Watching her father suffer chemotherapy-related complications to treat multiple myeloma, a blood cancer in the bone marrow, was all the motivation Dr Bawinile Hadebe needed to explore alternative treatment for the disease.
It was this endeavour that earned her the Saul Hertz Young Investigator Award, which she received at the 8th Theranostics World Conference in Cape Town earlier this month in recognition of her PhD work in theranostics.
The award, named after Dr Saul Hertz, the father of theranostics, celebrates its 85th anniversary this year, recognising Hertz’s pioneering work with radioactive iodine, which began in 1941 and laid the foundation for radiotheranostics.
Theranostics is a personalised approach to treatment that integrates diagnostic techniques and targeted therapies to detect and treat various cancers.
Hadebe, a senior UKZN lecturer and head of the Nuclear Medicine Clinical Unit at Inkosi Albert Luthuli Central Hospital (IALCH) in Durban, was honoured for her PhD work in CXCR4-targeted imaging and her contribution towards targeted radionuclide therapies for prostate and neuroendocrine tumours under the guidance of her supervisor and head of the Nuclear Medicine Discipline, Prof Mariza Vorster.
“Cancer is a growing challenge worldwide, and we urgently need new ways to fight it. Theranostics is an exciting approach that lets us ‘see what we treat and treat what we see’. We use a special ‘search-and-destroy’ approach that involves injecting the patient with a specific radiotracer, which finds and highlights cancer cells on a scan (allowing us to see the cancer),” Hadebe said.
“We then inject a radiotracer with a more potent radiation, which delivers a targeted dose of radiation to kill those cancer cells while leaving the healthy parts of the body unharmed.”
“Since this treatment targets the cancer directly, unlike other treatments such as chemotherapy, which target the whole body, we can avoid many of the harsh side effects often seen with chemotherapy,” she added.
Hadebe, from eHlokozi in iXopo on the south coast of KwaZulu-Natal, watched helpless as her father endured the physical and emotional toll of the treatment, a journey that ultimately ended with his passing in 2022.
That experience deepened her conviction that patients deserve treatments that are more precise and less debilitating. “My father is the quiet strength behind my work. I see his face in every patient I treat, fuelling my drive to redefine what is possible in cancer care.”
Targeted radionuclide therapy, she explains, remains a distant dream for many patients, and more effort is needed to make it more accessible.
Currently there is only approval for prostrate and endocrine treatment, and she believes much lobbying is needed to change this.
At IALCH she knows all too well the spread and prevalence of cancer.
“Definitely way more younger people are being diagnosed with cancer — breast and cervical cancer in women and lungs and prostrate cancer in men. In the last five years the increase in incidence is clearly visible.”
While there is no conclusive research for the increase, she attributes this to changes in lifestyle, diet and “everyone always being on their phones”.
According to Cansa, South Africa faces a rapidly growing cancer burden.
“With a population of approximately 60-million people, cancer incidence in South Africa is projected to double by 2030, reaching an estimated 220,000 new cases,” said Lorraine Govender, Cansa national manager: health programmes.
“This increase is driven by population growth, ageing and rising age-specific cancer rates. To improve cancer outcomes, healthcare must be people-centred — sensitive to patients’ perceptions, lived realities and information needs. This approach improves wellbeing, strengthens trust, promotes health equity and leads to better-quality care.”
“We are seeing more cancer in people under 50 than ever before,” said Vanessa Snow, head of medical affairs at Johnson & Johnson Innovative Medicine South Africa.
“It is no longer an outlier occurrence. It is becoming more frequent, and the patients are younger, often in their thirties or early forties”.
“What used to be considered a middle-aged diagnosis is now happening in people in their 20s and 30s,
— Vanessa Snow, head of medical affairs at Johnson & Johnson Innovative Medicine South Africa
Breast cancer remains the most commonly diagnosed cancer among women globally and is now growing in instance in younger age groups. This rise is occurring at a pace that demands attention. “Globally, and in South Africa, the number of breast cancer cases in women under 40 is on an upward trajectory,” Snow said.
Colorectal cancer is showing the same concerning pattern. “What used to be considered a middle-aged diagnosis is now happening in people in their 20s and 30s,” said Snow. “Many around the world only consult healthcare professionals when they are already in the late stage, because it is just not something they expected at that age.”
In South Africa, the University of Cape Town reported that nearly 25 percent of colorectal cancer cases are diagnosed in people under 50, with a large portion of those under 40.
“And these are not isolated incidents,” Snow said. “They are appearing more regularly, especially among young black South Africans, and often without any known genetic risk.” Snow noted that this growing pattern reflects a serious shift in disease burden, making increased awareness among newly affected groups critical for earlier intervention.
Lauren Pretorius, CEO of Campaigning for Cancer, stressed the importance of awareness among younger men, noting that testicular cancer remains one of the most significant health threats in this age group.
Beyond these well-recognised cancers, other types traditionally associated with older age are also rising among younger adults. Snow noted that pancreatic cancer, previously seen predominantly in older population groups, is increasingly being diagnosed in younger adults.
“It is no longer unusual to see pancreatic cancer in patients in their twenties and thirties,” she said.
Kidney, thyroid and stomach cancers are also being diagnosed more often in people under 50, and the same upward trajectory is being observed in certain blood cancers, including B-cell lymphomas and plasma cell neoplasms. These trends are echoed in global epidemiological studies, which show that these cancers are among the fourteen types increasing most rapidly in younger populations.
Snow explained that the rise of these cancers in younger groups is not incidental. “We are seeing a greater impact of diet, obesity, poor sleep, inactivity and higher stress levels in people at younger ages than in the past.”
“Smoking and alcohol use are starting earlier, and we are exposed to more environmental toxins whether or not we are aware of it.”
She added that some cancers are now being picked up incidentally during imaging for unrelated issues, raising questions about how long they may have gone undetected.
Another challenge is that most cancer screening guidelines still focus primarily on older adults. According to Snow, this gap is costing lives.
“Cancer is not being detected early enough because we are not looking for it,” she said. “When someone under 40 presents with unusual symptoms, it is still common for healthcare providers to attribute them to something benign. By the time testing is done, the cancer has advanced. The profile of cancer is changing, and our clinical and public health responses must evolve with it.”
Pretorius reinforced this message. “Persistent or unexplained changes in the body should never be ignored,” she said.
“As cancer becomes more common in younger adults, it has never been more important for people to stay informed and responsive to what their bodies are telling them. This growing shift in cancer patterns underscores the need for vigilance among younger adults, because understanding the warning signs and seeking medical advice early can save lives. If something doesn’t feel right, trust yourself and get it checked.”
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