Adapting for the Future: The Industry-Wide Impact of Theranostics on Cancer Care

Higher patient volumes coupled with persisting staffing shortages put a significant burden on health systems to do more with less. This is especially true when it comes to cancer care. According to the World Health Organization, there were nearly 20 million newly diagnosed cancer cases in 2022, resulting in nearly 10 million related deaths.

A fast-growing branch in the nuclear medicine space—known as “theranostics”—has been gaining traction among oncologists for its potential to help clinicians deliver on their long-sought goal of a new era in personalized, precision cancer care.

This approach employs specialized targeting compounds to both image and treat malignant cells. Theranostics leverages specialized imaging capabilities to help clinicians identify patients who are more likely to benefit from targeted therapies. It has gained recognition from clinicians for its effectiveness in treating cancer with limited and manageable side effects.

What Is Theranostics?

Theranostics is an approach to nuclear medicine that uses molecular imaging and targeted radionuclide therapies aimed at the same biological target to treat cancer and other medical conditions. By using specific targeting compounds for imaging and treatment, along with advanced digital and artificial intelligence (AI) solutions, precision-targeted radiotherapy becomes possible. This approach enables the accurate delivery of radiation to cancer cells anywhere in the body, effectively destroying them.

Most healthcare providers today rely on radiopharmaceuticals and molecular imaging to accurately determine the stage of a disease and pinpoint the exact location of a patient’s cancer. Theranostics takes it to the next level.

Theranostics helps therapeutic agents reach their intended target with greater accuracy while reducing the negative impact on surrounding tissue and organs. The integration of diagnostic imaging, quantification tools, and targeted therapies allows for more accurate and timely clinical decisions, helping providers put patients on the right therapy at the right dose at the right time.

While the use of theranostics is most advanced in the treatment of patients with prostate, thyroid, and neuroendocrine tumors, this emerging modality has the potential for broader applicability against other cancers, dependent on the pace of R&D progress.

Imaging Innovation in Theranostics

Positron emission tomography (PET) plays a critical role in theranostics. PET helps doctors confirm the presence of therapeutic targets, such as the PSMA protein in prostate cancer. Some advanced medical centers also use another imaging method called single photon emission computed tomography/computed tomography (SPECT/CT), which are nuclear medicine systems that combine functional imaging from single-photon emission computed tomography (SPECT) with anatomical details from computed tomography (CT), offering clinicians a comprehensive view of both the physiological and structural aspects of cancer.

SPECT/CT systems detect gamma rays emitted by therapeutic radionuclides (an unstable form of a chemical element that releases radiation as it decays), converting them into images that reveal the distribution of a therapeutic tracer. This allows confirmation that tumors are being effectively targeted while ensuring that important vital organs and tissues like kidneys, liver, and bone marrow are not exposed to harmful levels of radiation.

The most advanced SPECT/CT systems also help to speed up this process, completing it in 15 minutes or less, instead of traditional systems that require about an hour. Faster imaging is crucial for accommodating a higher number of patients and provides more comfort.

Digital and AI solutions are also playing an important role, standardizing the treatment monitoring process with dosimetry analysis and AI-based segmentation for patients across their treatment journeys.

In prostate cancer—the second most common type of cancer, responsible for more than 1.4 million new cases annually—theranostics enables better disease evaluation and monitoring. In addition, it helps clinicians treat metastatic castrate-resistant prostate cancer in patients who have typically failed on previous lines of therapy.

We have already seen a large health system in Michigan successfully leverage SPECT/CT technology to image tumors and assess treatment response to radioligand therapy for late-stage prostate cancer patients. Having this information can help clinicians see if patients are responding to treatment and going into remission, or if they are not responding, clinicians can discontinue therapy and avoid additional treatment that is not providing any health benefits to the patient. In addition to diagnostic and treatment benefits, theranostics also offers financial advantages by monitoring tumor response and optimizing each patient’s treatment plan.

Conclusion

The future of theranostics lies in its potential to transform oncology by bridging diagnostic imaging and therapy with unparalleled synergy between the two. As healthcare systems continue to leverage innovative and cutting-edge imaging systems, AI-driven solutions, and advanced radiopharmaceuticals, this modality could expand beyond its current applications in prostate, thyroid, and neuroendocrine cancers. With its ability to personalize and optimize cancer care while improving outcomes and reducing costs, theranostics is poised to become a cornerstone of precision medicine. In the next decade, I hope to see theranostics evolve from a niche field into a transformative force, reshaping how we diagnose, treat, and manage cancer care.