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Radionuclide Therapy

The Theranostic Approach in Cancer Treatment.

What is Theranostics?

Nuclear Medicine Theranostics is a form of targeted treatment utilising information obtained from diagnostic imaging to identify a specific target which is subsequently targeted for treatment.

This is a rapidly evolving field with many on-going clinical trials comparing the Theranostics approach to conventional therapy. However, as this form of therapy is still relatively new, it is currently used to treat certain cancers that have spread (metastasized) which are not responding to conventional treatments.

How it works?

An example of the Theranostics approach in Nuclear Medicine is in Prostate cancer. The imaging and treatment target for prostate cancer is known as prostate specific membrane antigen (PSMA), a transmembrane protein overexpressed in approximately 90% of prostate cancer cells.

A PSMA PET-CT is first performed to determine if there is sufficient expression of PSMA by the cancer cells. If the PSMA expression is sufficient, these cancer cells can then be targeted for treatment via PSMA directed radionuclide therapy. The treatment is administered via slow intravenous infusion and is usually performed as a day case.

Treatments available for Metastatic prostate cancer.

Diagram 1. Theranostic treatment - phenotype imaging achieved by using PET-CT specified radiolabel compound followed by radioactive therapy.

Prostate cancer Theranostics treatment offered at Advanced Medicine Imaging:

Lutetium-177 PSMA Therapy
An emerging targeted treatment for patients with advanced prostate cancer. it is currently used when the disease has metastasised and when other treatment options are poorly tolerated or have failed.

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Radium-223 Therapy
Radium-223 therapy is a form of radionuclide therapy used mainly in patients who have castrate resistant prostate cancer that has spread to the bones. The main aim of this treatment is to relieve bone pain caused by the cancer. Studies have shown that there is an added overall survival benefit compared to best supportive care.

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To understand more about the treatment, please contact us at 6708 7888 or email imaging@advancedmedicine.sg. We will be happy to assist you.