Cancer is caused by uncontrollably growing and proliferating cells. Prostate cancer is the most general type of cancer in males. The prostate is a small walnut-shaped male gland that produces the seminal fluid that transports sperm. Most prostate cancers grow slowly, while there are some that cause serious harm. It is most common in men over the age of 50.
When prostate cancer spreads to other body parts or comes back after the treatment, it is known as advanced prostate cancer. It grows when prostate cancer cells move through the bloodstream or lymphatic system.
Prostate cancer can spread to other body parts but mainly spreads to the bones and lymph nodes.
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Symptoms of Advanced Prostate Cancer
Males with advanced prostate cancer may or may not show any signs of sickness. Its symptoms depend on the size of the tumor and the part where the cancer has spread.
The most common symptoms of advanced prostate cancer are:
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Fatigue
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Bone pain
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Difficulty in urinating
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Blood in semen
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Weight lose
It is challenging to cure advanced prostate cancer completely, but there are treatments that can keep it under control and manage the symptoms. One of the recent and effective methods is Lu-177 PSMA therapy.
What is Lu-177 PSMA Therapy?
Lu-177 PSMA Therapy is also known as Prostate-Specific Membrane Antigen Therapy. It is an innovative treatment that is used to treat advanced prostate cancer. This treatment is effective and successfully reduces the tumor’s size and prevents the tumor from multiplication.
This therapy is used with the recommendation of the referring physician when other treatments are insufficient or become ineffective for patients. It has been shown that long-term improvement can be achieved with this therapy in many advanced prostate cancer patients.
How does Lu-177 PSMA Work?
PSMA therapy uses two drugs; one is a molecule of PSMA-617. It finds and attaches to PSMA on cancer cells. Other is a radioactive medicine named lutetium 177. It binds to PSMA-617, which carries it into the tumor. When Lu-177 PSMA is administered intravenously into the body, it travels throughout the bloodstream, reaches the cancer cells, and destroys or damages them by emitting radiation.
This therapy only targets the cancer tissue, and the radiation doesn’t affect the other parts of the body. The remaining part of Lu-177 PSMA is not held by tumor cells excreted from the body by saliva, urine, and feces.
Who is the Suitable Candidate for Lu-177 PSMA Therapy?
PSMA therapy is used on men with metastasized prostate cancer or who have tried hormone treatments and chemotherapy. It is one of the most effective therapies for managing metastatic prostate cancer after other types of treatments have failed. PSMA therapy may be an option when other treatments don’t slow cancer spread.
The following criteria are required to be a suitable candidate for Lu-177 PSMA Therapy:
- The patient should be 18 years or older.
- The patient has advanced prostate cancer.
- The patient is not getting any benefits from other medical treatments.
- The patient does not have any serious conditions such as liver or kidney failure.
Is This Therapy Safe?
It is a completely safe treatment because the radiation used in Lu-177 is designed only to destroy the cancer cells, and the whole body is never exposed to the radiation. With theranostic, the treatment becomes more personalized and precise. The radiation will only destroy the cancer cells, and the healthy cells remain untouched.
After the therapy, blood tests will be performed to make sure that the radiation is not damaging the healthy cells. With the help of imaging tests, it is also determined that the radioactive material at the tumor sites has been absorbed correctly.
Benefits of Lu-177 PSMA Therapy Over Other Treatments
Lu-177 PSMA Therapy has numerous benefits compared to external beam radiation and chemotherapy:
- It can be effectively considered when other treatments failed.
- It won't show any negative effect on the central nervous system because it doesn't cross the blood-brain barrier.
- No severe side effects are associated with this treatment.
- After starting this therapy, PSA levels tend to drop rapidly.
Side Effects of Lu-177 PSMA Therapy
As the treatment is directed toward the tumor, serious side effects do not usually see in patients. Some side effects are:
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Dry mouth
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Dry eyes
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Nausea
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Vomiting
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Tiredness
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Decrease in blood cells production
How to Prepare for a Lu-177 PSMA Therapy?
Before the Treatment
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Ensure that at least 4 weeks have passed since your last chemotherapy.
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Drink plenty of water for several days before the treatment.
