What are Radiopharmaceuticals?

Source: International Atomic Energy Agency – IAEA

Therapeutic radiopharmaceuticals contain, among other ingredients, radioactive atoms that release high-energy types of radiation -such as alpha or beta particles with short range in tissue –  which destroy or weaken unwanted cells or tissues, such as tumours or overactive thyroid cells.

Diagnostic and treatment processes share similarities, however treatment with radiopharmaceuticals focuses on delivering targeted radiation to specific cells, omitting the imaging step central to diagnostic use.

While the radiopharmaceutical is designed to make it  travel inside the body without harming healthy tissues, the patient may need to undergo additional tests to monitor potential side effects of this kind of therapy, which is normally considered safe and well-tolerated.

World Cancer Day 2024 Event: Raising Rays of Hope for Cancer Care for All

Source: International Atomic Energy Agency – IAEA

The IAEA will mark World Cancer Day on 1 February with a livestreamed event at 10:00 CET involving IAEA Director General Rafael Mariano Grossi and Director General of the World Health Organization (WHO) Tedros Adhanom Ghebreyesus. They will be joined by Khumbize Kandodo Chiponda, Ministers of Health in Malawi, and Karina Rando, Minister of Health in Uruguay. Raul Doria, the Head of Paraguay’s National Cancer Institute, will also join the high-level conversation.

Three-time cancer survivor and singer/songwriter Bianca Muñiz will also speak, giving her personal perspective on the complexities of cancer care.

The event will help raise awareness of the IAEA’s Rays of Hope initiative and how it is helping countries such as Malawi, Paraguay and Uruguay to tackle an increasing cancer burden by widening access to cancer care. The Ministers of Health of Malawi and Uruguay will share how progress is being made towards new cancer care facilities in their countries. Malawi is one of seven first wave Rays of Hope countries. Uruguay, which has a long history of cancer screening and focusing on early detection of cancer, will soon receive mammography machines and a linear accelerator through the IAEA’s cancer initiative.

The two-day programme organized by the IAEA, is being held to take stock of progress so far under the IAEA’s flagship initiative Rays of Hope: Cancer Care for All, launched on World Cancer Day in 2022 jointly with the then President of Senegal and of the African Union Macky Sall.

Following the livestreamed event, sessions on Donors’ Perspective, Preparing Strategic Funding Documents for Resource Mobilization at the National Level, and Partnerships for Hope will seek to address cancer care funding issues and deepen new funding avenues, including with development banks and the private sector.  

Through partnerships with governments, international financial institutions and the private sector, Rays of Hope is  helping to increase access to life saving radiotherapy and diagnostic imaging services used in cancer care, focusing on low- and middle- income countries where the need is greatest.

In high-income countries, nearly all patients have access to radiotherapy, but in middle-income countries, however, fewer than 60 percent do. In low-income countries, the figure drops to just one in ten — only ten per cent of cancer patients have access to this life-saving treatment.

Cancer already accounts for one in every six deaths worldwide, and according to estimates from the IARC, the number of global cancer cases is expected to grow significantly in the next two decades, increasing the burden on countries with limited or no access to cancer care.

The Rays of Hope initiative builds on the IAEA’s six decades of experience in working with partners such as the WHO to help countries fight cancer.

Rays of Hope: World Cancer Day Event Highlights Achievements and Explores New Funding Mechanisms for IAEA Cancer Care Initiative

Source: International Atomic Energy Agency – IAEA

The IAEA will mark World Cancer Day on 1 February with a livestreamed event involving IAEA Director General Rafael Mariano Grossi and Director General of the World Health Organization (WHO) Tedros Adhanom Ghebreyesus. They will be joined by Khumbize Kandodo Chiponda, Ministers of Health in Malawi, and Karina Rando, Minister of Health in Uruguay. Raul Doria, the Head of Paraguay’s National Cancer Institute, will also join the high-level conversation.

Three-time cancer survivor and singer/songwriter Bianca Muñiz will also speak, giving her personal perspective on the complexities of cancer care.

