Behind the Scenes of Your State-of-the-Art PET Scans Are Dedicated, Reliable Hearts
In their commitment to ensure patients have the best options for cancer diagnosis and treatment, the June E. Nylen Cancer Center (JENCC) has made many updates over the last 5 years including most recently upgrading their state-of-the-art PET scanner. Positron emission tomography (PET) is an important tool in the diagnosis and staging of cancer, including re-staging throughout treatment. Cutting-edge technology is only one aspect of excellent cancer care – you also need skilled, compassionate, and reliable staff that are dedicated to ensuring the best possible outcomes for patients.
Before a PET scan our technologists, Mason and Kristin, will inject a radioactive glucose called fluorodeoxyglucose (FDG) into the patient. FDG is consumed more quickly by cancer cells than normal cells. This results in higher concentrations of FDG in areas of cancer. The scan maps the location of these areas, confirming the presence of disease and its exact location in the body. This then helps your oncologist make a diagnosis of cancer and its stage or the extent to which cancer has spread in the body.
FDG is not like a lot of other medical supplies. There are some specific regulations that must be followed to ensure the safety and effectiveness of this radioactive tracer. That’s where Joe, Andriy, and Tim come in. Let us explain what happens behind the scenes every day in order for our patients to be able to have their PET scans at JENCC.
Joe Malfait has been driving for OnTrac, a delivery service company based out of Omaha that utilizes independent delivery drivers using their own vehicles for 7 years. The former army medic and then bricklayer and his faithful delivery partner, Rebel, age 3, have been picking up the radioactive tracer FDG from the nuclear pharmacy that the June E. Nylen Cancer Center contracts with in Omaha in the very early morning each business day for three years now. They drive to Sioux City to deliver just as the clinic is opening. They then proceed to Sioux Falls. Joe and Rebel drive 400 miles a day… no matter the weather.
“I’m glad what I do is helping someone,” says Joe. “This is an important product and I am happy to be a part of ensuring patients get what they need.”
Seeing Rebel each morning as they walk into the clinic makes the employees at JENCC happy. There are even dog treats at the back door to spoil Rebel – and Joe says Rebel perks up as they are getting near the cancer center.
While the radioactive product being delivered is in a secure, lead-lined case and transported in the vehicle’s trunk, the Cancer Center team wanted to ensure Rebel was protected as he rode in the back seat, so they lined Joe’s trunk with additional lead.
Joe is the only driver that goes onto Sioux Falls as part of his daily trip. Another of the deliveries of the PET tracer arrives later in the morning by Andriy Hayduk.
“I understand what I am delivering,” says Andriy. “I know what this means for patients and that they are waiting for this to have their scan. It’s important.”
That is why Andriy takes his reliability in maintaining his vehicle and delivering the radioactive medicine no matter the circumstances seriously. Andriy is from Ukraine and was a pharmacist in his home country for 10 years before he came to America in 1997. He worked as a pharmacy technician at a couple of Omaha hospitals for a few years but has been with OnTrac since 2009. Andriy may be serious about his reliability, but that changed quickly as he discussed his birthplace. He became emotional as he shared his gratitude for America supporting the Ukraine war. He has family, including an older brother, currently living in his hometown in Ukraine.
So why the need for multiple delivery drivers to bring different batches of the PET scan’s radioactive tracer to the Cancer Center? There is only so much capacity for FDG and other PET tracers to be produced at the manufacturing distribution center in Omaha. Once produced, the FDG is given to the manufacturer’s nuclear pharmacy and they put it into syringes to make it into dose form for patients and then package it. These doses are put into lead storage containers that shield the radiation. There are multiple FDG production runs throughout the day but how long the tracer stays radioactive and effective also has to be taken into account.
As soon as FDG and other radioactive tracers are produced, they start to decay immediately. So these are not products that can sit on the shelf to wait for delivery – they need to get on the road right away to be delivered for patient use. Think of the PET tracers like ice – it’s only useful for so long. The June E. Nylen Cancer Center does enough PET scans per day, they require three transports a day.
Delivery drivers go to the nuclear pharmacy to pick up their order for JENCC, place the containers into an additional shielded transport container, and then put the containers into their trunk. Transporting radioactive materials like FDG is a process approved by the Department of Transportation (DOT) and safety checks are completed routinely by surveying or measuring for radiation leaks.
The first pick-up from Omaha starts very early each morning. The radioactive PET tracer and well as other radiation medicines are delivered to a warehouse in Sioux City where Tim Hogan picks them up. Tim delivers to the June E. Nylen Cancer Center by 6:15 each morning, well before the clinic opens. He then proceeds to make his other deliveries around hospitals and medical clinics in Sioux City and Northwest Iowa.
Tim realizes firsthand the importance of ensuring the FDG makes its arrival to JENCC. Tim’s mother was a breast cancer patient many years ago at our cancer center. Tim says he was very familiar with our services and the wonderful care provided. His mother’s cancer went into remission and never came back. She lived to be 93 years old.
“These radioactive medicines are important. Patients need them,” says Tim who has been delivering to JENCC for a year and working for OnTrak for 4 years. In those 4 years, Tim has never not completed one of his deliveries.
The providers and staff at Nylen Cancer Center appreciate the dedicated reliability of their nuclear medicine pharmacy, the delivery service company, and more importantly these three gentlemen. Now that you understand the process behind the scenes of our PET scans, we hope you can share in this appreciation as well.
The postman’s motto as it appears on the main New York City Post Office is "Neither snow, nor rain, nor heat, nor gloom of night stays these couriers from the swift completion of their appointed rounds.” We think the same to be true for Joe (and Rebel), Andriy, and Tim.
Joe Malfait & Rebel
Andriy Hayduk
Tim Hogan