The front-line treatment of metastatic prostate cancer always includes pharmacotherapy, most commonly hormone therapy (aka androgen suppression therapy) and chemotherapy, or a combination of these. Often a medication to strengthen the bones is also used if cancer has metastasised to the bones.
There are several chemotherapy options, which can provide results for long periods of time, but usually they lose their efficacy sooner or later. If remission of prostate cancer is achieved by means of pharmacotherapy, Docrates Cancer Center always adds localised radiation therapy to the treatment palette in order to prevent urinary retention later on.
Radionuclide therapies in treating metastatic prostate cancer
Prostate cancer that has metastasised to the bones can also be treated by means of radioactive radium, which 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 then apply radiotherapy, even if the prostate cancer has extensive metastases in the bones. External radiotherapy is not an option in that situation. Clinical trials have proven the radium-223 radionuclide therapy to be well tolerated and efficient and to even improve survival. Singular bone metastases can also be treated with external radiotherapy, if necessary.
The new lutetium-177 PSMA is an effective treatment method
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, which transports the radioactive Lu-177 drug directly to the cancer cells. Lutetium-177 PSMA is a reasonably new substance in Finland in 2017, but the therapy has proven effective and well-tolerated. Docrates was the first to offer this treatment in Finland.
Lu-177 PSMA targets prostate cancer cells regardless of their location and allows for radiotherapy to be administered even at an advanced stage of cancer. The Lu-177 PSMA is a targeted radiotherapy treatment administered intravenously. 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.
The Lu-177 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. Patients can usually be discharged on the same day. Our medical team will continue to monitor the patient’s blood values during the treatment cycle. The most common side effect of the treatment is a dry mouth. We seek to prevent and reduce this by cooling the salivary glands during treatment.
A multi-disciplinary team is responsible for providing the treatment.
At Docrates Cancer Center, radionuclide therapy is provided by a multi-disciplinary team, led by Professor Kalevi Kairemo, Chief Physician, Molecular Radiotherapy & Nuclear Medicine.
Customised treatment without delay
An integral aspect of the treatment is a consultation with an oncologist immediately after the diagnosis. 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.