177Lutetium PSMA therapy
177Lutetium PSMA therapy can be used to treat advanced prostate cancer. Over time prostate cancer can become resistant to hormone therapy.
At GenesisCare, we provide specialist cancer care to thousands of people worldwide, with 14 treatment centres in the UK. We offer the most cutting-edge cancer treatments including advanced radiotherapy and Theranostics – a highly personalised approach to cancer medicine combining diagnostic imaging with therapy (177Lutetium PSMA therapy).
177Lutetium PSMA therapy is used for prostate cancer that has spread throughout the body and has become resistant to other treatments. Although these hard-to-treat cancers can’t be completely eradicated, 177Lutetium PSMA therapy aims to reduce the size and progress of the cancer, ease symptoms and, in doing so, maintain or improve quality of life.
This innovative therapy is available in a state-of-the-art Theranostics suite at our centre in Windsor. The service is led by the world-leading expert Dr Yong Du, Consultant Physician in Nuclear Medicine and PET/CT, who was the first in the UK to be licensed to perform this very specialist treatment.
When required, we will help our patients with transport depending on treatment and locations. Please enquire for more details.
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How does 177Lutetium PSMA therapy work?
Cells in the body have different kinds of receptors and proteins on their surface that bind to various substances to coordinate body functions. 177Lutetium PSMA therapy exploits this by using a substance called a carrier molecule that is attracted to PSMA – a kind of protein found in abundance on prostate cancer cells. By attaching a radioactive substance to this carrier molecule, it’s possible to seek out and destroy cancerous cells.
Your doctor will review your medical history and treatments to date to decide if this treatment is right for you. You can read more about who this treatment is used for below. If they think this is right for you, they’ll explain what you’re likely to experience during and after treatment so you can make an informed decision about whether you’d like to go ahead.
There are two key steps to this treatment – seek, to find cancer metastases and confirm if this is the right treatment for you – and the treatment phase, which aims to destroy the cancer cells.
Seek – diagnose with ⁶⁸Gallium PSMA PET/CT
Before starting therapy, you’ll have a 68Gallium PSMA PET/CT scan – a very precise diagnostic test. It uses a radioactive tracer that shows where prostate cancer has spread to other parts of your body that often can’t be seen on other imaging scans.
The tracer is a combination of a special carrier molecule and a radioactive substance called 68Gallium. The carrier molecule is attracted to a substance called prostate specific membrane antigen (PSMA). PSMA is a type of protein found in high concentrations on the surface of prostate cancer cells, including those that have spread to other parts of your body.
This means the carrier molecule takes the 68Gallium directly to cancerous prostate cancer cells – even in the smallest tumours. 68Gallium shows up on the PET/CT scan to reveal where these tumours are and help the Theranostics team plan your personalised treatment. 68Gallium doesn’t stay in your body for long and is eliminated naturally.
Destroy – 177Lutetium PSMA therapy
If your PET/CT scan shows that you could benefit from 177Lutetium PSMA therapy, you’ll start your first treatment within two weeks. 177Lutetium PSMA therapy is usually given every six to eight weeks, typically over six cycles as an outpatient in our purpose-built Theranostics suite in Windsor.
- Each cycle works in a similar way to the PET/CT scan. This time, another radioactive substance that can destroy cancer cells, called 177Lutetium, is attached to the carrier molecule that is attracted to PSMA.
- When this is injected into your bloodstream, the carrier molecule ‘locks’ onto PSMA on the surface of prostate cancer cells, delivering the 177Lutetium straight to its target. This sends a localised radiation dose to destroy the tumour, avoiding damage to healthy tissues in your body.
- You’ll have an appointment with your consultant and a blood test before each cycle of your therapy, to check how well things are going.
- After every two cycles, you’ll have a PET/CT scan to check how the cancer is responding to treatment and whether it’s appropriate to continue or consider other treatment options. Your treatment will be personalised according to your response and symptoms.
At the end of the sixth cycle, you’ll have another 68Gallium PSMA PET/CT scan to assess how well the treatment worked and what you can expect from it. You’ll be given a discharge summary for your referring doctor. You’ll need to have blood tests regularly after your treatment which does not need to be done at the Windsor centre. Your consultant will advise how often you should have them.
What about side effects?
As with all cancer treatments, you may experience side effects. These could include:
- A dry mouth
- Loss of appetite
You may also have reduced production of blood cells for a while. This is because bone marrow – which produces blood cells – can also take up some of the 177Lutetium. If you’ve already had chemotherapy and radiotherapy, your bone marrow may be more sensitive to the affects of radiation. Your doctor will discuss this with you before your treatment begins. After treatment, you’ll need to have regular blood tests to keep track of any changes to your blood.
The Theranostics team will be available during and after treatment should you have any questions and will continue to follow up on your health and wellbeing by phone or email.
Is it for me?
177Lutetium PSMA therapy may be suitable for you if you have prostate cancer that has spread elsewhere in your body and other treatments haven’t worked or you’re unable to tolerate them. The 68Gallium PSMA PET/CT scan must also show that you’re suitable for the treatment. The scan will show whether the special carrier molecule selectively targets the prostate cancer cells and not healthy cells.
Your consultant will discuss your prostate cancer, treatments to date and overall health with you in detail before advising if this is right for you.
Why choose GenesisCare?
We offer many state-of-the-art treatments for prostate cancer, including chemotherapy and advanced radiotherapy. Your personalised treatment plan will be tailored to your individual needs and delivered by a dedicated team including nuclear medicine specialists, physicists, radiographers and specialist nurses.
We know that cancer can be a worrying time. That’s why we have partnered with the Penny Brohn UK charity to offer personalised wellbeing therapies, such as acupuncture, massage and counselling, to help support you through this challenging time. We also offer every patient an exercise medicine programme which is proven to help improve treatment tolerance, function, fatigue and quality of life. Our exercise medicine specialists will tailor your programme to your abilities, goal and cancer diagnosis.
After all, we’re treating you – not just your cancer.