Radionuclide therapy in Cancer

Cancer treatment involves chemotherapy, radiotherapy and surgery. Traditional external radiotherapy involves exposing the cancer tissue to radiations which tends to damage the surrounding normal tissue as well. Modern technologies have now enabled targeting the cancerous tissues selectively. One such procedure is the Radionuclide therapy.

What is radionuclide therapy?

Radionuclide therapy uses a molecule labelled with a radioisotope to deliver a high level of radiation to treat some cancers. It is a very safe and effective targeted approach to treating certain cancers. Just like chemotherapy, this therapy is a systemic treatment, reaching cells throughout the body by travelling through the bloodstream. However, unlike chemotherapy, these radioactive substances specifically target diseased cells, thus reducing potential side effects. This treatment is used for both cancer (malignant) and for some non-cancer conditions.

TYPES OF RADIONUCLIDE THERAPY

Radioiodine therapy for thyroid cancer

Radioactive iodine (Iodine-131) has been used to treat thyroid cancer for almost 80 years because thyroid lesions have a unique property to trap iodine. This is done to treat thyroid cancer patients after thyroidectomy/thyroid surgery to destroy any remaining cancer cells and prevent the thyroid cancer recurrence. It is also used to treat patients with metastatic thyroid cancer. The patient needs to get admitted for a couple of days for the same. The isotope is given as an oral dose and the side effects are minimal.

Radioisotope therapy for hyperthyroidism

Radioactive iodine (Iodine-131) is routinely used to treat patients with hyperfunctioning thyroid gland caused by conditions such as Grave’s disease, toxic multinodular goitre or autonomously functioning thyroid nodule. It decreases the function of thyroid by destroying the thyroid cells. The dose used is much lower. Treatment is usually for a single session on an OPD basis and the patient does not have to take medications for long.

Radioligand therapy with Lu-177 PSMA for prostate cancer

Prostate cancer patients are usually treated with surgery, radiotherapy and hormonal therapy. In due course of time the cancer cells develop resistance to hormonal therapy. FDA has recently approved Lu-177 PSMA radioligand therapy to treat such patients who are showing no improvement despite other approved medications such as chemotherapy. This procedure is done as a Day Care procedure and has shown good results with very low side effects.

Peptide receptor radionuclide therapy (PRRT) with Lu-177 DOTATATE for Neuroendocrine tumors

It is a used to treat patients with neuroendocrine tumors in whom surgery is not feasible or when the cancer has spread in body. It is also a Day care procedure and has shown good control of disease and symptoms.

Y-90 microsphere therapy for liver cancer

It is used to treat cancers arising in liver or cancer which has spread to liver (hepatic metastases). The radiopharmaceutical is precisely injected into the artery which supplies the tumour and selectively destroys the cancer cells with very minimal effect on the adjacent normal liver cells. It has shown promising results with good disease control resulting in prolonging life of the patient. The effect is long lasting unlike ordinary chemotherapy.

Radionuclide therapy is a new treatment option in the multidisciplinary management of cancer. It is safe and has low side effects due to its precise mechanism to deliver radiation dose with minimal effect on surrounding normal tissues. Apollo Hospitals Navi Mumbai is now equipped to provide various radionuclide therapy.

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