Nuclear medicine in Northern Ontario: another spinoff benefit from the CANDU program

Bruce Power, by far Canada’s single largest electricity generating plant, is also the biggest clean energy centre in the western hemisphere. The plant’s eight CANDU nuclear generating units are capable of cranking out 50 billion kilowatt-hours of electricity each year. If generators running on allegedly clean natural gas were to provide 50 billion kWh, they would dump more than 27 million metric tons of carbon dioxide (CO2) into the air in a single year. As I mentioned last week, a big portion of those 27 million tons of CO2 would wind up in the world’s already-stressed oceans, making their water more acidic. We cannot afford to let this happen. Thank heavens for Bruce, and all other nuclear plants—they produce power without CO2.

The Bruce plant is also a major world producer of cobalt-60, arguably the most widespread and important medical isotope. Co-60 is made in CANDUs and other reactors (primarily the NRU at Chalk River) by bombarding cobalt-59, the naturally occurring isotope of the element cobalt, with neutrons. It is an extremely useful material, because of its strong gamma radiation. In some circumstances, gamma rays kill cancer. In fact Co-60 gammas have treated millions of cancer patients world wide.

“The world’s newest and most powerful atomic weapon in the fight against cancer.” The cobalt-60-loaded external beam cancer therapy unit was first used in London, Ontario in 1951, to treat a case of cervical cancer. Up to then the only gamma source strong enough to kill cancer was radium, but it occurs naturally in such tiny amounts that it is prohibitively expensive. Co-60 made radiation therapy affordable. This appealed to Saskatchewan premier Tommy Douglas, a tireless champion of affordable universal healthcare.

Co-60 is also used in hospitals and blood banks all over the world to sterilize blood prior to transfusion in infants and immuno-deficient patients, in order to prevent a transfusion-related disease that is almost always fatal. Gamma sterilization is the only sure way to protect against this disease.

Gamma rays from Co-60 are used in numerous other preventive medical applications, including sterilization of medical instruments and food preservation. As I mentioned a few weeks ago, astronauts like Canadian Chris Hadfield, current commander of the International Space Station, live in space on food that has been sterilized with gamma rays. This ensures they do not catch foodborne diseases, something nobody can afford in space.

Welcome news then that Bruce Power has partnered with the Northern Ontario School of Medicine to “foster better educational outreach in radiation and health and build a strong university network of expertise to support the future scientific and health needs of Bruce Power, NOSM and Ontario.”

With this partnership, Bruce Power continues extending the remarkable benefits that have sprung from the far-sighted decisions of earlier Ontario and federal governments to fund the development of the CANDU reactor. The CANDU is probably the greatest success story in the annals of Canadian government industrial research and development policy. From its inception in the 1950s to today, this reactor has gone toe-to-toe with the far-better-funded light water reactors of America, France, and Japan. CANDUs have been for the past forty years making the bulk of Ontario’s electricity. CANDUs produce all of the output in the “Nuclear” category in Tables 1 and 2 in the left-hand sidebar, and as you can see that huge output comes with no CO2.

Far less known is the role that Canada’s nuclear investment has played in our health care system. Universal health care is only possible if that care is affordable. Canada owns its position as the world leader in medical isotope production solely because we invested early in nuclear power research and development. That early research and development was performed in research reactors like the NRU and its predecessor the NRX: these reactors allowed the early CANDU developers to figure out how to effectively and efficiently burn natural uranium in heavy water, as well as to see how other materials behave in the reactor environment.

In doing that R&D, Atomic Energy Canada Limited, the company that developed the CANDU, realized it could sell some of the isotopes that were the byproducts of reactor tests. Co-60 was the first of these, but by the 1970s AECL had developed a worldwide market for numerous other isotopes, including the famous molybdenum-99 and various iodine isotopes—these materials had opened breathtaking new horizons in medical diagnosis and therapy. The isotope business was so lucrative that the federal government spun it off in the late 1980s; that is how present-day Nordion was born. (Nordion was, in the 1940s, part of Eldorado Mining, the crown corporation that eventually became present-day Cameco; that was in the days when naturally occurring radium was the only known gamma ray source. It was transferred to AECL in the early 1950s.)

It must be realized that CANDU R&D led to the development of the worldwide medical isotope market. Nobody would ever have developed medical isotopes if isotope production had not been a happy coincidence of power reactor development. Isotopes would have been far too expensive in that case. They were only affordable then, and are only affordable today, because the capital equipment that made them possible was built to serve a far larger market, electricity. Electricity is worth many billions of dollars a year. That is why it makes sense to invest billions of dollars to make the equipment that makes electricity. Those investments pay off.

Medical isotopes and nuclear medicine are the result of Canada’s far sighted investment in developing the CANDU reactor. Canada’s universal health care system depends on cheap, highly effective medical isotopes. These materials are used in roughly 1.5 million procedures per year in Canada: 66,000 for radiation therapy, and the rest for diagnosis (this is where the isotope molybdenum-99 is the most important). Who knows how many lives nuclear medicine procedures involving Mo-99 and Co-60 have saved by alerting physicians of serious problems, or protecting blood, or sterilizing instruments, or killing germs in food. But it was all made possible because of Canada’s investment in CANDU R&D.

The encouraging thing is, we have barely scratched the surface of nuclear medicine in Canada. The sheer number of potential applications of medical isotopes boggles the mind. So the Bruce Power partnership with the Northern Ontario School of Medicine is very, very good news.

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