Prostate cancer is a common male oncological disease experienced by men. Prostate cancer can be treated in the early stages. However, on condition of distant metastases life prognosis becomes unfavorable. But, the development of medicine forges ahead.

A new drug called Lutetium 177-PSMA was introduced for the treatment of metastatic prostate cancer. It helps to considerably prolong a patient's life.

Technique principle

LU-177-PSMA-therapy stands for Lutetium 177 prostate‐specific membrane antigen radionuclide therapy. Thus, the membrane antigen selectively binds with cancer cells. Lutetium 177 (Lu177) radionuclide is attached to this substance which is a beta emitter.

After the introduction of radiolucently labeled PSMA into the human body, it binds only with the cells of the prostate gland malignant neoplasm. Since beta radiation extends a short distance (several millimeters), healthy tissues are not irradiated. After the course of PSMA therapy, cancer cells die, and the tumor size is significantly reduced.

Key point of this technique is that the drug kills not only primary tumor in the prostate gland, but daughter tumors as well thanks to the selective binding.

Goals of treatment

The technique using nucleotide labeled PSMA, is used to diagnose and treat prostate cancer in men. Diagnosis involves the use of scintigraphy, which involves scanning the body and recording the beta radiation of the tumor formation region.

Also, the technique is used for a therapeutic purpose, when the death of cancer cells occurs after a course of therapy with a radiopharmaceutical.

Preparation

PSMA, labeled with a radionuclide, is a compound that can lead to the development of an allergic reaction. Therefore, a test for hypersensitivity is mandatory before its intravenous administration during the main course of therapy or during diagnostic scintigraphy.

Also, preparatory measures include visualizing the tumor, which includes scintigraphy, computer, magnetic resonance imaging, and ultrasound. These methods determine the size, location of malignant neoplasm and its metastases.

The radiopharmaceutical used to perform PSMA therapy is excreted by the liver and kidneys, therefore, general clinical studies are carried out before its use, including a clinical analysis of urine, blood, and a biochemical blood test. Clinical studies help a doctor to assess the degree of possible risk associated with the influence of the radiopharmaceutical on the liver and kidneys. During the treatment course, these studies can be administered to the patient several times to monitor the functional state of the organism.

A diet is prescribed with the exception of fatty, fried foods, and also alcohol a few days before the start of treatment course.

How does the procedure work?

The specialist intravenously introduces a radiopharmaceutical on an inpatient basis after all the preparatory measures. The drug flows through the body and binds with the cells of the malignant neoplasm and its metastases within a certain period of time, providing the necessary therapeutic effect.

Procedure is usually carried out several times. A patient is under the supervision of the attending physician at all times. Kidneys and salivary glands are cooled down before each procedure for their safety. Side effects, if any, are blocked with the medication.

The duration of PSMA therapy may vary, depending on the stage of prostate cancer. The end of treatment is determined by the results of the control study, including scintigraphy with the labeled radionuclide PSMA. The average length of stay in a medical hospital is 3-4 days.

Efficiency control

The attending physician prescribes a follow-up study after the course of PSMA therapy, which necessarily includes scintigraphy. Based on his results, he decides on the completion of treatment and the possibility of discharging the patient from a hospital.

A positive result, indicated by the effectiveness of the PSMA-therapy, is the absence of malignant neoplasm foci in the prostate gland, as well as in other areas of the body where metastases may develop.

Benefits

PSMA therapy has many advantages over other metastatic prostate cancer treatment techniques, primarily with chemotherapy.

Among them are:

Selective action on atypical cells (healthy tissues are almost not irradiated)

The possibility of destruction of metastases in any part of the body

Good tolerance of therapy

Absence of irreversible side effects

PSMA therapy is usually used when chemotherapy fails to give results, or if the patient refuses it because of poor tolerance to the treatment.

Where to undergo a PSMA-therapy course?

Prostate cancer with metastases treatment by Lutetium 177 can be done in Germany, at the University Hospitals