required equipment in each scanning site is still ongoing, “although there have been some installation delays due to Covid-19”.
“It is anticipated that Edinburgh and Dundee will be ready to go live in early 2021, with Aberdeen following in spring 2021 and Glasgow in the second half of 2021,” she said.
“It is also anticipated that until all sites are fully operational that patients will have access to services at one of the other sites where appropriate.”
Mr Fraser, who represents the mid Scotland and Fife region, said: “The fact that there is not one suitable scanner in Scotland for those men who have advanced prostate cancer is an utter disgrace, and yet again underlines how the SNP have failed to properly fund health services in the country.
“The letter from the health ministers suggests that the installation of the required PSMA equipment has been delayed due to the pandemic, but I know the Scottish Government announced this back in June 2019, so this has been too long a wait for many people.
“It’s important that there is an awareness of prostate cancer. Prostate Cancer UK have said that around 12,000 men lost their lives to prostate cancer last year and they have highlighted the problem the need for a screening programme. The key to earlier diagnosis is a screening programme.”
When the announcement of the PSMA facilities was made two years ago, Roger Staff, PET/CT lead for the Scottish Clinical Imaging Network, said: “The introduction of this service represents a marked service development that will significantly improve the management of prostate and neuroendocrine cancer in Scotland.”
In March, last year, scientists found that an improve PSMA prostate cancer scan could save lives by detecting those at risk of recurrence.
Scientists have found using a radioactive molecule which sticks to prostate cancer cells and lights them up in a scan is 27 per cent more accurate than the methods which are routinely used.
The technique detects when prostate cancer has spread further into the pelvis or beyond and, therefore, identifies the men who need more powerful radiotherapy, or wider surgery.
If missed, prostate cancer cells that have spread can lurk in the body and cause a recurrence years later. If they can be found, and removed, it prevents men getting a devastating second diagnosis.
Researchers found the scan correctly detected whether prostate cancer cells had spread or not in 92 per cent of men.
Conventional CT and bone scans produced accurate results in just under two-thirds. The results were taken from 295 men newly diagnosed with high-risk, more aggressive prostate cancer, from ten Australian hospitals.