Law in Ontario prevents cremation of brachytherapy patients

A law in Ontario prevents brachytherapy patients from being cremated

March 14, 2019
by John R. Fischer , Staff Reporter
A law preventing the cremation of loved ones who underwent brachytherapy in life is wrong and should be eliminated, say cancer and radiation oncology experts in the Canadian province of Ontario.

A case involving the refusal of multiple funeral homes to cremate the remains of Al Monk, whose family was unsure if he had TheraSeeds implanted for prostate cancer treatment, has prompted many to speak out against what they call an “outdated” law, claiming that it deters patients from receiving what could be a necessary treatment.

"It means that a fairly large group of people that have end-of-life plans that include cremation … are now not getting the best therapies that they might need," Curtis Caldwell, the chief scientist at the Radiation Safety Institute of Canada, told CBC News, adding that “about two years after this [brachytherapy] has been administered, you really need no precautions at all, no matter how much you treated the patient.”

Around 400 men in Ontario were treated with brachytherapy for prostate cancer in 2012, with the complete number reaching into the thousands annually. The most common form of brachytherapy involves the implanting of radioactive isotopes with a half-life of around 60 days. The total amount of radioactive material is then reduced by half every two months.

Along with Saskatchewan, Ontario forbids the cremation of human remains with nuclear substances, an issue that has caused many to seek other alternatives for laying their loved ones to rest, including shipping their remains to other countries that do not have such laws.

Supporters of the law argue that implants, such as TheraSeeds, put cremation operators at risk for radiation exposure and risk damaging crematorium equipment. Oncologists, however, say precautions such as wearing a mask, can protect against exposure.

The issue made headlines this past month in the Great White North when the family of Al Monk was told they could not bury him because they were unsure if he had received the form of treatment while battling prostate cancer. The family was turned away by multiple funeral homes, despite the fact that Monk had made all the preparations before his death and paid 2,124.40 Canadian dollars (US $1,590.33) to cover all costs associated with a basic cremation.

The family was shocked, as neither his doctors nor Highland Funeral Home, the place where he made his final arrangements, had informed them that such a law existed. Even the contract he signed did not specify it.

"I think any oncologist who has offered that treatment to a patient should know the law," Al’s daughter, Cindy Monk-Fuller, told CBC News.

Dustin Wright, senior director of marketing and communications for Arbour Memorial, the parent company of Highland Funeral Home, said that such information is not in their jurisdiction.

"Our role is to really provide the families with guidance in creating funeral and memorializations that are meaningful to them and their loved ones," he told CBC News. "Asking that kind of question or having that within our agreement is not part of our scope.”

The family was luckily able to move forward with the cremation after contacting Al’s physician, who pulled up his records and reported back with a handwritten note for the home that Al had only undergone standard radiotherapy. Monk-Fuller, however, says avoiding stressful scenarios like this requires greater transparency and education of the law.

"If you're sitting down with a client and you're taking their money, I think it's incumbent upon you to have the correct information," she said.

Inquiries about the law have been heard and are currently being evaluated, said David Woolley, a spokesperson for the Ministry of Government and Consumer Services, in an email to CBC Toronto. "This is a complex issue that we are currently examining in greater detail for all available options.”

More Rad Oncology

Fivefold difference found in Medicaid reimbursements for radiotherapy

Trends in radiation oncology workforce potentially threaten rural patients, says study

Varian showcases first preclinical findings of Flash therapy trial

Female oncologists submit fewer charges, paid less than male

Four considerations before embarking on a carbon therapy center

Q&A with Scott Warwick, executive director of the National Association for Proton Therapy

New approach identifies lung cancer patients most likely to respond to chemotherapy

Aussies and Americans develop 3D models for assessing impacts of radiotherapy

IBA tech plays first-time role in flash therapy demonstration

Access to proton therapy increasing for pediatric patients