The event will help raise awareness of the IAEA’s Rays of Hope initiative and how it is helping countries such as Malawi, Paraguay and Uruguay to tackle an increasing cancer burden by widening access to cancer care. The Ministers of Health of Malawi and Uruguay will share how progress is being made towards new cancer care facilities in their countries. Malawi is one of seven first wave Rays of Hope countries. Uruguay, which has a long history of cancer screening and focusing on early detection of cancer, will soon receive mammography machines and a linear accelerator through the IAEA’s cancer initiative.

The two-day programme organized by the IAEA, is being held to take stock of progress so far under the IAEA’s flagship initiative Rays of Hope: Cancer Care for All, launched on World Cancer Day in 2022 jointly with the then President of Senegal and of the African Union Macky Sall.

Following the livestreamed event, sessions on Donors’ Perspective, Preparing Strategic Funding Documents for Resource Mobilization at the National Level, and Partnerships for Hope will seek to address cancer care funding issues and deepen new funding avenues, including with development banks and the private sector.  

Through partnerships with governments, international financial institutions and the private sector, Rays of Hope is  helping to increase access to life saving radiotherapy and diagnostic imaging services used in cancer care, focusing on low- and middle- income countries where the need is greatest.

In high-income countries, nearly all patients have access to radiotherapy, but in middle-income countries, however, fewer than 60 percent do. In low-income countries, the figure drops to just one in ten — only ten per cent of cancer patients have access to this life-saving treatment.

Cancer already accounts for one in every six deaths worldwide, and according to estimates from the IARC, the number of global cancer cases is expected to grow significantly in the next two decades, increasing the burden on countries with limited or no access to cancer care.

The Rays of Hope initiative builds on the IAEA’s six decades of experience in working with partners such as the WHO to help countries fight cancer.

Empowering Guinea: The IAEA Provides Guidance on Cancer Control Measures to One of its Newest Member States

Source: International Atomic Energy Agency – IAEA

One of the health centres visited by the imPACT Review team was the Donka hospital in Conakry, Guinea. (Photo: M. Nobile/IAEA)

“Cancer control is a priority for the WHO Country Office in Guinea and, in order to ensure a comprehensive approach, we will integrate the recommendations put forward by the imPACT Review experts into the biennial Plan of activities 2024-2025,” stated Jean Marie Kipela, WHO Country Representative.

At the end of the mission, experts from the imPACT Review team presented their key recommendations to the Ministry of Health. The findings stem from an initial period of data gathering and analysis, corroborated by the exchanges and visits that took place over the course of the weeklong mission. The recommendations included the need to integrate cervical cancer screening into the essential health care package on offer to public patients; reinforcing diagnostic services by equipping regional hospitals with mammographs and CT scanners; developing teleradiology (a technology which enables radiological patient images to be shared between doctors based in different hospitals); and setting up an integrated centre for cancer diagnosis, treatment and research.

Following the imPACT Review, a three-day workshop was organized by the Ministry of Health, with WHO assistance, to draft a National Cancer Control Plan (NCCP). This plan will guide all future national efforts in terms of cancer prevention, management and monitoring in the country, aiming to reduce the challenges faced by patients in accessing cancer care and improve coordination between government institutions, the private sector and civil society organizations. It also seeks to re-establish and formalize the cancer registration system that was created in 1992, in order to enable the Ministry of Health to track the impact of cancer control efforts and spending on rates of cancer incidence.

International Day of Clean Energy: Why Nuclear Power?

Source: International Atomic Energy Agency – IAEA

Friday is the first ever International Day of Clean Energy, drawing global attention to the debate on the fastest way to phase out coal without damaging our economies. 

Only two forms of clean energy can currently provide the scale of power needed to keep electricity flowing 24/7, while the world transitions away from fossil fuels. Both hydropower and nuclear power offer the non-stop baseload power required for sustainable economic growth and improved human welfare. 

Nuclear energy already provides around a quarter of the world’s low-carbon electricity. It offers large amount of reliable, dispatchable power providing stability and resilience to the electrical grid and backing up variable renewables such as solar and wind when sunshine or wind are lacking.  

