While some may associate nuclear technology with clean energy or weaponry, this field has also been at the forefront of molecular medicine or personalized medicine leading to significant clinical advances — specifically in the fight against cancer.

Nuclear medicine has become an important tool for cancer detection and treatment, as well as alleviating cancer-related pain in palliative care, explains Dr. Christopher O’Brien, Chief of Nuclear Medicine for the Brant Community Healthcare System. “In select populations, this is a very powerful tool that helps treat the patients more effectively and in a more balanced way.”

Catching cancer earlier

Before cancer can be treated, it must be accurately detected. Medical imaging such as CT scans, MRIs and X-rays show what’s beyond the skin’s surface, but nuclear medicine adds a new perspective. 

“MRI and CT scans look at the structure and anatomy of what an organ actually looks like,” says Dr. O’Brien. “What nuclear medicine is actually looking at, is the  cellular function.”

“In select populations, nuclear medicine is a very powerful tool that helps treat patients more effectively.”

Nuclear imaging involves the patient swallowing, inhaling or being injected with a radiopharmaceutical — a drug comprised of a pharmaceutical agent targeted at a specific organ or tissue as well as a material that gives off small amounts of radiation. According to the Canadian Cancer Society, areas that contain tumours will “take up” the pharmaceutical in an abnormal way. The radiation acts as a marker, bringing potentially cancerous tumours to the physicians’ attention.  
“Nuclear medicine looks at cellular and tissue activity, allowing us to detect disease entities earlier on, before the organ actually changes shape,” says Dr. O’Brien.

According to O’Brien, adding nuclear imaging to the arsenal of cancer-detecting tools can lead to a more accurate picture of a patient’s condition — allowing doctors to see if a cancer has spread or assess if treatment is working.

“You need the anatomic assessment and you need the functioning assessment to be able to plan your best treatment more effectively,” he says.

Treatment and pain relief

Once diagnosed, nuclear medicine can also provide patients with additional treatment for cancer, particularly for those with thyroid cancer or specific types of adrenal gland, neuroendocrine or blood cell tumours.

Nuclear medicine uses radioactive isotopes specifically targeted to an area of the body — such as radioactive iodine used to combat thyroid cancer — to destroy cancerous cells.

“The radioactive iodine will be picked up by the residual cancer cells that may be there and that will kill off those cells,” says Dr. O’Brien. “The same thing occurs if the cancer has spread to the lungs or other parts of the body or in the bone; the cancer is still picking up the radioactive iodine and is able to be treated that way. This therapy complements surgery, for instance, and together they minimize the chances of the disease coming back.”

When cancer causes pain, such as when it has migrated into a patient’s bones, nuclear medicine can also be used to target and kill the cancerous cells, thereby alleviating some of the patient’s discomfort — often with minimal side effects.

“Nuclear medicine looks at cellular and tissue activity, allowing us to detect disease entities earlier on, before the organ actually changes shape.”

“As we’ve become more familiar with the treatment options, we’ve found that many more people can access medical isotope treatment without any complications and the reason for that is that it’s targeted therapy, it’s not affecting the whole body,” says Dr. O’Brien.
The Canadian Cancer Society estimates that 196,900 new cases of cancer will be diagnosed this year. For some of these patients, nuclear medicine can make a difference in how their disease is understood and treated. 

“[Nuclear medicine is] something a patient should not be afraid of because of the name,” says Dr. O’Brien. “It’s very important to have a discussion with your doctor to see if therapy with radiopharmaceuticals would be beneficial for your type of cancer.”