What is Lutetium Treatment?
Lutetium treatment is a radionuclide therapy that aims to destroy prostate cancer cells that have spread to areas of the body, such as the lymph nodes and bone marrow.
Destroying prostate cancer cells may increase survival and also have the potential to relieve symptoms such as bone pains associated with skeletal remnants of cancer.
How Does Lutetium Therapy Work?
Lutetium-177 is a radionuclide that emits damaging radiation that will destroy nearby cells. It is combined with PSMA, a protein that will seek out PSMA receptors on the surface of prostate cancer cells.
When lutetium-177 PSMA is introduced into the patient’s bloodstream (Lutetium treatment), it targets and binds to PSMA receptors on prostate cancer cells.
The radiation emitted by lutetium-177 causes the death of prostate cancer cells over time.
Who is Lutetium Treatment Suitable For?
Currently, lutetium treatment is applied to patients with metastatic prostate cancer and advanced prostate cancer who have failed to obtain results from other treatment methods, such as hormone therapy or chemotherapy.
Before starting treatment, patients should undergo a PSMA PET-CT scan, and the presence of PSMA receptors on cancer cells that will be targeted in Lutetium-177 PSMA therapy should be confirmed.
Benefits of Lutetium Therapy
In most patients treated with lutetium, positive results, such as alleviating symptoms, are expected. In some cases, long-term regression of the disease can be achieved. Furthermore, the expected survival time can be extended.
Large-scale studies are ongoing to determine the full extent of the treatment’s benefit.
How Is The Treatment Administered?
The administration of the treatment is in the form of injections into the bloodstream every 6-8 weeks. An intravenous line is established on the day of treatment, and Lutetium-177 PSMA is given intravenously over 30 minutes.
In addition, simultaneously, anti-nausea (antiemetic) and diuretic (diuretic to increase urinary excretion) are given.
A SPECT scan is performed 24-72 hours after treatment to ensure that areas of the disease are adequately reached.
Most patients require four treatment sessions. After two sessions, a PSMA PET-CT scan is repeated to evaluate the treatment response. If the PSA level drops and positive results are seen in repeated PSMA screening, the remaining two treatment sessions can be applied to complete the four sessions.
Side Effects Of Lutetium Therapy
The most common side effects are dry mouth and eyes. Rarely, some patients may experience nausea and vomiting. A slight tendency to sleep is also a side effect. These effects are temporary and usually go away after a few days.
Bone marrow suppression is also a possible side effect in patients with extensive bone disease caused by collateral damage from radiation to the adjacent bone marrow.