At 11:00pm each weeknight in Melbourne, life-changing nuclear medicine is created for transport to Tasmania the next morning.
When the pandemic took hold and restrictions were placed upon people’s movements, it also had an impact upon the smooth passage of this incredibly time-dependent resource used in the management of cancer.
As a radioactive material, nuclear medicine degrades by half every two hours.
After a number of hours, the medicine is no longer viable for use.
Tasmania does not have the facilities to create nuclear medicine and relies upon a Victorian facility to make and deliver it each weekday via a large, commercial airline.
For Marc Macenko, a senior supervisor at Royal Hobart Hospital’s nuclear medicine department, the sudden drop in commercial flights had devastating consequences.
“If a flight was supposed to be here at 10:30am and we had ordered enough for 10 patients, but it did not come till 12:00pm, then we would have to cancel half our patients,” he said.
For that one patient, the nuclear medicine would be injected and travel to a cancer.
Positron emission tomography (PET) scanning was then used to learn the extent of a disease prior to cancer treatment, or to assess if a treatment was working.
It is a crucial step in a patient’s health journey.
Another bump in the road
An added stress in the transportation of nuclear medicine is its proximity to animals also in transit.
Many airlines will not carry radioactive material if a cat or dog is on board.
“We have one main carrier who has promised to not offload radioactivity, but when those flights were getting cancelled and the medicine moved to another carrier, some of the other pilots would offload it if there was a pet onboard.” Mr Macenko said.
As the weeks progressed, Mr Macenko became desperate for a reliable solution.
“I thought, ‘If I talk to the most important person I know and they do the same thing, then it’ll go all the way to the top’, and eventually it got up to the Premier and Cabinet level,” he said.
The solution came in the form of regional airline Par Avion.
Known primarily for scenic flights to iconic locations across Tasmania, managing director Shannon Wells said he noticed a sudden shift in requests as large commercial carries became less available.
“We had freight operators trying to move fresh produce out of Tasmania and requests to fly people’s dogs and cats into Tasmania,” he said.
“We even flew down the Tasmania Police breeding dog.”
But one call came through though, that was particularly important.
One such thing is nuclear medicine.
At 6:30am each weekday the regional airline now transports the medicine between the two states.
The importance of this service is not lost on Mr Wells, who is a childhood cancer survivor himself.
Dogs, cats and life-saving medicine
Initially, Mr Wells was concerned he would not be able to transport the nuclear medicine alongside cats and dogs, but a discussion with the Civil Aviation Safety Authority found a safe solution for all.
“We asked how far the nuclear medicine has to be from the puppy dogs and found there’s an equation we can use,” he said.
“Now we are taking three or four animals to Melbourne every day and bringing two or three back, as well as this life-saving medicine.”
It is a solution that Mr Macenko is extremely grateful for.
“This is an important spot on a patient’s journey in the health system,” he said.
“It was just awful.”
Within weeks of the alternative arrangements starting Mr Macenko and his team have been able to return to normal patient numbers and complete scans at the most important time.
“The first thing they ask when they walk up to the front desk is, ‘is the plane coming on time today?'” he said.
“Everyone is quite happy to say yes.”
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