Update, 12 October: The Health Ministry says the matter is under review, the hospital is using its PET scanner as a stopgap — though breast cancer patients cannot be scanned on it — and radiotherapy throughput has fallen from about 300 patients a day in April to around 200. The replacement timeline is also now dated. See Update, 12 October below.

Around 1,500 patients who need radiation therapy are facing delays at the Maharagama Apeksha Hospital because its CT simulator is not working, the Society of Government Radiological Technologists of Sri Lanka said, according to the Daily Mirror.

The machine is not old or broken. A new CT simulator was installed to replace the hospital’s previous unit and was handed over to hospital staff last month for clinical use. It has remained unusable since.

A software problem, not a hardware one

The association said the fault is one of incompatibility between the new machine’s software and the software the hospital uses for radiation therapy planning. The two systems will not work together.

A CT simulator produces the images oncologists use to plan where radiation should be directed and at what dose. Without it, treatment cannot be planned accurately, and the planning step sits ahead of the treatment itself — so a machine that cannot be used stops the queue rather than slowing it.

What it costs patients

The association said the delay is causing severe difficulties for patients waiting for treatment, and pointed to the alternative: obtaining radiation therapy privately costs a patient between Rs. 500,000 and Rs. 2 million.

Apeksha, the national cancer hospital at Maharagama, is the main public provider of radiation oncology in Sri Lanka. For patients who cannot meet private costs, there is no practical substitute.

Not reported

The filing does not say when the incompatibility was identified — the replacement is now dated: the old unit was removed on 29 April and the new one handed over on 7 September. Still not reported: who supplied or commissioned the machine, or whether the procurement specified compatibility with the hospital’s existing planning software. It does not say what the Ministry of Health or the hospital administration have done since the fault was found — answered 12 October: the Ministry says the matter is under review. No timeline for a fix has been given.

It also does not state what interim arrangement, if any, is in place for the 1,500 patients — answered 12 October: the hospital is using its PET scanner, which cannot take all patients. How long the average wait has become is still not reported, and no response from the hospital director or the supplier has been published.

Update, 12 October: the Ministry is reviewing it, and the PET scanner is carrying the load

The Health Ministry is concerned over the technical issues affecting the new CT simulator, and a senior Ministry official said the matter was under review, the Daily Mirror reported. That is the first Ministry response on the record.

The replacement now has dates — and they reframe the story

The hospital’s previous CT simulator was removed on 29 April to make way for a replacement. The new machine was handed over to hospital staff on 7 September but has been unable to support radiotherapy treatment planning because of the software compatibility issue.

Those two dates change how the gap should be read. This newsroom reported in September that the CT simulation service had not worked properly since 28 April — which lines up with the removal of the old unit a day later. The service has therefore been degraded for more than five months, and what reads as a six-month equipment breakdown is better described as a replacement project: the old machine was taken out on schedule, the new one arrived four months later, and it has now sat unusable for a further five weeks.

The stopgap, and who it excludes

As a temporary measure the hospital has been using its PET scanner to carry out CT simulation. The scanner cannot accommodate all patients because it lacks the specialised accessories and capacity the procedure requires, and breast cancer patients in particular cannot be scanned on it.

That is a significant qualification. The workaround is not a substitute for the simulator but a partial one, and it excludes patients from the disease group the National Cancer Control Programme identifies as the most common in Sri Lankan women — about 6,000 new breast cancer cases a year.

Relying on PET scans for planning was already flagged as unsatisfactory. Medical sources told the Daily Mirror in September that it is not the preferred method for CT simulation and could further complicate timely delivery of radiation therapy.

A harder measure of the damage

Government Radiographers’ Association Chairman Chanaka Dharmavikrama said nearly 1,500 patients were on the waiting list for CT simulation, warning that delays could allow their cancers to progress.

He gave a figure that measures the shortfall more directly than the waiting list does: the number of patients receiving radiotherapy at the hospital has fallen from around 300 a day in April to approximately 200 — a drop of about a third — despite four linear accelerator machines remaining operational.

That last clause is the important one. The treatment capacity is intact and running; it is the planning step ahead of it that has throttled throughput. Roughly 100 fewer patients a day are being treated on machines that are working.

The association repeated that radiotherapy in the private sector costs between Rs. 500,000 and Rs. 2 million.

One discrepancy

The 9 October filing attributed the account to the Society of Government Radiological Technologists of Sri Lanka; this one attributes it to the Government Radiographers’ Association. Both are the Daily Mirror. The two names may refer to the same body rendered differently, but no filing says so, and this desk has not reconciled them.

Still open

No filing gives a timeline for resolving the software incompatibility, names the supplier or the commissioning agent, or says who is accountable for a compatibility failure that was not caught before handover. None says whether the fix is a software update, a licence, or a replacement of the planning system — which determines whether this is a matter of weeks or of another procurement.

Nor does any filing say what happens to breast cancer patients who cannot use the PET scanner in the meantime.

A single-source story

Both filings are the Daily Mirror’s. Ada Derana has also carried the case, but its site has returned a CloudFront block to this desk for twenty-three consecutive days and could not be fetched or cited. Hiru News and NewsFirst carried no corresponding report on 12 October, and searches of the Daily FT, the Island, the Sunday Times, EconomyNext and Colombo Gazette returned only older, unrelated coverage of the hospital’s PET scanner.

Sources: Daily Mirror, 9 October, Daily Mirror, 12 October.