Cancer is one of the major causes of death in the world. Despite advancements in medical science, there is no cure for most cancers, unless they are detected early.
Most deaths from cancer occur when it is discovered in the advanced stage, so it is important that we detect cancer very early on. However, how effective this is, to a large extent, depends on the technique used for cancer detection.
A Short History of Cancer Detection
The earliest non-invasive method of cancer detection is by touch. That is, the doctor physically feels for abnormal growth in the body. By the time a growth can be felt inside the body (at least 100 mm), it would already be in the advanced stage and treatment would be difficult, if not impossible.
Literally, this was a “touch and go” method, with a high degree of inaccuracy, and resulting in a high percentage of deaths.
Then came the discovery of non-invasive imaging techniques: X-Ray, Gamma-Ray, Ultrasound, Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET). Each is an improvement on the other with PET being the most advanced.
Today, most doctors in Malaysia rely on CT and MRI for the diagnosis and management of cancer, and they still do not know that PET is much better for cancer diagnosis and management, especially when cancers are still in their very early stages, when even blood tests are normal.
Computed Tomography (CT) & Magnetic Resonance Imaging (MRI)
CT and MRI show structures within the body in black and white. They are “anatomical” imaging techniques. They tell you where the tumours are, and their size. They cannot tell you whether the tumours are active or not. Usually, they cannot detect cancers that are less than 10 mm.
Positron Emission Tomography (PET)
This is the latest addition to the medical imaging techniques. It is a “functional” imaging technique, meaning that it shows the activity of tumours in colour. It is always combined with low-dose CT, to show in which organ the active tumours are located, and it is always a whole-body scan, known as PET/CT.
The amount of radiation received from a whole-body PET/CT, using low-dose CT, is less than from a normal whole-body CT, so patients should not be worried.
It can detect cancers as small as 1 mm, if very active, whether it is in the bones or in the soft tissues. It can also distinguish live cancerous cells from dead or non-cancerous cells. After cancer treatment, it is important to know whether a tumour is dead or still alive, and only PET can do this, but not MRI or CT. Therefore, for the diagnosis and management of cancer, PET/CT should replace MRI, CT and Bone Scan. For certain cases, PET/CT should replace Mammogram. Plain X-Ray, like Chest X-Ray, is obsolete, as far as cancer is concerned.
Today PET/CT Has Become the Medical Imaging Technique of Choice for Cancer, Internationally
In short, when doing imaging for cancer, doctors in developed countries are already using PET/CT, a “functional” technique combined with an “anatomical” technique, and not purely “anatomical” imaging techniques like MRI or CT. Unfortunately in Malaysia, many doctors are still unaware of this, and that is why we are writing this article to promote awareness among doctors and the public.
A Case In Point
In a high profile case recently, a prominent client from Malaysia sued a hospital in Singapore, because part of his pancreas was taken out thinking that it was cancerous, but it was not. There would not have been the need for surgery which is expensive and dangerous, if this person was correctly diagnosed.
So, Why Is PET/CT Not Widely Used In Malaysia?
Because PET/CT is a new technique and not many doctors are familiar with it yet. The other reason is costs.
When PET/CT first came out in Malaysia in 2005, hospitals were charging around RM7000 for a scan. This is beyond what the average Malaysian can afford.
Fortunately, in 2010, AUSTRAL-EURO DIAGNOSIS brought the cost of a whole-body PET/CT down to RM1000-RM2000 per scan, which most Malaysians can afford. Others were forced to lower their prices, but they are still higher.
This company was founded and operated by Dr Raymond Ngeh, a dedicated Nuclear Medicine doctor, upon his retirement from abroad, and with his own money (no investor believed in his project), to make PET/CT, the best technique available today for cancer, really affordable to the masses in Malaysia.
AUSTRAL-EURO DIAGNOSIS operates two PET/CT centres in Malaysia: one in Kuala Lumpur, and one in Johor Bahru. You can call the centres directly for more information, or go into their website: www.australeuro.com.
107-109 Jalan Maarof, Bangsar, 59000 Kuala Lumpur Tel: 03-2141 1373
Menara Landmark (33a), 80000 Johor Bahru Tel: 07-222 8332