Dr. Simron Singh
Medical Oncologist, Sunnybrook Health Sciences Centre
Dr. François Lamoureux
President, Canadian Association of Nuclear Medicine
With highly-trained specialists from the nuclear medicine field joining the cancer team, patients can be assured that every angle of attack is covered.
Cancer is a many-faced beast and no two cancer patients are alike. It’s a complex problem, but researchers in Canada and around the world are bringing cutting-edge technology to bear in developing new precision solutions that target the unique cancers of individual patients. One of the newest treatment approaches has arisen from the field of nuclear medicine, previously known primarily for cancer diagnostics rather than treatment.
This innovation has provided a launching ground for a multi-disciplinary revolution in cancer care. With highly-trained specialists from the nuclear medicine field joining oncologists, surgeons, and nurses on the cancer team, patients can be assured that every angle of attack is being covered.
“Until recently in the cancer world, nuclear medicine was really a diagnostic field,” says Dr. Simron Singh, a medical oncologist at Sunnybrook Health Sciences Centre. “It would help us identify and understand the cancer. What’s happening now is that we’re moving into a new era where nuclear medicine is becoming a therapeutic field as well. This is very much a collaborative approach. It’s not just the oncologist that’s involved in treatment — there are other doctors, there are nurses, there are nuclear medicine technicians, and everyone plays a role in providing the best theranostic approach to the patient.”
From diagnosis to therapy in one technology
The new treatment, known as radioligand therapy, is a triumph of theranostics, a blending of diagnostic technologies with therapeutic applications. Radioligand therapy takes the same radionuclide-tagged compounds that are used to highlight cancer cells in PET imaging and weaponizes them against cancer. Now, in addition to pinpointing the cancerous cells within the body, these compounds can be used to deliver a targeted payload that destroys these cells directly.
“The use of radioactive agents to diagnose cancer goes back 40 or 50 years,” explains Dr. François Lamoureux, President of the Canadian Association of Nuclear Medicine. “But in the last two or three years, we’ve developed new radioactive agents that can selectively kill the diseased cells while leaving healthy cells intact. This is a major advancement in treating certain cancers as there is no invasive intervention – there’s no surgery, no incision.”
A simultaneously systemic and targeted approach
It’s in cancer’s nature to be invasive and clandestine. It propagates aggressively, hiding amid healthy cells and becoming very difficult to root out with previous methods. Surgery and external beam radiation therapy can target heavily-localized cancers but are unable to deal with the holdouts concealed throughout the body. Chemotherapy, on the other hand, is a systemic therapy that can be effective against diffuse cancers — but at the cost of considerable damage to healthy tissue. In the battle against cancer, the holy grail is a strategy that is at one systemic and targeted.
“Fighting cancer is a war,” says Dr. Lamoureux. “The bad guys, the cancer cells, have the ability to very rapidly multiply themselves and invade. Fortunately, now we have a systemic treatment that can patrol the whole body and directly target the bad guys.”
The potential to treat other types of disease
This is a real breakthrough in cancer care and its use is ramping up quickly. Early applications of radioligand therapy in neuroendocrine cancers have been such a game-changer that its potential is now being investigated for other types of disease. Of the many new doors radioligand therapy opens, one of the most significant is the possibility of truly effective cancer treatment with a more easily-tolerated burden of care.
“Quality of life and the burden of treatment are an ongoing concern in all types of cancer care,” says Dr. Singh. “Every patient is different, of course, and they will each have their own preferences and tolerances in terms of a treatment path. That’s why it’s so valuable to have new options available to us to create a treatment plan that works for each patient. Moving forward, this will become a very powerful option to have at our disposal.”
A bright new day in cancer care innovation
With the world’s top scientists and brightest minds forging bold new developments in cancer treatment technology, there’s genuine cause for optimism that tomorrow’s cancer care, and even today’s, will be even more advanced and effective. And, critically, from the patient perspective, it will also be significantly easier to tolerate. For those battling cancer, this represents a huge leap forward in quality of life and quantity of life both.
It’s rare for a new technology to deliver on so many levels, so it’s with good reason that radioligand therapy is being held as a beacon of promise for cancer care and cancer research alike.