Nuclear Medicine In Oncology

December 15, 2023

Nuclear medicine therapy, also known as molecular radiotherapy or peptide receptor radionuclide therapy (PRRT), is an innovative approach for treating certain types of cancer. This targeted treatment can be used alone or combined with other therapies like chemotherapy, surgery, hormone therapy or radiation therapy.

How Does Nuclear Medicine Therapy Work?

Nuclear medicine utilizes radioactive materials called radiopharmaceuticals that release radiation to kill cancer cells. The radiopharmaceuticals used contain a radioactive isotope attached to a peptide or molecule that recognizes and binds to receptors on tumor cells.

When injected into the patient’s bloodstream, the radiopharmaceutical circulates through the body and accumulates in the cancer sites. The radiation it gives off destroys the cancer cells it is attached to while leaving healthy cells unharmed.

The most common radiopharmaceuticals used are:

- Lutetium-177 DOTATATE (Lutathera) for neuroendocrine tumors

- Iodine-131 MIBG for neuroblastoma or pheochromocytoma

- Radium-223 (Xofigo) for prostate cancer that has spread to the bone

What are the Benefits of This Treatment?

Compared to traditional chemotherapy and radiation therapy, nuclear medicine has several advantages:

- Targeted: Only cancer cells are targeted, reducing damage to healthy tissue. Radiation is delivered directly inside cancer cells.

- Effective: High doses of radiation can be given to kill tumors without increasing side effects. It is effective for treating cancers that no longer respond to other therapies.

- Repeated dosing: Treatment sessions can be repeated multiple times for maximum anti-cancer activity.

- Outpatient therapy: Patients do not require hospital admission and treatment is provided in an outpatient setting.

- Improved quality of life: Optimal symptom relief with minimal side effects allows patients to maintain daily activities.

What to Expect During Treatment

Patients receive nuclear medicine therapy in a specialized room with trained medical staff to ensure safety. Each treatment session may last up to 8 hours.

To help protect the kidneys from radiation, patients are given intravenous amino acids before and after the therapy dose. The radiopharmaceutical is injected through an IV line and allowed to circulate for 30-40 minutes.

Imaging tests like SPECT or PET scans may be performed during treatment to monitor distribution of the drug. Patients can usually go home shortly after completion of the infusion. Multiple treatment cycles are scheduled over weeks or months.

Side Effects of Nuclear Medicine Therapy

Nuclear medicine therapy is well tolerated but some possible side effects include:

- Nausea, vomiting, diarrhea

- Decreased blood cell counts

- Loss of taste or decreased appetite

- Fatigue

- Hair loss

- Blood disorders

Side effects are generally mild and reversible. Doctors work to optimize doses and timing of therapy sessions to maximize efficacy while minimizing risks. Supportive care is provided to manage any side effects if they occur.

With its unique benefits and generally favorable safety profile, nuclear medicine therapy is an important weapon for fighting cancer and improving patient outcomes.

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