Aggressive prostate cancer calls for active treatment methods
In many cases, even advanced prostate cancer can be effectively treated. The newest treatment is radionuclide therapy with Lutetium PSMA, which in many cases successfully destroys metastases both in the skeleton and outside of it.
The key to treating patients with advanced prostate cancer is an individualized treatment program. The front-line treatment of metastatic prostate cancer always includes medicine treatments, most commonly hormone therapy and chemotherapy, or a combination of these. Often a medication to strengthen the bones is also used if cancer has metastasized to the bones.
There are several options of medicine treatments and they often provide remissions or stabilization of the disease for long periods of time, but usually they lose their efficacy sooner or later. If remission of prostate cancer is achieved by means of medicine treatment, and the patient has not received irradiation before, we at Docrates Cancer Center always consider adding localised radiation therapy to the sites of disease involvement. Irradiating the prostate may for instance prevent urinary retention later on.
Radionuclide therapies in treating metastatic prostate cancer
Prostate cancer that has metastasized to the bones can also be treated by means of radioactive radium, which is a radioactive tracer that targets the bones. The principle in this type of radionuclide therapy is to introduce the radioactive substance to the immediate vicinity of the cancer cells and thus irradiate the cancer cells there. This also makes it possible to simultaneously irradiate bone metastases at very different sites of the body.
Clinical trials have proven the radium-223 radionuclide therapy to be well tolerated and efficient and to even improve survival. Solitary, or a small number of, bone metastases can also be effectively treated with external radiotherapy, if necessary.
The new lutetium-PSMA drug is an effective treatment method
Most prostate cancer cells are PSMA positive, which means that they include PSMA (Prostate Specific Membrane Antigen). A prostate cancer patient with PSMA positive metastases confirmed by means of Ga-PSMA-PET-CT imaging is a candidate for treatment using a drug carrier that transports the attached radioactive drug lutetium-PSMA directly to the cancer cells. Lutetium-PSMA is a reasonably new radioactive drug in the treatment of cancer, but the therapy has proven effective and well-tolerated. Docrates was the first hospital in the Nordics to offer this treatment.
Lu-PSMA is a targeted radiotherapy treatment administered intravenously. Lu-PSMA targets prostate cancer cells regardless of their location and allows for radiotherapy to be administered even at an advanced stage of cancer, and effectively treat metastases both in the soft tissues and the bone. The radiation caused by the radioactive drug is very local, emitting only a few millimeters, thus exposing the surrounding tissues to minimal unnecessary radiation stress. Hence, multiple metastases can be irradiated simultaneously with the same medicine dose.
The Lu-PSMA treatment regimen is tailored to the needs of each individual patient and is usually administered 2–6 times over the course of 4–6 weeks. The patients can usually be discharged on the same day. Our medical team monitors the patient’s blood values throughout the treatment cycle.
The most common side effect of the treatment is a dry mouth. This side effect we seek to prevent and reduce by cooling the salivary glands during the infusion.
Lu-PSMA has a special permission for compassionate use by the Finnish Medicines Agency (Fimea).
Customized treatment without delay
An integral aspect of treatment of advanced prostate cancer is a consultation with an oncologist immediately after the diagnosis, and seamless collaboration between the different specialist. Our experienced specialists use reliable examinations to determine, without delay, whether the patient is a candidate for new treatment options and subsequently draw up a tailored treatment plan for each patient.
At Docrates Cancer Center, radionuclide therapy is provided by a multi-disciplinary team, led by Chief Physician of Nuclear Medicine Jukka Kemppainen.
Our service consultation and appointments are at your service at
tel. + 358 10 773 2050 (Mon-Thu 8 am-6 pm, Fri 8 am-4 pm, Finnish time GMT +2)
or by e-mail: international (a) docrates.com