According to a 2022 report from the International Energy Agency (IEA): “Nuclear energy can help make the energy sector’s journey away from unabated fossil fuels faster and more secure.”  

Wind and solar are expected to lead the push to replace fossil fuels. But IEA experts advise that electricity grids also need more stable, resilient and dispatchable power to keep the flow of energy going non-stop. This cannot currently be provided by renewables alone. 

Gas has been providing this stability, but it still emits greenhouse gases. Hydropower can also provide grid stability, but only in specific environments. 

Like hydro, nuclear power does not release any carbon during its use. 

Aside from its low carbon credentials, nuclear power has other features that further support energy supply security and the clean energy transition. For example, one large nuclear power plant can replace multiple coal-fired power plants to provide the same level of energy. Or small modular reactors could be slotted in to replace the old coal-fired plants of similar size, on the same site. 

Energy-intensive industries, such as steel production, which use coal for heating and hydrogen production, could also be decarbonized using nuclear power, thanks to the ability of advanced reactors to produce high temperature steam. 

Nuclear electricity production costs are less sensitive to changes in fuel prices than electricity from oil and gas. Uranium is available from a range of diverse producer countries, and is incredibly energy dense, meaning comparatively low volumes are required. Enough uranium fuel for several years of electricity production can also be easily stored on the site of nuclear power plants. 

When compared with other sources of electricity from cradle to grave, nuclear energy has the lowest carbon footprint, uses fewer materials and takes up less land. For example, solar power needs more than 17 times as much material and 46 times as much land to produce one unit of energy. 

Nuclear power is also the second safest source of energy in the world and nuclear waste is carefully managed and regulated. Nuclear energy has some challenges, including high upfront costs. But over their long lifetime, nuclear power plants produce some of the most competitively priced low-carbon energy. 

As IAEA Director General Rafael Mariano Grossi wrote in his recent op-ed for the World Economic Forum in Davos: “Nuclear is one of the safest, cleanest, least environmentally burdensome and — ultimately, over the lifetime of a nuclear power plant — one of the cheapest sources of energy available.” 

These benefits are being increasingly recognised by environmental activists and world leaders. For example, at COP28 in Dubai, leaders from 22 countries came together to sign a declaration to triple global nuclear energy capacity by 2050 to meet climate goals and energy needs.  

“After 28 years in the wilderness, nuclear is finally having its moment at the world’s most important gathering on climate change—and not a moment too soon,” said Zion Lights, a former UK spokesperson for the environmental movement Extinction Rebellion. “As someone who once protested against nuclear energy and changed her mind about it, it is heartening to see just how much attitudes to nuclear energy have changed.” 

This year will see the first ever Nuclear Energy Summit, hosted jointly by the IAEA and Belgium, on 21 March 2024. 

Co-chaired by IAEA Director General Rafael Mariano Grossi and Belgian Prime Minister Alexander De Croo, it will be the highest-level meeting to date exclusively focused on the topic of nuclear energy. 

“More and more countries are either planning to introduce nuclear power in their energy mix or expand already existing nuclear energy programmes. We have seen a clear positive shift in recent years, with a growing realization that nuclear energy is an indispensable part of the solution to some of the most pressing global challenges of our time,” said Director General Grossi. 

New Radiotherapy Technique for Treating Head and Neck Cancer Could Reduce Treatment Times by Nearly Half

Source: International Atomic Energy Agency – IAEA

For head and neck cancer patients around the world, a new evidence-based, resource-efficient approach has the potential to increase access to radiotherapy. In 2010, the IAEA launched a  coordinated research project (CRP) – the HYPNO trial – to test an advanced treatment technique on a disease that disproportionately affects LMICs. Conventional treatments for head and neck cancers normally require patients to undergo seven weeks of radiotherapy. Previous clinical trials explored the viability of intensified treatment regimens that delivered either a higher overall dose over the same seven-week period (hyperfractionated radiotherapy) or the same total dose but over a shorter period of five to six weeks (normo-fractionated accelerated radiotherapy, as seen in the IAEA-ACC study). Both approaches were found to be safe and effective, with the latter notably using fewer radiotherapy-related resources.

