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Sunday, September 27, 2020

Is the Lutetium-177 PSMA Therapy Beneficial for All Patients With Prostate Cancer?

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Although at the early disease stages cancer is potentially curable (5-year survival rate reaches 100%, which is impressive), not all patients demonstrate good response to the numerous conventional therapeutic approaches.

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That is why international medical society is in the constant search for new therapy schemes. Thus, during the intense scientific work oncologists, urologists and radiologists from the German Cancer Research Center and University Hospital Heidelberg have created the specific peptide PSMA-617.

PSMA-617 serves as a unique carrier for other molecules (these may be drugs, antibodies, etc.), as it perfectly recognizes prostate cancer cells regardless of their location. Connecting PSMA-617 with the radiation source Lutetium-177 (the therapeutic radionuclide) started the epoch of Lutetium-177 PSMA therapy.

Looking for the information about “innovative prostate cancer treatment” each patient finds few descriptions of the Lutetium-177 PSMA therapy on the authoritative websites. But is this technique really beneficial for all men?

Prostate cancer treatment options

Basically, prostate cancer therapy includes 3 groups of methods:

Surgical interventions:

  • open radical prostatectomy;
  • robot-assisted nerve-sparing prostatectomy (with da Vinci robot);
  • transurethral electroresection.


  • conventional external irradiation;
  • interstitial brachytherapy (implantation of radioactive seeds near the tumor);
  • intensity-modulated radiation therapy (IMRT);
  • systemic Lutetium-177 PSMA therapy.

Drug therapy:

  • conventional chemotherapy;
  • immunotherapy or biological therapy;
  • androgen deprivation therapy (ADT) in androgen-dependent neoplasms;
  • bone-modifying drugs for men with bone metastases;
  • symptomatic treatment for improving life quality.

First of all, preference is given to radical treatment. Complete tumor removal is connected with fewer relapse risks and better prognosis. Thus, at early disease stages surgery is the most effective option. Performed carefully, surgery does not require further radiation therapy or drugs intake.

In men with local (without metastases) inoperable tumors doctors usually perform brachytherapy or IMRT. Local irradiation may be enhanced by drugs intake, e.g. chemotherapy or ADT. These prevent neoplasm from spreading and reduce size of the primary malformation. No systemic radiation therapy is required as well.

Patients with advanced (metastatic) prostate cancer require more sophisticated therapy. This is where Lutetium-177 PSMA therapy is beneficial.

Peculiarities of treatment in patients with metastatic cancer

When a doctor tells about “metastatic cancer”, he means that a tumor has spread far beyond the prostate gland. Secondary oncological foci can be found in bones, lungs, liver, etc. Treatment methods for patients with metastatic cancer have special requirements:

  1. Minimal damage to healthy tissues.
  2. Minimal side effects, as patients are often elderly and have unsatisfying general condition.
  3. Ability to reach all metastases, including loci of atypical cells in bones.
  4. Preventing the primary tumor from further spreading.
  5. Reducing size of primary tumor and distant metastases.
  6. Availability of easy-to-perform diagnostic tests for the treatment efficacy estimation.
  7. Performing on the outpatient basis or requiring short hospital stay.

Lutetium-177 PSMA therapy is the most appropriate option exactly for such patients. Being connected with the molecule of PSMA-617, Lutetium-177 accumulates in the prostate cancer cells throughout the whole body. Thus, the irradiation affects only atypical cells, destroying their DNA and making die, finally.

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PSMA therapy with Lutetium-177 is well tolerated and requires only 2-4 days of hospital stay. The most severe possible side effects include allergic reactions and dry mouth. Control PSMA-PET CT scans and osteoscintigraphy reflect early results of the therapy already in few days. Blood test for PSA (prostate-specific antigen) is also indicative of the disease activity and may be used as the less expensive control examination.

Does treatment abroad have any advantages?

Choosing treatment abroad you primarily select the hospital, doctor and treatment technique. You do not have any limitations, as medical facilities from all over the globe are ready to offer specialized care.

Actually, medical tourism has become a great step towards fighting oncological disorders. Nowadays patients do not wait for the approval of innovative drugs or technical devices in their native countries. They can travel to more developed regions freely and start the necessary treatment without any delay.

This concerns PSMA therapy with Lutetium-177 as well. Application of the therapeutic radionuclides is subject to strict safety protocols, as it poses potential health risks. Only properly equipped hospitals and doctors with correspondent qualification are authorized to carry out Lutetium-177 PSMA therapy. Leading of them are:

  1. University Hospital Heidelberg.
  2. University Hospital Carl Gustav Carus Dresden.
  3. University Hospital Frankfurt am Main.
  4. University Hospital of Ludwig Maximilian University of Munich.
  5. University Hospital Muenster.

One more advantage of treatment abroad is careful follow up. After the therapy completion, doctors carry out a number of control tests in order to assess response to Lutetium-177 administration and general health state. If necessary, urologic rehabilitation is performed simultaneously.

Costs of treatment and procedure of admission to a clinic abroad

Cost of Lutetium-177 PSMA treatment  is not the same in different healthcare facilities. It depends on the country, hospital level and number of sessions required (sometimes a single procedure is not enough). Thus, an international patient sometimes should think not only about choosing hospital, but about comparing prices and choosing the affordable one.

Taking mean numbers, price of the diagnostic PSMA-PET CT in the hospital with modern equipment starts from 3,500 €, and Lutetium-177 PSMA therapy starts from 10,500 €. The good news is that the sum may be fully or partially covered by your insurance company. You should check this in advance in order to prepare all the necessary permissions and reports.

Paying attention to all peculiarities of treatment abroad is rather complicated for men without the relevant experience. If you want to undergo Lutetium-177 PSMA therapy in the leading hospital with the worldwide reputation, it is better to seek help of Booking Health. Booking Health is the only international certified medical tourism operator that takes care about all patients’ interests.

Doctors of Booking Health will investigate your medical reports and give you a piece of advice regarding additional diagnostic tests for confirming the diagnosis (actually, misdiagnosing is frequent in countries with poor medicine), required therapy and follow up schedule.

Travel specialists of Booking Health will help you in receiving visa, preparing medical and administrative documents, booking tickets and accommodation, transfer, interpreting and translating services. Your individual coordinator is in touch with you 24/7, making you feel safe and confident during staying abroad. Should you leave the request on the Booking Health website, preparation to your treatment will start the same day.

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Disclaimer: This article is purely informative & educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.

Editorial Staffs at Healthtian, A team of Writers.
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