Radiation and cancer experts say it’s time for Ontario to change an outdated law that prevents people who have received a certain type of radiation treatment from being cremated.
The procedure, known as brachytherapy, involves permanently implanting dozens of minuscule radioactive seeds in a localized area to attack cancer cells.
It has become a common and effective method for treating prostate cancer, in addition to other forms of the disease, but patients who opt for the treatment — and their families — are often shocked to find out that it is illegal to cremate a body containing the implants.
The issue made headlines last week when CBC Toronto published a story about a family who were told they could not cremate their father due to the existing regulations.
“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,” said Curtis Caldwell, the chief scientist at the Radiation Safety Institute of Canada.
Caldwell’s organization says Ontario’s law forbidding the cremation of patients who have received brachytherapy or other forms of seed implants is excessive and unnecessary.
The most common form of brachytherapy treatment involves radioactive isotopes with a half-life of around 60 days, which means that the total amount of radioactive material is reduced by half every two months.
“About two years after this has been administered, you really need no precautions at all, no matter how much you treated the patient,” Caldwell explained.
Thousands have received the treatment
He went on to say that even if a patient dies sooner than two years after receiving treatment, taking basic precautions during the cremation process — such as wearing a mask — is enough to prevent harmful radiation exposure.
In 2012, around 400 men in Ontario were treated with brachytherapy for prostate cancer. The total annual number of patients receiving the treatment is believed to be well into the thousands.
“I think if the politicians involved were aware of the issue, they would probably agree with trying to get this changed,” he added.
In an email to CBC Toronto, a spokesperson for the Ministry of Government and Consumer Services said the government is aware of the concerns.
“This is a complex issue that we are currently examining in greater detail for all available options,” wrote David Woolley.
Ontario and Saskatchewan are the only provinces with strict laws forbidding the cremation of human remains that contain nuclear substances.
Quebec updated its laws earlier this year to permit cremation two years after treatment.
Families unaware of law
The family in last week’s CBC Toronto story said multiple funeral homes around Toronto all refused to cremate the remains.
The deceased man, Al Monk, arranged to have his remains cremated, and his family says he was never told by Highland Funeral Home that past radiation treatments could prevent that from being done.
However, after providing a medical history showing that implants were never used, the family was able to go through with the cremation.
Patients declining treatment due to law
Jean-Pierre Bissonnette, a medical physicist at the University of Toronto, said brachytherapy can be among the most effective and least taxing cancer treatments available
“A normal course of external radiation therapy would stand probably on the order of five to seven weeks, whereas a permanent seed implant would involve a single visit to the hospital,” he explained.
The seeds can also reduce side effects in other forms of radiation treatments, he said.
Despite those advantages, Caldwell says patients — particularly those with religious beliefs that call for cremation — sometimes opt for other forms of treatment due to the existing cremation restriction.
In some cases, he said families have shipped human remains overseas to be cremated in jurisdictions without similar laws.