Going nuclear: Beating cancer on a molecular level

Nuclear scans provide the best possible images of internal organs and tissues based on the body's chemistry. They have, in the past three years, moved from a purely diagnostic function to providing actual therapy – with previously unheard-of success.

That's according to the Head of Nuclear Medicine Department at University of Pretoria and Steve Biko Academic Hospital, Professor Mike Sathekge, who says this modality changes cancer management in over half the patients he and his colleagues handle.

Nuclear medicine can help improve cancer treatment outcomes

Prof Sathekge goes so far as to say that if people are unable to access nuclear medicine, the likelihood of mismanagement increases because the treating physician may not realise the full extent of the disease.

Many oncologists are not aware of the benefits of nuclear medicine, and there is an overwhelming need to include this modality of diagnostic/therapeutic treatment where indicated.

Cost and availability are major barriers to access, with 64 nuclear physicians in the country, (most whom are active). There are only 13 public nuclear medicine units and about 46 in private (the private sector units tend to open and close over time and have the same owners).

Advances in cancer treatment

Types of cancer for which nuclear medicine works best are neuro-endocrinal tumours, prostate and thyroid cancer and bone pain palliation (slowing cancer growth), while in children it is also used for neuroblastomas.

Sathekge says the research horizon in prostate and breast cancer and neuro-endocrine tumours is very promising. Current work is already providing the basis for successful radionuclide therapy via the theranostic approach which integrates diagnostic testing to determine the presence of a molecular target for which a specific treatment or drug is intended. This is already available to everyone who can afford it.

With prostate and neuro-endocrinal cancer the success rate is about 80% (especially when prostate cancer recurs), while for thyroid cancer it's in the 90% range.

Sathekge emphasises that although raising awareness of nuclear medicine among colleagues is vital, all treatment is multidisciplinary. "We don't want to do it alone – there can be no unilateral decisions," he adds.

This article is an extract from an in-depth piece on understanding cancer research. The full piece explains currently available treatment options, such as:

• Positron Emission Tomography
• Nuclear medicines and radiation
• Molecular Theranostics
• PSMA-targeted treatment
• Peptide Receptor Radionuclide Therapy (PRRT)

Read the full article on Discovery's 'Understanding Cancer' hub here.

This article is meant for information purposes only and should not be taken as medical or financial advice. For tailored advice, please contact your healthcare practitioner or financial adviser.