Only overheats under hard load...
I WOULD suggest that you check temp. differential across the cooler, it would be THE most reliable way of determining where the issue lies.. but that may be hard to do on a piece of mobile equipment, so...
If the truck is equipped with any other coolers that are in front of the radiator (i e a/c condensor, trans. cooler, p/s cooler) then verify that there is NOT a build up of road grime between the coolers that is restricting air flow.
By using compressed air with the engine off and holding your hand on the inside at the same time, you can determine whether or not the cooler is restricted on the air side. If no compressed air is readily available, use a GOOD flashlight and a friend to shine the light thru from one side while you follow the light from the other.... YOu SHOULD see light everywhere, if light does not come thru, then neither can air..
Make sure you ahve a thermostat installed, without it, the coolant wont stay in a properly functioning radiator long enough to strip heat out of the coolant. (when working hard)
Yes, pump impellers can erode away, usually its due to poor cooling system maintenance.
As 75H2 stated, a partially plugged exhaust system will cause the engine to run hot. It wil be exponentially worse as heat, load, and engine speed are increased. Another possible issue could be engine timing. Can't remember which specific years, but if you have the flyweights and springs inside your particular year of distributor, if those wear out or the springs break, the engine timing will NOT be correct for engine speed/load.