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Avoid alcohol consumption and do not take aspirin and anticoagulants.
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It is important to use the medication prescribed by your physician.
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PSMA PET Scan is done to spot cancer outside the prostate, which helps to target the treatment.
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Complete blood count and other blood tests are also done.
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Bring comfortable and wide clothes with short sleeves for the treatment.
During the Treatment
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Lu-177 PSMA is administered through a vein placed on your arm.
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The drug will take around 30 minutes to infuse into the bloodstream.
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During and after the injection, you need to stay in the hospital for some time to ensure that the radiation level decreases.
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For patients who have urinary retention problems, urinary catheters are used.
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2-6 total treatment cycles are applied at 6-8 weeks intervals.
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If needed, you will be given anti-nausea medications during or after the treatment.
After the Treatment
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After the therapy, most patients can return home within 48-72 hours.
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Avoid any strenuous activities for 24 hours after the treatment.
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It would help if you avoided close contact with other people for 24 hours after the injection.
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Blood tests will be done 2 weeks to 6 weeks after the treatment.
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After getting discharged from the hospital, you need to avoid close contact with young children and pregnant women.
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Avoid sharing your bed with another person for at least 3 days.
Lu-177 PSMA Therapy Can’t Be Applied When
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There is an obstruction and enlargement in the urinary tract
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The total white cell count is less than <2.5×109/L
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The platelet count is less than <75×109/L
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There is any liver and kidney disease and infections
Cost of Lu-177 PSMA Therapy in Germany
- The cost of Lu-177 PSMA Therapy in specialized hospitals ranges from 8000- 16000 Euros.
- This amount will cover initial laboratory tests, PSMA therapy, follow-up appointments, the hospital stay, and any recommendation for future treatment.
- The cost of the therapy can also vary according to the hospital and the treating doctor.
Best Doctors for Lu-177 PSMA Therapy in Germany
- Prof. Dr. Med. Robert Krempien: He is among the renowned Radiation Oncologists having more than 25 years of experience.
- Prof. Dr. Med. Petra Feyer: A well-established Radiation Oncologist with 41 years of rich experience in her field.
- Prof. Dr. Anca-Ligia Grosu: She is a leading Radiation Oncologist practicing for more than 25 years in her field.
- Prof. Dr. Dimos Baltas: A respected Radiation Oncologist with more than 32 years of experience in his field.
- Prof. Dr. Med. Claus Belka: He is a trained Radiation Oncologist with 27 years of experience and is well-versed in radiation therapy.
Best Cancer Hospitals in Germany
- Helios Hospital, Berlin: It is one of the best hospitals in Europe and is accredited with ISO 9001 International Standard Quality. All the doctors and surgeons in the hospital are highly-qualified to handle complex cases.
- Vivantes Hospital Group: The group was founded in 2001 and is one of the largest state-owned healthcare companies operating around 100 medical departments and institutions in Germany. The tumor center of Vivantes consists of three cancer centers in the north, south, and center of Berlin. All three cancer centers are certified by the German Society for Hematology and Oncology.
- Carl Gustav Carus University Hospital, Dresden: Established in 1815 and is one of the oldest hospitals in Germany. The Dresden University Hospital Cancer Center received the “Best Oncology Center” from the German Cancer Aid Society (DKH), in 2007.
- University Hospital Heidelberg: It is one of the biggest medical centers in Germany that operates nearly 1 million outpatients and 65,000 inpatients every year and is well-renowned for treating cancer.
- University Hospital Düsseldorf: Established in 1907, the hospital has been providing high-quality medical services. They have a team of experienced and dedicated medical professionals who are available round-the-clock to provide medical treatments to every patient.
To Conclude
Lu-177 PSMA Therapy is an innovative approach to treating advanced prostate cancer in men. Most types of prostate cancer have high levels of tumor-like PSMA. However, 5 to 10 percent of all prostate cancer patients do not produce PSMA. Therefore, before starting Lu-177 PSMA therapy, it is essential that imaging with GA-68 PSMA PET/CT is performed. It will help to determine if the treatment is targeting the tumor tissue. Approximately 80% of men who undergo Lu-177 PSMA therapy give a positive response to the treatment.
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