Lutetium PSMA Therapy: An Effective and Minimally Invasive Treatment for Prostate Cancer

Kapanlagi.com - Prostate cancer is one of the most common types of cancer affecting men. In its progression, this cancer can spread to other organs and become difficult to treat with conventional methods.

Lutetium PSMA presents itself as an effective radioactive therapy solution for patients with advanced prostate cancer. To learn more about this therapy, Dr. Febby Hutomo, Sp. KN (K), FANMB, a nuclear medicine specialist consultant in nuclear oncology at RS Siloam MRCCC Semanggi, will explain it further.

1. About Lutetium PSMA

Lutetium PSMA is a radioactive therapy that targets specific molecules in prostate cancer cells. The Lutetium-177 used in this therapy has the ability to bind to PSMA (Prostate-Specific Membrane Antigen), a protein commonly found on the surface of prostate cancer cells. Once inside the body, Lutetium-177 binds to PSMA and delivers radiation directly to the cancer cells without damaging the surrounding healthy tissue.

This therapy offers a more targeted approach compared to other treatment methods, such as chemotherapy or hormone therapy, which can have widespread effects on other body cells. Therefore, Lutetium PSMA is considered a safer alternative with minimal side effects.

2. Timing of Therapy Administration

According to international guidelines, Lutetium PSMA is used in patients with prostate cancer that has spread (metastasis) and is no longer responding to hormone therapy. This condition is referred to as metastatic castration-resistant prostate cancer (MCRPC). At this stage, the cancer has progressed to a more aggressive form and requires a more advanced treatment approach.

"Lutetium is a prostate cancer treatment that is administered when hormone therapy can no longer be used for the patient," says Dr. Febby. By using Lutetium PSMA therapy, patients who previously faced limited treatment options can gain new hope. This therapy can slow the progression of cancer, reduce symptoms, and significantly improve the quality of life for patients.

3. Safety for Healthy Tissue

One of the main advantages of Lutetium PSMA is its safety for the healthy tissue surrounding prostate cancer. Unlike external radiation therapy, which can damage the tissue around the treatment area, Lutetium PSMA only targets cancer cells that have PSMA on their surface. This makes the side effects on normal tissue very minimal.

The side effects that may occur tend to be milder compared to conventional therapies, such as chemotherapy. Some patients may experience a short-term decrease in blood cell counts, but this condition can generally be managed with supportive therapy.

"Overall, the organs that are usually damaged by other treatments like chemotherapy are targeted precisely by this Lutetium for prostate cancer cells and have a lower risk than other therapies," said Dr. Febby.

4. Process and Preparation Before Therapy

Before undergoing Lutetium PSMA therapy, patients must go through a series of medical examinations to ensure the procedure's feasibility. These examinations include a physical examination by a multidisciplinary team, complete laboratory tests, and a PSMA PET scan.

"For the use of Lutetium in patients, it should be emphasized that the patient's anatomical pathology must be clearly established first before proceeding to the PSMA PET scan to determine the extent of the spread that has occurred in the patient," said Dr. Febby.

PSMA PET (Positron Emission Tomography- Prostate-Specific Membrane Antigen) is a medical imaging technique used to detect prostate cancer that expresses PSMA. PSMA PET works by injecting a radioactive substance that can bind to PSMA on the surface of prostate cancer cells. Once this substance accumulates in the cancer area, the PET scan will capture the radioactive signal and produce images that accurately show the location of the cancer.

This method is crucial in determining whether a patient can undergo Lutetium PSMA therapy. If the PSMA PET results show sufficient PSMA expression in the cancer cells, then the patient can undergo this procedure with a high potential for success. Additionally, PSMA PET also helps doctors monitor disease progression and the patient's response to the therapy provided.

"Furthermore, after the PSMA PET is conducted, the patient will undergo blood tests, physical examinations, and finally, the assessment will determine if there are any blockages in the kidneys to understand the patient's condition," Dr. continued. Febby.

5. Handled by Specialist Doctors

Lutetium PSMA therapy involves a multidisciplinary team consisting of several specialist doctors, each with their respective roles, namely:
Urology Specialist: Responsible for the diagnosis and evaluation of prostate cancer, including determining whether the patient meets the criteria for Lutetium PSMA therapy.
Anatomical Pathology Specialist: Conducts analysis of prostate cancer tissue to ensure the characteristics of cancer cells and the presence of sufficient PSMA expression.
Nuclear Medicine Specialist: Plays a role in the implementation of Lutetium PSMA therapy, from dose planning to monitoring therapy effects.
Internal Medicine Consultant Oncologist: Provides a holistic approach in managing prostate cancer patients, especially in managing side effects and ensuring the patient's condition remains optimal during therapy.

The combination of expertise from various specialist doctors ensures that patients receive the most optimal care tailored to their medical conditions.

6. How Therapy Works

This therapy is performed by injecting Lutetium-177 through infusion into the patient's body. Once it enters the bloodstream, Lutetium-177 will seek out and bind to prostate cancer cells that have PSMA. The radiation released by Lutetium-177 will damage the cancer cells from within, stopping their growth and development.

This procedure is performed in a special room designed according to nuclear medicine safety standards. After the procedure is completed, patients can go home immediately without needing special isolation, as the radiation levels left in the body are very low and not harmful to others.

7. Post-Treatment Care and Expected Results

After undergoing Lutetium PSMA therapy, patients do not require special care. However, they are advised to maintain their overall health to optimize the therapy results. Evaluation of the therapy's success is usually conducted after the third cycle, which is about 4-6 weeks after the last procedure.

Generally, this therapy consists of three cycles administered with a 4-6 week interval between each session. Patients begin to feel an improvement in their condition after the last cycle, and the results will be evaluated by the medical team.

"Patient care is actually focused on their general condition, not due to radiation exposure. This needs to be explained first. Some patients may experience side effects on the spinal cord, or anemia, which require further treatment," said Dr. Febby.

8. Prognosis and Success Rate

The success of Lutetium PSMA therapy depends on several factors, such as the type of prostate cancer, Gleason score (an indicator of cancer aggressiveness), as well as the number and location of metastases. Studies show that this therapy can extend the life expectancy of patients, especially for those who no longer respond to conventional therapies.

If a relapse occurs, Lutetium PSMA therapy can be repeated with an interval of 6-8 weeks, depending on the patient's condition. Therefore, this therapy provides flexibility for patients in managing advanced prostate cancer.

"So the effects of Lutetium PSMA can typically be observed after 3 cycles (with each cycle lasting 6-8 weeks)," said Dr. Febby.

9. Use of Advanced Facilities

The Siloam Hospital Group, particularly Siloam MRCCC Semanggi, is equipped with advanced nuclear medicine facilities to support Lutetium PSMA procedures. With modern equipment and an experienced medical team, patients can undergo this therapy safely and comfortably.

Compared to other hospitals, Siloam MRCCC Semanggi has advantages in nuclear medicine services, with facilities designed to optimally support Lutetium PSMA procedures. Patients in need of this therapy can consult directly with the specialist team for more information.

If you or a relative has prostate or oncology issues and wish to consult a doctor, you can book an appointment through the MySiloam app, visit siloamhospitals.com/cari-dokter, or contact the Call Center at 1-500-181.

(kpl/rsp)