Building on this body of evidence, the IAEA conducted applied research that examined a more intensified treatment regimen (hypofractionated radiotherapy): fewer but higher doses of radiation over the course of four weeks – nearly half the time that standard radiotherapy takes. Under this first-ever comparison, 729 patients received either normo-fractionated accelerated radiotherapy or hypofractionated radiotherapy. Patients in both groups showed similar outcomes and survival rates, demonstrating the safety and effectiveness of fewer but higher doses in a condensed time frame.

The trial’s practice-changing results were presented at the 65th annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) by its principal investigator, Søren M. Bentzen, Professor of Radiation Oncology and Director of the Division of Biostatistics and Bioinformatics at the University of Maryland School of Medicine. Held in San Diego, California from 1 to 4 October, ASTRO’s annual meeting drew over 11 000 healthcare professionals from around the globe who specialise in treating patients with radiation therapies.

 “There is a great opportunity and need to conduct randomized controlled trials in LMICs to define evidence-based best practices within these settings,” Bentzen said highlighting the HYPNO trial as a good example of such research. “The IAEA played a crucial role in facilitating the trial via the long term relationships they have built with clinicians in cancer centres all over the world,” he pointed out.

As a direct result of the HYPNO trial, radiation oncologists can now treat more head and neck patients while maintaining similar clinical outcomes. For providers and patients alike, hypofractionation offers a cost-effective and convenient tool to navigate resource constraints. 

“HYPNO fundamentally demonstrates both the impact of conducting funded research that corresponds to global cancer needs and the importance of multi-national trials to inform clinical decision making through powerful, real-world data on the impacts of treatments,” said May Abdel-Wahab, Director of the IAEA Division of Human Health. “Innovation in cancer care, which the IAEA supports through its coordinated research activities and its Rays of Hope Anchor Centres, will be key to ensuring that all patients, regardless of where they live, can receive the timely and high-quality care that they deserve,” Abdel-Wahab emphasised.

Davos 2024: Nuclear Technologies for Climate and Cancer Highlighted

Source: International Atomic Energy Agency – IAEA

Later that evening, the Director General took part in a high-level reception with Microsoft founder and nuclear energy advocate Bill Gates and Belgian Prime Minister Alexander De Croo on ‘Clean Tech Innovation on the Road to Net Zero’. 

Prime Minister De Croo highlighted Belgium’s ongoing commitment to achieving a clean energy transition and Bill Gates emphasized its ability to support other green energy technologies. 

“We really need to get going with nuclear mixing with renewables,” Mr Gates said. “Nuclear is complementary to a lot more renewables, maybe fifty to ninety per cent of renewables.” 

The Director General discussed how important global inclusivity and non-proliferation are to this ongoing effort and introduced the first ever Nuclear Energy Summit, which will be held in Brussels in March. 

“It’s incredible that after seventy years of the commercial operation of nuclear power there was never an opportunity for world leaders to get together like this on this topic. In Brussels we will discuss the possibilities, discuss the issue of finance, and talk about addressing this global challenge of climate change.” 

The Director General is also attending other meetings that discussed the opportunities offered by low-carbon nuclear power, including a dialogue between engineering experts and senior policy-makers, and a session on how the Middle East and North Africa can best decarbonise their energy sectors. 

As well as engaging on nuclear power, the IAEA Director General also assembled a key event on the importance of nuclear technologies in cancer care, and ways to increase access to these therapies in low- and middle-income countries. 

The ‘affiliate session’ on access to radiotherapy [watch recording of livestream on YouTube] was held by the IAEA on Wednesday in conjunction with the Union for International Cancer Control and The Lancet Oncology journal. 

Djibouti Steps Up Plans for its First National Cancer Centre

Source: International Atomic Energy Agency – IAEA

Plans are well underway to build a national cancer centre in Djibouti – the first of its kind in a country that currently has no access to radiotherapy, a life-saving treatment estimated to help in approximately 50 per cent of all cancer cases.  Djibouti’s Ministry of Health invited experts from the International Atomic Energy Agency (IAEA), the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC) to  conduct a comprehensive cancer assessment imPACT Review in the country in October 2023.

