Radiopharmaceuticals and Radiotherapy: Advances in Radiation-Based Therapies

Ever since the discovery that radiation is lethal to cells and organisms at certain doses, there has been interest in the use of radiation to target cancer cells without killing or damaging the surrounding tissue. When it comes to treating prostate cancer, this was pioneered through the use of primitive versions of brachytherapy involving the insertion of radioactive needles into the prostate. The progress made in the use of radiotherapy to manage prostate cancer in the following century has led to the development of modern techniques such as IMRT and SABR. Meanwhile the development of radiopharmaceutical, radionuclides attached to a specific interactive molecule that can identify and associate with cancers based on the presence of specific molecular markers, has led to two branches of theragnostic; in one hand the radiolabeled probe can be used for diagnostic imaging purposes, while in the other the labelled molecule can target cancer cells specifically to receive DNA damaging doses of radiation leading to cell death. New advances in radiotherapy include the development of new radiopharmaceutical pioneering techniques such as SABR as well as the specific delivery of radiopharmaceuticals using nanomedicine and targeted nanoparticles. Despite these developments, questions have always surrounded radiotherapy with regard to its safety and the resulting toxicity of overexposure. However, its use in South Africa is growing with it being adopted as a frontline therapy and not just an option for the treatment of advanced disease. These limitations can be dealt with through careful patient monitoring and regulations regarding the level of exposure.