Nuclear fusion is on the precipice of advancing America’s oncology landscape

A form of nuclear medicine that most doctors use to diagnose chronic diseases like cancer is currently produced almost entirely outside the US, leading to shortages, lost supply, and gaps in care. But we could be on the brink of change, thanks to burgeoning nuclear fusion technology.

The medicine in question contains technetium-99m (Tc-99m), a radioactive material that can detect disease by allowing it to show up on medical imaging. When a patient is being tested for cancer or cardiovascular disease, doctors will most likely inject them with a radiopharmaceutical containing Tc-99m to make a diagnosis.

Tc-99m is derived from another radioactive material, or radioisotope, called molybdenum-99 (Mo-99). Even though these materials power radiopharmaceuticals that are used in a whopping 80% of nuclear medicine procedures, the nation’s supply of Mo-99 is shipped here from nuclear fission reactors in other countries—and can be subject to tariffs.

“We lose about 20% of product just in shipment—when things go well. And when things go poorly, we don’t get product. You need shipments every single week, and sometimes multiple times a week, because it doesn’t have a shelf life. Like shipping ice on a hot day,” Greg Piefer, CEO of nuclear fusion company Shine Technologies, told Tech Brew.

Shine Technologies is currently building nuclear fusion devices that the company says will produce Mo-99 and other radioisotopes domestically, which will dramatically alter the supply chain. Unlike nuclear fission, which currently produces most of the world’s Mo-99, fusion is sustainable and more cost-effective. And now that Shine has “mastered” the fusion technology needed to produce medical isotopes, Piefer said, its Wisconsin-based infrastructure will be operational in the next two years.

“We invented these technologies in the United States. It’ll return production leadership to the United States. But more importantly, it’ll prevent shortages in the United States, and, frankly, all of the West,” Piefer said. “The fact that we’re already selling isotopes gives us confidence that the investments in the fusion plant are worth it.”

A nuclear family: Though the radioisotopes that Shine plans to produce domestically currently come from foreign nuclear reactors, other types of radioisotopes that help treat cancer are produced in the US via particle accelerators, like those from radiopharmaceutical company NorthStar Medical Radioisotopes.

Daniel DeVries, the company’s senior director of medical radioisotope product development, told Tech Brew that radioisotopes generated by fusion technology will be “complementary” to those produced by particle accelerators because they serve different medical purposes.

“We can’t all do the same things,” DeVries said. “All of these techniques are necessary to create all of the different isotopes that we want as a health system to have access to.”

Increased demand: Cardinal Health, a healthcare services company that specializes in nuclear medicine, also produces radioisotopes via particle accelerators. Mike Pintek, the company’s president of nuclear and precision health solutions, told Tech Brew that a domestic supply of radioisotopes created by nuclear fusion is vital as demand for radiopharmaceuticals rises.

“The population is growing, but it’s also true that there’s a growing number of the population that is aging, and as they age, there is a higher incidence of disease as well,” Pintek said, thus increasing the need for “precision medicine” made possible by radioisotopes.

On top of that, the list of conditions that can be treated using radiopharmaceuticals is growing beyond cancer and other solid tumor diseases due to radiopharmaceutical technological advances.

“New and novel radiodiagnostics are prevalent and impacting patients very positively in the areas of cardiology and Alzheimer’s disease,” Pintek said. “It’s a wide variety of disease states and a growing number of disease states that we expect to come in the future as well.”

It’s for those reasons—in addition to “painful” radioisotope shortages as a result of foreign nuclear reactor miscoordination that the industry has weathered in the past—that Pintek is so excited about the prospect of a domestic supply.

“Fusion technology…will continue to support growth and stabilize the supply chain even further as we go forward,” Pintek said. “And that can only be good for patients.”