The role of Lutetium therapy in advances for prostate cancer
Lutetium-177 treatment works well even in the advanced stages of prostate cancer. The technique is widely used in Germany and other developed countries. It helps control metastatic, aggressive, hormone-resistant tumors. Visit Booking Health to find out which clinics offer Lutetium treatment for prostate cancer and how much the procedure costs.
How the method works
The essence of treating fourth-stage prostate cancer with Lutetium-177 is that a radioactive substance is injected into the body. It selectively accumulates in cancer cells and destroys them with radiation. The treatment has low toxicity and is well tolerated.
Lutetium therapy refers to several types of prostate cancer treatment:
- Systemic radiotherapy - radiation is used to destroy cells, and the radiopharmaceutical injected into the body affects all tumors at once
- Radionuclide therapy - because a radioactive substance called Lutetium-177 is used to treat cancer
- Radiation-targeted therapy - because it is directed at a target, i.e. prostate-specific membrane antigen (PSMA)
- Radioligand therapy - because the radiopharmaceutical contains ligands (these molecules can bind to PSMA and deliver Lutetium-177 to tumor cells)
Lutetium-177 PSMA therapy is a unique method of treatment that works in the advanced stages of cancer, providing a good result even when other types of therapy are ineffective, and in some cases allows complete destruction of all tumors in the body. At the same time, the method has a minimum of contraindications, is well tolerated even by older, weakened patients, and rarely causes serious complications. Each course of treatment consists of a single infusion of a radiopharmaceutical.
Who is a good candidate for treatment with Lutetium-177?
Lutetium-177 therapy is mainly used in such cases:
- Stage 4 prostate cancer with metastases
- Ineffectiveness of hormonal therapy (castration-resistant cancer)
- Ineffectiveness, poor tolerance or contraindications to chemotherapy
High expression of PSMA in tumor cells is a prerequisite for the efficacy of radiotherapy. For this reason, physicians perform a PSMA PET scan before starting treatment. This is a scan of the body after injecting a small amount of a radiopharmaceutical that targets PSMA.
The study helps physicians understand where tumor foci are located, determine their size to further evaluate the effectiveness of therapy, and check whether the tumor can accumulate radiopharmaceuticals. Most tumors are able to accumulate them. Typically, the more aggressive the cancer, the higher the expression of PSMA and the better the radiopharmaceutical accumulates in the cancer cells.
How the treatment is performed
A course of treatment consists of a single intravenous injection of a radiopharmaceutical. The person then spends 3-4 days in the hospital until the radionuclide leaves the body through the excretory system.
During infusion, doctors take measures to protect the kidneys and salivary glands. These are the organs most likely to be affected. The most common complication of PSMA therapy is dry mouth. To protect the salivary glands, they are cooled during the infusion of Lutetium-177 to slow the metabolism and reduce the intensity of blood flow to these organs, thereby reducing the accumulation of the radiopharmaceutical. Intravenous infusion therapy is used to protect the kidneys. All patients undergo regular tests to assess the function of these organs.
Treatment courses are repeated every 6-8 weeks. PSMA-PET is performed after every two courses to measure tumor foci. Treatment courses are repeated as long as the treatment is effective and does not cause unacceptable toxicity.
Treatment may be discontinued when all tumor foci have disappeared and are no longer detectable by radiologic techniques. In this case, the patient undergoes follow-up examinations regularly. If the cancer returns, treatment with Lutetium-177 may be repeated.
What results can you expect?
One study reported an average biochemical response rate (PSA level 2-fold or greater from baseline) of 56%, while the rate of any reduction in PSA level was 75%. Other studies have reported improved overall survival and recurrence-free survival. The best treatment outcomes were seen in patients who:
- Have not received any previous chemotherapy
- Have only lymph node metastases
- Have an initially low PSA level
Following treatment with Lutetium-177, PSA levels decrease, tumor size decreases according to PET/CT data, and patient survival rates improve.
Cases of complete response (disappearance of tumors) and long-term remission of prostate cancer, although described in the literature, are achieved in a small percentage of patients. Therefore, Lutetium-177 therapy should not be considered as a cure for end-stage cancer. This technique is used primarily to control cancer and improve the duration and quality of life.
Where to go for treatment
It is possible to undergo diagnostics and treatment of stage 4 prostate cancer abroad, for example in Germany. The Booking Health website presents the best hospitals with Lutetium-177 treatment and indicates the actual cost of medical services.
Leave a request on the site to receive a consultation from a medical tourism specialist. They will help you choose a clinic and organize your trip abroad. Prices when booking treatment through Booking Health will be lower than when applying directly to the medical center, due to the absence of additional charges for foreign patients.