“Introducing radiotherapy is a top priority for our government,” said Ahmed Robleh Abdilleh, Minister of Health for Djibouti, “as it will reduce unnecessary deaths from cancer and enable our citizens to avoid having to travel abroad to receive the life-saving treatment they deserve.”

Out of Djibouti’s population of one million, it has been estimated that over 750 new patients were diagnosed with cancer and over 500 people died from the disease in the year 2020 alone (GLOBOCAN – IARC). These numbers are expected to increase by 70-80 per cent in the next twenty years due to delays in diagnosis and limited treatment options within the country. However, they are only estimates because the country does not currently have a population based cancer registry in place to provide reliable data – something experts from the mission pointed out as a priority action area. “A comprehensive health information system is essential for the government of Djibouti to be able to plan, monitor and evaluate the success of different cancer control strategies and take informed decisions,” confirmed Renee Van de Weerdt, Representative for the WHO Djibouti office.

Following data gathering and desk review, eight specialists from the IAEA, WHO and IARC travelled to Djibouti to assess the situation first hand. Experts were fielded from institutions based in Algeria, Egypt, Morocco, Senegal and Sudan underscoring the importance of regional cooperation in addressing pressing health priorities.

New IAEA Publication: Applicability of IAEA Safety Standards to Non-Water-Cooled Reactors and SMRs

Source: International Atomic Energy Agency – IAEA

Over 80 new reactor designs are currently under development around the globe, some of which are expected to be deployed by 2030. The IAEA has completed a project to assess how well the existing IAEA safety standards — the cornerstone of global nuclear safety — apply to the innovative technologies, such as small modular reactors (SMRs), which are being introduced.

More than 150 experts from thirty countries worked together to identify and document areas of novelty of these technologies when compared against the existing fleet of reactors, and assess the potential implications on the applicability of the safety standards.

The findings of this wide-ranging exercise are presented in the IAEA Safety Report No. 123 Applicability of safety standards to non-water-cooled reactors and small modular reactors, which identifies gaps and areas for additional consideration covering over 90 safety standards related to  the entire life cycle of nuclear power plants.

“The safety report is a practical starting point for understanding how the IAEA safety standards might be used for new technologies and where additional guidance may be needed to inform their application,” says Paula Calle Vives, Technical Officer of the safety report and Senior Nuclear Safety Officer at the Division of Nuclear Installation Safety.

The applicability review covered everything from siting, design and construction to commissioning, operation, and decommissioning. It also included the application of safety standards to related nuclear fuel cycle facilities; radioactive waste management; safety assessment; emergency preparedness and response; and transport. In addition, the publication considers the interface between safety, security and safeguards in the design of those technologies.

Based on the findings of the report, further activities on the safety of evolutionary and innovative reactor designs, including SMRs, are being pursued by the IAEA. For example, the IAEA is working on a number of projects covering regulation, safety, security and safeguards by design in SMRs, and safety considerations of High Temperature Gas Cooled Reactors, Liquid Metal Cooled Fast Reactors and Molten Salt Reactors.

“Accruing knowledge and, when available, experience on the safety of advanced reactor technologies is essential to be able to fill the gaps identified in Safety Report 123 and to ensure that, in due course, the IAEA safety standards will be fully applicable to various types of innovative reactor designs,” said  Ana Gomez Cobo, Head of the Safety Assessment Section. We are also developing training materials on SMR safety to support Member States to build technical capabilities to evaluate those new designs,” she said.

Underscoring further work in this area, Gomez Cobo said: “It is important that any claims on the high levels of safety of new reactor designs should be supported with strong scientific reasoning and evidence, this is why our work to develop new guidance, such as a new Safety Guide on Safety Demonstration of Innovative Technology in Power Reactor Designs is so important.”

The broad scope of this publication makes it valuable to regulatory bodies, technical support organizations, operating organizations of nuclear power plants, vendor companies (such as designers, engineering contractors, manufacturers) and research establishments.

