Medical Isotopes to the Rescue

Radiation isn't something to fear, but to understand — and use to save lives.

Nuclear technology isn’t only about electricity – it’s also integral to modern medicine. While the word “radiation” often evokes fear, especially linked to nuclear power, in truth radiation is a routine lifesaver in hospitals worldwide. Medical isotopes (radioactive atoms used in diagnosis and therapy) and radiation-based equipment are crucial tools for doctors.

Every day in clinics, controlled doses of radiation are used to scan for disease, treat cancerous tumors, and sterilize medical supplies to prevent infection. This medical reliance on nuclear science puts radiation risks in perspective. The fear of radiation from nuclear energy is often overblown when compared to the far larger exposures we willingly and safely receive for medical benefit or even from nature. The average person is bathed in natural background radiation (from cosmic rays, the ground, and small amounts of natural radioisotopes in our food and air) totaling about 2.4 millisieverts per year globally. This natural dose is several times higher than what the public receives from the entire nuclear power fuel cycle in a year (which is only on the order of 0.001–0.01 mSv for those living near a reactor). In other words, living near a nuclear plant typically adds less radiation exposure than eating a bag of Brazil nuts or taking a cross-country flight. Even the additional exposure a patient might get from a year of nuclear energy-generated electricity is negligible compared to, say, a single CT scan.

By contrast, medical uses of radiation are accepted as overwhelmingly beneficial – a chest X-ray (~0.1 mSv) or a PET/CT scan (5–10+ mSv) carries a tiny risk, yet these procedures can find a cancer or diagnose heart disease in time to save a life. We take these exposures in stride because the medical payoff is enormous. Likewise, the radiation from nuclear power (kept extremely low under strict safety standards) is trivial when set against the public health payoff of clean air and climate stability that reactors provide. In short, context matters: radiation is a natural part of our environment, and when used with care – as in nuclear medicine or power – it can be a force for saving lives, not endangering them.

One of the most direct contributions of nuclear technology to health is through the production of medical isotopes. Specialized nuclear reactors (and some particle accelerators) manufacture isotopes that are the workhorses of diagnostic imaging and cancer therapy. A prime example is Technetium-99m (Tc-99m), a short-lived isotope used in roughly 85% of all nuclear medicine diagnostic procedures. Doctors use Tc-99m in scans to image the heart, bones, and many organs – it emits gamma rays that can be detected by cameras to reveal physiological function and locate abnormalities like tumors or blood flow issues. Globally, this and other nuclear medicine procedures sum up to about 40–50 million procedures per year, meaning nuclear isotopes are involved in tens of millions of diagnoses – from detecting early-stage cancers, to mapping cardiac blood flow in a stress test, to gauging thyroid gland activity. Without these tools, we would have to rely on more invasive or less accurate diagnostic methods. In cancer treatment, radiotherapy often employs radiation generated by machines or isotopes to kill cancer cells. For instance, Cobalt-60, a radioisotope produced in reactors, has been used for decades in cancer radiotherapy machines (the “Cobalt bomb”) to deliver targeted gamma rays to tumors. Co-60 remains vital for certain therapy devices and for stereotactic radiosurgery (like the Gamma Knife for brain tumors) – in fact, Cobalt-60 from Canada’s reactors is used in Gamma Knife treatments in hundreds of hospitals worldwide. Moreover, brachytherapy, where small radioactive seeds (like isotopes of iridium or cesium) are placed inside or next to tumors, is another lifesaving technique enabled by nuclear science. These therapies are part of why over half of cancer patients receive some form of radiation therapy in their treatment course – it’s often the most effective way to destroy malignant cells that surgery or chemotherapy alone cannot.

Nuclear reactors also play an unsung role in maintaining the sterility of medical equipment and supplies through the production of isotopes for industrial radiation sterilization. The same Cobalt-60 mentioned above is a workhorse not just for treating cancer, but for sterilizing disposable medical devices – things like syringes, surgical gloves, scalpels, bandages, and pacemakers. Gamma irradiation from Co-60 is a cold sterilization method that can penetrate packaging and kill bacteria and viruses without heat or chemicals, making it ideal for bulk sterilization of healthcare products. Astonishingly, about 40% of the world’s single-use medical supplies are sterilized using Cobalt-60 gamma radiation. In other words, nearly half of the sterile syringes or catheters in hospitals owe their safety to a nuclear isotope produced in a reactor. Without it, hospitals would face greater risk of infections and would have to revert to less efficient sterilization methods (which might not be feasible for the sheer volume of modern disposable items). During the COVID-19 pandemic, this sterilization capacity was crucial for rapidly preparing large quantities of personal protective equipment and swabs – another reminder of how nuclear technology underpins public health behind the scenes.

A secure supply of medical isotopes is therefore critical for healthcare worldwide – and here we face a challenge: many of the research reactors that produce these isotopes are aging, and supply chains have become fragile. Today, a handful of reactors (in countries like Canada, the Netherlands, Belgium, South Africa, and Australia) produce the bulk of key isotopes like Molybdenum-99 (which decays into Tc-99m for diagnostics) and Cobalt-60. For example, Mo-99 is mostly made in just five reactors globally. If one goes offline unexpectedly, it can create a worldwide shortage. This isn’t just a theoretical concern – it has happened. In 2009–2010, unplanned outages at major isotope reactors (Canada’s NRU and Europe’s HFR) led to a crisis where hospitals in many countries ran low on Tc-99m. During one period in 2008, 20% to 70% of nuclear medicine procedures were delayed or canceled in affected regions because the isotope supply couldn’t meet demand. Doctors had to postpone critical scans or use less optimal diagnostic tests, impacting patient care. The supply chain will remain fragile as long as it relies on a small handful of reactors. This is why experts urge investment in new production facilities and technologies to secure medical isotopes for the future. Supporting nuclear science and infrastructure – whether that means keeping reactors operating, building new research reactors, or developing accelerator-based isotope production – has a direct bearing on whether patients can get timely scans and treatments.

If we allow fear or misunderstanding to shut down nuclear reactors indiscriminately, we risk severing the supply of isotopes that our healthcare system depends on. It’s notable that countries strong in nuclear technology (Canada, for instance) have become hubs for medical isotope supply, benefiting the entire world. Going forward, medical professionals have a stake in nuclear policy: advocacy for nuclear research and facilities is advocacy for the diagnostic and therapeutic tools that save lives daily.

Nuclear energy and radiation contribute profoundly to medicine. Nuclear medicine diagnostics enable early detection of disease; radiation therapies cure cancers and relieve suffering; and radiation sterilization guarantees the safety of medical consumables. These benefits reach far into every hospital and clinic. When we consider nuclear energy, it’s not only about powering our homes – it’s also about powering our hospitals. By ensuring a strong nuclear sector, we ensure that doctors continue to have these indispensable isotopes and techniques at their disposal. The next time someone gets a life-saving PET scan or a tumor precisely zapped by proton beams (another advanced form of nuclear technology), it’s thanks in part to the often invisible nuclear infrastructure supporting healthcare. Therefore, building public support for nuclear energy isn’t just an energy issue; it’s a healthcare issue as well.