Radioisotopes & the Case for Nuclear Power
While the production of nuclear energy entails some risk—however small it may be—we must not let our sensationalized, and irrational fear of nuclear meltdowns (mis)guide our judgement.
Nuclear power is safe and cheap—France has run largely on nuclear reactors for 60 years and never had a problem.
But that’s not what I want to discuss. There’s plenty of information on nuclear energy’s efficacy that’s publicly available.
Instead, I’d like to zero-in on an issue that’s been completely neglected by both sides of the debate: medical isotopes.
While most people never give it a moment’s thought, modern medicine is actually predicated upon the nuclear energy industry—it can’t function without it.
Nuclear reactors generate the hundreds of different, and important radioactive isotopes that we use every day in our hospitals.
We use them in medical imaging, diagnostics, and to treat advanced metastatic cancers.
In many ways, modern medicine is nuclear medicine—it’s not an understatement to say that without nuclear reactors, modern medicine couldn’t exist as it currently does.
And yet the public health impacts of closing down our nuclear reactors never factors into our policy assessments—Germany is shutting down all its nuclear reactors by 2022, and no one has considered how this will impact German healthcare.
Let’s open up this conversation.
Radioisotopes & Nuclear Medicine: Diagnostics, Oncology, & Sterilization
Radioactive isotopes made in nuclear reactors are a staple of modern medicine.
Nuclear isotopes are used in over 40 million medical procedures every year, and demand for them has increased rapidly, at 5% per year.
Not only are they widely used, they fill a variety of niches: radioactive isotopes serve diagnostic purposes, are routinely used to treat cancer, and are used to sterilize contaminated medical equipment.
Radioisotopes are Critical to Modern Medical Diagnostics
Radioactive isotopes are a key component of modern medical diagnostics.
Because when combined with imagining devices that can track gamma radiation, they provide a dynamic, detailed picture of the human body. The benefits of using isotopes, as opposed to external radiation sources (like x-rays) are manifold.
Isotopic imaging is far more precise than anything else we’ve devised—we can use radioisotopes to build a three dimensional model of what’s going on in the body.
Not only are they accurate, they’re superior because they don’t just provide a snapshot isolated in time (like an x-ray), they provide information dynamically, and are therefore useful in understanding the spread of cancers, or organ damage—they tend to accumulate in “hot spots”.
Another advantage is that radioisotopes can be used to image soft tissue (organs, the brain) as well as bone. They give us a complete picture. They’re versatile.
And of course, radioisotopes are non-invasive. Medical isotopes have very short half-lives (hours to days), and decay into inert elements that the body simply excretes.
Let’s look at a specific example.
The most common radioisotope used in modern medicine is Technetium 99—it’s present in 80% of all nuclear medicine procedures.
Because Technetium 99’s (Tc 99) (i) half-life is just six hours, which gives physicians time to image, while minimizing the radiation dose to the patient; (ii) it’s a relatively low-radiation option (much less than your average x-ray); and (iii) Tc 99 is a versatile chemical that can be used to trace a wide range of organic compounds, and can therefore be used to study a variety of different problems.
All good stuff.
We’re going to revisit Technetium 99 later in the article, so remember why it’s so important.
What should you take away from this section? Radioisotopes are a critical component of modern diagnostic technology because they are significantly more precise, versatile, and less-invasive than traditional methods of exploring the human body (surgery, x-rays).
Nuclear Medicine: Treatments & Therapies
Right now treatment using radioisotopes is relatively rare compared to their use in imaging and diagnostics, but they are nevertheless critical to treating cancer—and they’re only growing more important as science improves.
Like all cells, cancerous cells are sensitive to radiation—concentrations of radioisotopes can kill. That’s why nuclear medical therapies are generally centered around killing tumors.
Doing so endogenously via isotopes has a number of distinct advantages over exogenous radiation therapies like teletherapy (blasting someone’s tumor with a gamma or x-ray beam) or gamma knife radiosurgery—both of which lack fine-tuning.
