Lutetium-177 PSMA therapy

What is Lutetium-177 PSMA therapy?

Lutetium-177 Prostate Specific Membrane Antigen (Lu-177 PSMA) therapy is a personalised treatment that aims to relieve symptoms and potentially slow the growth and spread of a person’s prostate cancer. It is used in the therapy phase of theranostics.

PSMA - The target

To understand how Lu-177 PSMA therapy works, it’s important to first understand what PSMA is.

Prostate Specific Membrane Antigen (PSMA) is a protein found on the surface of cells in the prostate gland. Prostate cancer cells, even those that have moved to other areas of the body (metastasised), typically have more PSMA than normal cells.

Lu-177 PSMA therapy uses this protein as a target to help identify and destroy prostate cancer cells.

The role of diagnostic imaging in Lu-177 PSMA Therapy

To determine if Lu-177 PSMA therapy is suitable for you, a PSMA PET/CT scan is used to identify if (and how much) PSMA is present on your prostate cancer cells. Click through the steps below to find out how this works.

Step 1
Before the PSMA PET/CT scan, a radioactive drug called a radiopharmaceutical is injected into your bloodstream. The drug is made up of a radioisotope (which gives off a small amount of radiation) connected to a carrier molecule. This carrier molecule can attach to cells with PSMA proteins on the surface (prostate cancer cells).
Step 2
Once in your bloodstream, the drug finds and attaches to the prostate cancer cells in your body.
Step 3
The small amount of radiation from the radioisotope then shows up as ‘hot spots’ on a PET/CT scan.
Along with other imaging scans like an MRI and CT scan, this helps your doctor understand exactly where the cancer is throughout the body (even tumours that are a few millimetres in size) and organise a personalised treatment plan for you.

How Lu-177 PSMA Therapy works

If you are determined suitable for Lu-177 PSMA therapy, you can proceed to treatment. Click through the steps below to find out more.

Step 1
For therapy, a different radiopharmaceutical (radioactive drug) is injected into your bloodstream.
This drug also contains a molecule that can attach to cancer cells with PSMA on the surface (prostate cancer cells), however it carries a different radioactive isotope called Lutetium-177.
Lutetium-177 gives off a different type of radiation that aims to injure or kill cancer cells.
Step 2
Once in your bloodstream, the drug finds and attaches to the prostate cancer cells in your body. This carries the radioactive Lutetium-177 directly to the cancer cells.
Step 3
Once attached, the radiation released from the radioisotope injures and potentially kills the cancer cells without damaging the healthy cells around them.

We're here for you, every step of the way.

To learn more about Lu-177 PSMA Therapy or find out where to receive this treatment at Icon, go back to our theranostics page.

Frequently Asked Questions about Lu-177 PSMA Therapy

Lu-177 PSMA therapy may be an option for people:
- who have been diagnosed with advanced prostate cancer
- where other treatment options have not worked as well as expected or are unsuitable
- where the cancer has spread to other areas of the body (metastasised)
- where cancer symptoms are affecting their quality of life
A specialist and nuclear medicine physician involved in your care can help determine if Lu-177 PSMA therapy is right for you.
At Icon, Lu-177 PSMA therapy is generally given as two initial treatments, approximately six to eight weeks apart. Your doctor will monitor how you respond to these treatments using regular scans and tests, and will use the results to see if another treatment is needed. Most people receive a total of six to eight treatments.
With your permission, we may let other people involved in your care know about your treatment at Icon Cancer Centre.
The actual Lu-177 PSMA treatment will be injected through a cannula in your vein over about 20 minutes, however you will need to stay at the centre until you have passed urine and your radiation levels are below the regulatory limit. This can take around two to four hours, so it’s important to plan accordingly and bring things to keep you comfortable during your stay.
Lu-177 PSMA therapy may cause side-effects such as a dry mouth, nausea, tiredness and loss of appetite. Most of these side-effects are minimal and can be managed well. Your care team will keep a close eye on you during and after your treatment, and they will help you manage any side-effects you experience.
Lu-177 PSMA therapy is usually painless and most people feel little to no discomfort during treatment. The treatment is given through an injection in your vein, which takes approximately 20 minutes.
As Lu-177 PSMA therapy uses radioactive drugs, you will be radioactive for a period of time following treatment. This amount of radiation is not dangerous and the risks to you are low. Your care team will let you know how to keep yourself, your loved ones and those around you safe during this time.
For safety reasons, visitors are not allowed in the treatment area while you are receiving Lu-177 PSMA therapy. You are welcome to bring a support person to your appointment, however they will need to stay in the waiting room during your treatment.
Most people can return to work around six to seven days after treatment, however your doctor will provide advice specific to the nature of your work and your personal circumstances. It is important to follow your doctor’s advice and to inform your employer about your treatment and recovery time.