What is 177Lu-PSMA Therapy?
177-Lutetium PSMA (177Lu-PSMA) therapy is a form of targeted therapy used to treat advanced prostate cancer. PSMA (Prostate Specific Membrane Antigen) is a protein found in the prostate gland on the surface of the cells. In patients with prostate cancer, this protein is over expressed, meaning there is more of this PSMA protein on the cell. If the prostate cancer has metastasised or spread, the PSMA protein will also be found these cells.
177Lu-PSMA therapy uses Lutetium-177, a beta emitting radioactive substance, which is attached to a molecule which specifically targets the PSMA protein. When close to cancer cells, Lutetium-177 is able to damage and over time destroy those cells. The PSMA protein works to guide the 177-Lutetium to the prostate cancer cells, so it can target the unhealthy cells and minimise damage to other healthy cells in the body.
177Lu-PSMA therapy is used to treat advanced prostate cancer which has spread to other parts of the body and which has not responded to other treatments. The effectiveness of this treatment varies for each individual patient and not everyone is suitable for this treatment. The goal of treatment is not to cure prostate cancer but to help manage your symptoms.
The treatment can help to:
- Reduce your pain, fatigue, and other prostate cancer symptoms
- Reduce the size and slow the progression of your tumours
- Provide you with an increased quality of life
This therapy is available at Qscan Annerley, Mackay, Maroochydore, North Lakes, Southport and University of Canberra.
Prior to the treatment
After an initial consultation, a Qscan Radiologist and Nuclear Medicine Specialist will determine your eligibility, you will be given a date and time for your treatment. You may have up to six treatments, with treatments given once every 6 – 10 weeks.
On the day of the treatment
The entire process will take between 2-5 hours each cycle. You will be given your own room for treatment, equipped with a comfortable chair and television. You may also bring your own reading material or entertainment.
A cannula will be placed in your arm and the treatment will be given intravenously by a highly trained member of our team - it will take no longer than 5 minutes to complete the treatment – after which you will be monitored and encouraged to drink more water.
You will be able to leave the department once you have passed urine and the level of radioactivity has dropped to a safe level.
You will not be able to have any visitors with you during the treatment, carers and family will be asked to stay in the waiting room.
During your consultation with our specialised radiologist prior to the therapy, you will be provided you with all relevant information about preparation, the procedure, and aftercare.
It is essential you are well hydrated on the morning of the treatment – aim to drink a minimum of 1L of water before arriving at the clinic. You should also eat a light breakfast prior to your treatment.
You may experience some of the following in the days after your treatment
- Nausea and vomiting
- Fatigue
- Increased bone pain
- Dry mouth
- Dry eyes
- Reduction in blood count, white cells or renal function
- Diarrhea
For further information about side-effects and how to manage them, our radiologist will explain these in greater detail, alternatively you can also discuss with your oncologist.
At the end of your procedure you may be given a prescription for some medication – please take all medication as instructed. You will be given two pathology request forms for specific dates. All follow up care will be provided by your referring doctor.
In the days following your procedure, a large amount of the injection will be excreted in your urine. It is essential that you remain well hydrated for two days following your treatment.
Upon returning home, you family and friends are not at risk, but we ask you to follow these precautions for five days after the treatment:
- Restrict close contact (<2m) for prolonged periods of time (<2hrs/day, but <15mins/day for pregnant woman and young children).
- Sleep in a separate bed to anyone, including current partner and do not sleep in the same room as children or a pregnant woman for seven days after the treatment
- No sexual contact for seven days post-treatment
- As for any radioactive treatment, sufficient contraception is required if you are sexually active. You must use adequate contraception during and for three months after any therapy
- Flush the toilet twice after use, immediately wipe up any urine spills with toilet paper and flush to discard
- Avoid air travel or public transport, or any activity where you need to be close to people a prolonged time
- If you have any doctor or dental appointments in this time, please your doctor know you have had 177Lu-PSMA therapy
- For carers: If you require assistance from a carer in the bathroom, they should wear disposable gloves during this time, this includes helping to clean up any urine. If you use urine catheter bags, these must be emptied directly into the toilet
Our friendly customer service team can advise you of all costs involved with your therapy including any out-of-pocket costs, if relevant. Please contact us for a quote or to book your appointment.