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PSMA therapy is a targeted nuclear medicine treatment used
for selected patients with prostate cancer. It uses a radioactive substance
linked to a molecule that targets prostate-specific membrane antigen (PSMA)
found on many prostate cancer cells.
One commonly used
form is Lutetium-177 PSMA therapy (Lu-177 PSMA), also known as PSMA
radioligand therapy. The treatment is designed to deliver radiation directly to
PSMA-expressing cancer cells while limiting radiation exposure to surrounding
tissues.
PSMA therapy may
be considered for selected patients with advanced or metastatic prostate
cancer, particularly when the disease has progressed despite previous
treatments. Eligibility is determined through specialist assessment and
PSMA-based imaging.
PSMA therapy
combines targeted treatment with radioactive radiation delivery.
The treatment
uses a PSMA-targeting molecule attached to a radioactive isotope, such as Lutetium-177.
After administration, the PSMA-targeting compound travels through the
bloodstream and attaches to prostate cancer cells that express PSMA.
The radioactive
component then delivers radiation to the targeted cells, helping damage and
destroy them.
PSMA therapy is
generally considered when other treatment options are no longer providing
adequate disease control or when the patient's clinical situation makes
targeted radionuclide therapy appropriate.
The number of Lu-177
PSMA therapy cycles varies from patient to patient.
Treatment may be
given as multiple cycles at planned intervals rather than as a single
treatment, with the treating nuclear medicine and oncology team determining the
number and timing of cycles based on treatment response, disease status, blood
test results, kidney function, side effects and tolerance, PSMA expression and
overall clinical condition.
Further cycles
may be considered when the patient continues to meet the required treatment
criteria.
●
Maintaining
appropriate distance from others for a specified period
●
Limiting
prolonged close contact
●
Special
precautions around children and pregnant individuals
●
Careful toilet
and bathroom hygiene
●
Drinking adequate
fluids when advised
●
Frequent
urination to help eliminate the radioligand
●
Handling of
bodily fluids according to the medical team's instructions
●
Following all
discharge instructions provided by the nuclear medicine team
PSMA therapy
requires specialised nuclear medicine facilities, radiation safety systems and
appropriate imaging capabilities. Treatment planning and monitoring may involve
PSMA PET-CT imaging, Lu-177 radiopharmaceutical administration, radiation
monitoring equipment, radioactive material handling facilities, blood and
biochemical monitoring, imaging-based treatment assessment and dedicated
radiation safety protocols.
The specific
facilities and technologies used depend on the patient's treatment plan and the
protocols followed by the nuclear medicine department.
●
Provide targeted
radiation treatment to PSMA-expressing prostate cancer cells
●
Help manage
advanced or metastatic prostate cancer
●
Offer a treatment
option when previous therapies have stopped controlling the disease
●
Target cancer
deposits at multiple sites in the body
●
Support disease
control in selected patients
●
Provide a
personalised treatment approach based on PSMA imaging
●
Specialist
Nuclear Medicine Assessment: Evaluation of
patients being considered for targeted radionuclide therapy.
●
PSMA-Based
Treatment Planning: PSMA imaging
findings help determine treatment suitability.
●
Comprehensive
Pre-Treatment Assessment: Laboratory tests
and clinical evaluation before therapy.
●
Radiation Safety
Protocols: Appropriate precautions during treatment
and after discharge.
●
Multidisciplinary
Coordination: Coordination
with oncology and other specialists when required.
●
Treatment
Monitoring: Follow-up through clinical assessment,
laboratory testing and appropriate imaging.
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