Overview
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.
What Is PSMA Therapy and How Does It Treat Prostate Cancer?
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.
How Many PSMA Therapy Cycles May Be Required?
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.
Radiation Precautions After PSMA Therapy
- 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
Technology and Infrastructure
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.
Benefits of PSMA Therapy
- 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
Why Choose Specialist Nuclear Medicine Care for PSMA
- 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.
