The Trials and Tribulations of Implementing Safe Radiopharmaceutical Therapy at BC Cancer – Vancouver

Radiopharmaceutical therapies (RPT) using Lutetium-177 and Actinium-225 are promising treatments whose use is rapidly expanding around the world. Clinical trials using these RPT radioisotopes to treat prostate and neuroendocrine disease have shown impressive patient response.

In early 2019, BC Cancer-Vancouver administered the first Lu-177 patient treatment in British Columbia. Accomplishing this milestone required a substantial amount of preparation and administrative work including: identifying rooms suitable for RPT preparation, administration, and waste storage; identifying and training staff to carry out RPT activities; identifying and purchasing required radiation safety equipment; preparing standard-operating-procedures (SOPs) and patient and caregiver radiation safety precautions; and applying for CNSC licencing for RPT.

Initial roll-out of the RPT program at BC Cancer–Vancouver presented several minor challenges with respect to radiation safety. These included dealing with small, contained, contamination incidents, the need to optimize RPT waste decay storage and several instances of adapting to individual patient travel and living circumstances that necessitated updating patient and caregiver precautions. Expansion of RPT patient numbers coincided with a handful of more serious radiation safety incidents including substantial contaminations in the treatment rooms leading to room shut-down and eventual room renovations, building sewer main blockage that required temporary shut-down of an exterior area, and a near-miss disposal of a patient RPT dose in the building garbage.

This talk will review the setup of the current BC Cancer–Vancouver RPT program including the radiation safety lessons learned along the way and how these lessons are being applied to expansion of the BC Cancer RPT program across British Columbia.