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2019-10-01

A revolutionary method for treating metastatic prostate cancer with the lutetium isotope 177

Prostate cancer is the most common cancer in men. And in the later stages, when the patient has metastases, traditional methods of therapy are not always effective enough. In recent years, doctors have come up with an innovative method of “point” radiation therapy with lutetium isotope (177Lu PSMA), which helps to prolong the patient’s life even in the most difficult and neglected cases. It is used in many leading clinics in the world, including Germany, USA, Israel, Australia and Canada. Recently, the Latvian Nuclear Medicine Center began to offer treatment with lutetium in conjunction with AmberLife Cancer Clinic, an integrative medicine clinic.

Effective help in advanced prostate cancer

According to IARC (International Agency for Research on cancer), in 2018, 1.276 million new cases of prostate cancer were detected in the world. In the early stages, this ailment is treated quite successfully and with very good forecasts. But, unfortunately, it is not always possible to identify it in a timely manner - many men are not eager to go to an unpleasant preventive examination to a urologist, and do not pay attention to slight discomfort: as a result, they turn to doctors when the disease is already running.

In the later stages, when metastases have already begun, traditional methods, including surgical treatment, as well as hormonal therapy, are not always quite effective. Metastases spread to bone tissue, lymph nodes, liver and lungs, and malignant cells change their properties, adapting to the effects, and continue to grow.

In recent years, a new innovative method has begun to be applied in the best clinics in the world - lutetium 177Lu PSMA isotope therapy, which helps patients suffering from metastatic prostate cancer, not sensitive to hormone or chemotherapy or poorly tolerating these treatments.

This is a real revolution in the treatment of prostate cancer. For a number of patients with aggressive and extensive neoplasms, this is actually the only way to prolong life. Here is what the leading Latvian radiotherapist Dr. Maris Mezhetskis, practicing this method: “Radionuclide therapy with 177Lu PSMA lutetium isotope is a huge and very important step in the struggle to prolong the life of patients with prostate cancer. Such treatment helps when other methods are powerless: when is first-line androgen deprivation therapy (ADT), complete androgen blockade, and even second-line ADT? and chemotherapy no longer works. This is a very smart and gentle procedure - 177Lu PSMA detects and destroys cancer cells, with few side effects. Due to its low toxicity, some patients even choose this treatment method before chemotherapy.”

"Point" impact

If most of the traditional methods of treatment can be compared to shooting from a cannon at sparrows, when the whole body is exposed to powerful toxic effects, then 177Lu PSMA isotope therapy is a “sniper”, pinpoint effect directly on malignant cells. The method belongs to the class of so-called “targeted therapy”: the drug molecule “sees” certain markers of the disease and delivers the active substance exactly to the address, to the tumor cells, without affecting healthy ones.

We will tell you more about 177Lu PSMA therapy. The surface of the cells of the prostate gland contains a special protein PSMA (prostate-specific membrane antigen). When a person is healthy, his concentration is insignificant, but with oncological damage to the prostate - it increases many times. And in the case of metastases, PSMA is also present on the surface of metastatic cells.

The principle of action of 177Lu PSMA therapy is based on the use of a molecule that specifically binds to the PSMA protein and thus delivers the radioactive isotope directly to the tumor cells, destroying them.

The experience of using this method in a number of leading foreign clinics has shown that in 50% of cases the condition of the patients has improved significantly: up to the point that there has been a regression of distant metastases (complete destruction), which is usually extremely difficult to treat. Due to the targeted effect of lutetium 177, in a short time it is possible to reduce the volume of the tumor, slow down the growth of metastases, and relieve the patient of pain and other symptoms of the disease. At the same time, unlike other, more toxic treatments, the side effects are minimal and reversible: about 30% experience dry mouth, and up to 10% experience nausea and vomiting.

Treatment with lutetium 177

The Latvian Nuclear Medicine Center and the Integrative Medicine Clinic AmberLife Cancer Clinic have developed a joint offer for the comprehensive treatment of prostate cancer, including all necessary examinations, consultations with oncologists and immunologists, 177Lu PSMA therapy followed by scintigraphy, and various rehabilitation procedures that alleviate the patient's condition.

Before starting treatment, a comprehensive examination is carried out: there must be an oncologist's opinion, a fresh general clinical and biochemical blood test (done in the last 10 days), as well as a PSMA PET-CT study, with confirmed PSMA accumulations in the tumor tissues, made in during the last 2 months.

The procedure itself is carried out at the Center for Nuclear Medicine: together with the preparation, it takes 6-8 hours. The drug is administered intravenously, for 20-30 minutes, with all precautions. In the process, treatment can be carried out 2-6 cycles of procedures with an interval of 6-8 weeks.

The next day, the patient is given scintigraphy (SPECT) to assess the level of isotope accumulation and treatment effectiveness. Before each subsequent cycle, liver and kidney counts are checked, as well as a number of other studies and the dose of the drug is adjusted.

As concomitant methods for the treatment of prostate cancer, AmberLife Cancer Clinic, located in Jurmala, offers procedures that improve the body's immune response (ozone therapy, vitamin C therapy, etc.), detoxification, as well as physiotherapy, acupuncture and qigong, special nutrition and consultations with a dietitian.

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