This is because radioisotopes can remain active longer, and are much more precise.
For example: short-range radiation therapy, known as brachytherapy, is one of the most effective ways to kill tumors. How does it work? A small radiation source, often a concentration of Iodine 131 isotopes, is implanted next to a tumor and kills it with the gamma radiation.
The benefit of doing this is that the radiation is more concentrated and targeted, and therefore does less harm to the patient’s healthy cells in other parts of the body—patients can endure more treatments this way, and are therefore more likely to beat their cancer.
Radioisotope therapy for treating cancer was like discovering fire—it changed the name of the game. Nuclear medicine has been one of the biggest breakthroughs in oncology, and for it to continue, we need nuclear reactors.
No one ever talks about this, but it’s incredibly important.
Bacteria are evolving antibiotic resistance at an alarming pace. And what’s worse, they’re now evolving resistance to drugs of last resort, such as Colistin.
The epicenter of this is hospitals. In 2016 the Center For Disease Control (CDC) identified a number of antibiotic resistant microbes, and said they pose a major threat to America’s healthcare system.
Antibiotic resistance is a big deal.
And yet there’s not many ways around it: hospitals must be sterile.
That’s where radioisotopic sterilization comes in: gamma rays from decaying isotopes can kill bacteria and leave no survivors—there’s no mutating against gamma radiation.
It has other benefits too: radiation can sterilize without physical contact. That’s why it’s radioisotopes are increasingly being used to sterilize burn dressings and bandages—it’s faster, there’s less mess, and there are no issues of microbial resistance.
The Future of Nuclear Medicine: Artificial Supply Constraints
The radioisotopes generated in nuclear reactors are the key behind modern medicine—from imaging, to diagnostics, to treating cancer, and sterilizing hospitals in a way that minimizes antibiotic resistance.
Basically, nuclear medicine is awesome.
And yet it’s being completely ignored by our politicians in their debate over the future of nuclear energy.
Rather than shutting our nuclear reactors down because we’re afraid of the boogeyman that is a nuclear meltdown, we should be building more—as many as we can.
Nuclear power’s not only cheap, but the demand for medical isotopes is only going up and up.
Right now, the OECD predicts impending shortages of medical isotopes in the western world because of our misinformed policies—shut down the reactors, shut down nuclear medicine. And remember, you can’t store isotopes because they decay (quickly), therefore, you really do need a stable domestic supply.
If you don’t, things get bad.
And we’re already starting to feel the effects.
Here’s an example: the home of nuclear medicine is Canada (of all places). Canada’s Chalk River reactor produces some 20% of the world’s supply of Technetium 99 (remember from earlier). The plant is undergoing maintenance, and the global supply of this isotope is going to fluctuate until 2018.
Have you heard about this? Has anyone? No.
That’s my point. Here we have one of the world’s most important (especially if you’re a cancer patient) supply chains being completely disrupted because of maintenance in a single facility, and no one hears about it.
Why not? Because nuclear energy is demonized by the media, and (ironically) environmental groups. They hate nuclear energy, they want it gone.
So why would they mention how critical the nuclear industry is to our healthcare? It doesn’t fit the narrative.
Meanwhile, the developing world is building nuclear power plants at a furious pace: between 2017 and 2020 the world will start construction on 48 new nuclear reactors. Where are they? Well, only 4 are in the western world (2 in the US, 1 in France, 1 in Finland). As for the rest: 20 are in China, the rest are mostly in Russia, Pakistan, India, and Eastern Europe.
Meanwhile, we’re shutting ours down.
Not only will this hurt our economies, but it’s going to give these rather unsavory countries a choke-hold on the world’s supply of medical isotopes.
Do we really want to rely on China for our cancer medicine? No.
America must ensure she retains sufficient nuclear capacity to provide enough radioisotopes for her people.