The IAEA remains fully committed to enabling the effective deployment of safe and secure advanced nuclear reactors.

Following the development of the safety report, the IAEA had organized a series of webinars to provide an overview of the outcomes of the review. Videos of the webinars are accessible here.

The new safety report is available for free here.

The IAEA is organizing an SMR Conference from 21-25 October 2024 to provide an international forum to take stock of progress and discuss the opportunities, challenges and enabling conditions for the accelerated development and safe and secure deployment of SMRs among all possible SMR stakeholders and to create a wider awareness on the importance of safety, security and safeguards for technologies such as SMRs.

More information on registration and participation is available here

New IAEA Publication Available: Applicability of IAEA Safety Standards to Non-Water-Cooled Reactors and SMRs

Source: International Atomic Energy Agency – IAEA

Over 80 new reactor designs are currently under development around the globe, some of which are expected to be deployed by 2030. The IAEA has completed a project to assess how well the existing IAEA safety standards — the cornerstone of global nuclear safety — apply to the innovative technologies, such as small modular reactors (SMRs), which are being introduced.

More than 150 experts from thirty countries worked together to identify and document areas of novelty of these technologies when compared against the existing fleet of reactors, and assess the potential implications on the applicability of the safety standards.

The findings of this wide-ranging exercise are presented in the IAEA Safety Report No. 123 Applicability of safety standards to non-water-cooled reactors and small modular reactors, which identifies gaps and areas for additional consideration covering over 90 safety standards related to  the entire life cycle of nuclear power plants.

“The safety report is a practical starting point for understanding how the IAEA safety standards might be used for new technologies and where additional guidance may be needed to inform their application,” says Paula Calle Vives, Technical Officer of the safety report and Senior Nuclear Safety Officer at the Division of Nuclear Installation Safety.

The applicability review covered everything from siting, design and construction to commissioning, operation, and decommissioning. It also included the application of safety standards to related nuclear fuel cycle facilities; radioactive waste management; safety assessment; emergency preparedness and response; and transport. In addition, the publication considers the interface between safety, security and safeguards in the design of those technologies.

Based on the findings of the report, further activities on the safety of evolutionary and innovative reactor designs, including SMRs, are being pursued by the IAEA. For example, the IAEA is working on a number of projects covering regulation, safety, security and safeguards by design in SMRs, and safety considerations of High Temperature Gas Cooled Reactors, Liquid Metal Cooled Fast Reactors and Molten Salt Reactors.

“Accruing knowledge and, when available, experience on the safety of advanced reactor technologies is essential to be able to fill the gaps identified in Safety Report 123 and to ensure that, in due course, the IAEA safety standards will be fully applicable to various types of innovative reactor designs,” said  Ana Gomez Cobo, Head of the Safety Assessment Section. We are also developing training materials on SMR safety to support Member States to build technical capabilities to evaluate those new designs,” she said.

Underscoring further work in this area, Gomez Cobo said: “It is important that any claims on the high levels of safety of new reactor designs should be supported with strong scientific reasoning and evidence, this is why our work to develop new guidance, such as a new Safety Guide on Safety Demonstration of Innovative Technology in Power Reactor Designs is so important.”

The broad scope of this publication makes it valuable to regulatory bodies, technical support organizations, operating organizations of nuclear power plants, vendor companies (such as designers, engineering contractors, manufacturers) and research establishments.

The IAEA remains fully committed to enabling the effective deployment of safe and secure advanced nuclear reactors.

Following the development of the safety report, the IAEA had organized a series of webinars to provide an overview of the outcomes of the review. Videos of the webinars are accessible here.

The new safety report is available for free here.

The IAEA is organizing an SMR Conference from 21-25 October 2024 to provide an international forum to take stock of progress and discuss the opportunities, challenges and enabling conditions for the accelerated development and safe and secure deployment of SMRs among all possible SMR stakeholders and to create a wider awareness on the importance of safety, security and safeguards for technologies such as SMRs.

More information on registration and participation is available here