Radionuclide Therapies

Radionuclide Therapies

Gallium-68 PSMA PET-CT

It is the most successful current imaging technology used to evaluate the spread of prostate cancer to other organs or tissues. The prostate-specific agent called PSMA binds to the gallium-68 radioisotope, and is administered to the patient intravenously and a PET-CT imaging is performed. Gallium-68 PSMA binds to some special molecules in prostate cancer cells and enables visualization of cancerous tissues. In this method, radiation in very high dose is not given to the patients.

How is the Gallium-68 PSMA PET-CT process?

Imaging should be scheduled a day in advance. Therefore, an appointment is made. It is waited for 45 to 60 minutes after the agent is administered intravenously. When the patient is in the device, the imaging takes approximately 20 minutes and the patient should not move during this period of time. The process can take a total of 2-3 hours in the Nuclear Medicine Department. The patient is recommended to drink plenty of water before and after the imaging. Since the radiation will remain in the body for a while (8 to 12 hours) after imaging, it is necessary to be away from pregnant women and children in particular.

Gallium-68 DOTA-TATE PET-CT

It is the most advanced technology that can be used for the diagnosis of neuroendocrine tumors. Neuroendocrine tumor cells have a special receptor (sensory protein) called “somatostatin” on their surface. DOTA-TATE is a peptide compound that can bind to these receptors. When it is combined with a radioactive agent called “Gallium-68” and administered to the patient, the tissues containing tumor cells can be visualized with high accuracy on the PET-CT device. In this method, radiation in very high dose is not given to the patients.

LUTETIUM-PSMA Therapy

Lutetium-PSMA (177Lu-PSMA) therapy is an increasingly used radionuclide therapy for patients with advanced stage prostate cancer. The goal of this therapy is to reduce tumor size and stop the growth of tumor cells. In this context, both the progression of the disease can be controlled and it is possible to relieve advanced disease symptoms such as diffuse bone pain and fatigue. This therapy is usually administered when the disease progresses, spreads or when the side effects of other therapies such as chemotherapy cannot be tolerated by the patient.

Is LUTETIUM-PSMA therapy safe?

The radiation used in this therapy is designed to kill cancer cells. Injected into the body, PSMA travels towards the tumor and targets cancerous cells. Apart from prostate cancer cells, PSMA is also found in tissues such as salivary glands, lachrymal glands and kidney. Therefore, these tissues can also be exposed to radiation. However, this effect is low and since PSMA adheres directly to cancer cells, it does not show the destructive side effects of chemotherapy. Side effects such as dry mouth, temporary fatigue or temporary decrease in blood values can be observed in some patients. These effects can be controlled by blood tests performed at certain intervals in the post-therapy period. In addition, patients who are likely to experience side effects can be identified through tests before a treatment decision is made. Personalized therapy strategies specific to each patient, supported by test results and dosimeter studies, ensure that side effects are seen at the lowest possible level.

LUTETIUM-DOTA-TATE Therapy

Lutetium-Octreotide, [Lutetium-DOTA-TATE (177Lu-DOTA-TATE)] therapy is an increasingly used therapy in patients with advanced neuroendocrine cancer. Its another name is “Peptide Receptor Radionuclide Therapy” (PRRT). The goal of this therapy is to reduce tumor size and stop the growth of tumor cells. In this context, both the progression of the disease can be controlled and it is possible to relieve advanced disease symptoms such as diffuse bone pain and fatigue. This therapy is usually administered when the disease progresses, spreads or when the side effects of other therapies cannot be tolerated by the patient.

Is LUTETIUM-DOTA-TATE therapy safe?

The radiation used in lutetium-Octreotide therapy is designed to kill cancer cells. Injected into the body, smart molecules targeting somatostatin receptors target cancerous cells during their journey towards the tumor. Apart from cancer cells, somatostatin receptors are also found in many different organs. Therefore, these tissues can also be exposed to radiation. However, this effect is low and, since smart molecules adhere directly to cancer cells, they show none of the destructive side effects of chemotherapy. Side effects such as temporary decrease in blood values can be observed in some patients. These effects can be controlled by blood tests performed at certain intervals in the post-therapy period. In addition, patients who are likely to experience side effects can be identified through tests before a treatment decision is made. Personalized therapy strategies specific to the patient, supported by test results and dosimeter studies, ensure that side effects are seen at the lowest possible level.

Radium Therapy

Radium therapy is a form of treatment used in patients in whom prostate cancer has caused metastases to the skeletal system and bones. The aim of this therapy is to destroy the cancer cells in the bones so allowing the tumors to shrink or even disappear. In addition to its therapeutic effect, it is also used to relieve pain caused by bone metastases.

Is radium therapy safe?

Since the energy level of radiation used in radium therapy is very high, its destructive power is very high. However, this alpha-type radiation can travel very short distances due to its nature. By short distance here is meant a length equal to the size of 2 to 10 cells. Because of the properties of this alpha-type radiation, it destroys the cancer cells in the bone and does not affect the healthy normal cells. Post-therapeutic side effects are rare and usually cause a temporary decrease in blood values. Therefore, patients should be checked at regular intervals after treatment.

Actinium Therapy

Ac-225 PSMA is the name of the radioactive agent administered to the patient in targeted alpha therapy in prostate cancer. It is a therapy form that can be used in metastatic advanced prostate cancer patients. The goal of this therapy is to reduce tumor size, stop the growth of tumor cells and destroy them. Radionuclide therapies are preferred during the treatment of prostate cancer when the disease progresses, spreads or when other treatments such as chemotherapy are ineffective or the side effects of the therapies are not tolerated by the patient. As a general approach, Lutetium PSMA is the first choice for patients who are decided on radionuclide therapy. Lutetium-PSMA is a treatment method that has been administered to thousands of patients both in Turkey and in the world. Reducing symptoms, extending life span and improving quality of life are among the main goals of Lutetium-PSMA therapy. However, despite Lutetium-PSMA therapy, some patients may not respond to therapy or the response of the disease to therapy may be insufficient. The disease may even continue to progress despite treatment. It has been shown in the medical literature that targeted alpha therapies with Actinium-225-PSMA give much better results in this group of patients.

Is actinium therapy safe?

The radiation used in actinium (AC-225) therapy is designed to kill cancer cells. Injected into the body, PSMA travels towards the tumor and targets cancerous cells. Apart from prostate cancer cells, PSMA is also found in tissues such as salivary glands, lachrymal glands and kidney. Therefore, these tissues can also be exposed to radiation. However, this effect is very low and, since PSMA adhere directly to cancer cells, it shows none of the destructive side effects of chemotherapy. Side effects such as dry mouth, temporary fatigue or temporary decrease in blood values can be observed in some patients. These effects can be controlled by blood tests performed and examinations at certain intervals in the post-therapy period.