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Calling it an "absolute disgrace," the head of a cancer group says Ontario's restricted access to PET scans is not only forcing some medical residents to relocate for training but it is also hampering patient care.

"That's an absolute disgrace coming from Ontario," said James Gowing, a hematologist-oncologist based in Cambridge, Ont., and board chairman of the Cancer Advocacy Coalition of Canada.

"I've been embarrassed a number of times to tell people I'm from Ontario and this would be another one."

Dr. Gowing's comments follow a Globe and Mail story that revealed how the University of Western Ontario must send its nuclear-medicine residents to the United States and elsewhere for three months to train on a Positron Emission Tomography machine.

The university cannot offer that training at St. Joseph's Health Care in London due to the low number of cancer patients eligible for the scans in Ontario.

That hospital scans as few as four patients a week, sometimes none.

The residents learned that they had to relocate for PET training after an evaluation conducted by the Royal College of Physicians and Surgeons of Canada, a body that accredits postgraduate medical programs in addition to certifying specialists.

The college told the university the lack of training in PET scanning needed to be fixed.

Consequently, the university was asked to put in writing its plan for ensuring its residents receive the necessary PET training elsewhere, said Damien Maharaj, program director of nuclear-medicine at Western's Schulich School of Medicine & Dentistry.

He stressed the program remains fully accredited and that London produces some of the best nuclear-medicine specialists in Canada.

Sandy McEwan, an Edmonton-based nuclear medicine physician and president-elect of the U.S.-based Society of Nuclear Medicine, said there is no doubt tight controls on the use of PET machines in Ontario are impairing patient care.

"In cancer care, the rest of the world has identified the areas where it [PET] makes a difference," Dr. McEwan said. "The rest of the world has recognized it and is scrambling to get current technology in place."

Of all the provinces that have PET scanners, Ontario has the most restrictive access.

Cancer patients can access Ontario's nine PET scanners under five clinical trials or through a patient registry. That registry is limited to suspected recurrent colorectal, thyroid or germ-cell cancer and patients with certain solitary pulmonary nodules. As of Oct. 31, 408 Ontario patients had obtained PET scans through the registry and 926 patients had scans as part of the clinical trials.

The province says it is trying to determine how best to use them on cancer patients -- answers that will be provided through the clinical trials it is conducting.

However, "there is not a set time line for these studies, simply because they are dependent on meeting a target enrolment on the number of patients," A. G. Klei, an Ontario Health Ministry spokesman, said yesterday.

Quebec provides the broadest access to PET machines; this year, it plans to do 21,000 scans. Patients can access PET scans in British Columbia, Alberta, Manitoba and New Brunswick. Nova Scotia also plans to purchase a scanner and expects to have it operating by the fall.

A PET scan can find a lung cancer that has spread, preventing a futile operation.

Colorectal cancer patients may discover tumours on their liver can be safely removed.

A scan can also help determine when chemotherapy is not working, prompting doctors to change a drug cocktail.

The scan costs roughly $2,500 in Ontario and $1,250 in Alberta, the difference in price being due largely to Alberta's proximity to the short-lived radioactive tracer isotope that is mixed with a sugar called fluorodeoxyglucose. The closer the source, the cheaper the cost.

With PET scans, cancer absorbs the glucose more readily than healthy tissue, causing it to light up on a scan.

However, the results need to be carefully interpreted as non-cancerous conditions can resemble cancer; only a biopsy can confirm the presence of cancer.

Yesterday, Conservative health critic Elizabeth Witmer called the relocation of nuclear-medicine residents an "embarrassment." She said she is concerned they may not return to Ontario.

"This government should be ashamed of itself," Ms. Witmer said in a telephone interview. "It's unbelievable the [medical] residents are going to have to leave this province.

"We're already short of doctors. If they have to go outside of the province, the truth is maybe they'll never return."

Shelley Martel, the NDP health critic, said PET scans should be covered under Ontario's Health Insurance Plan.

"They are an excellent new technology and people should not have to pay out of pocket to access them," Ms. Martel said, noting that some cancer patients have purchased the scans at a private clinic.