Actinium PSMA

Last Updated: December 16, 2024 by Michael Kahn. Published: December 16, 2024.

Doctors abroad are using an innovative type of treatment for stage 4 prostate cancer called targeted radionuclide therapy. A radiopharmaceutical that targets prostate-specific membrane antigen, a molecular target, is injected into the body. As a result, the radioactive substance only penetrates and destroys cancer cells. Lutetium targeted radionuclide therapy is usually used. An alternative option is Actinium PSMA therapy, which is also effective in patients for whom Lutetium no longer works.

How does PSMA therapy work?

PSMA therapy is a radiotargeted (radioligand, radionuclide) method of treating prostate cancer, a type of systemic radiation therapy. It selectively targets cancer cells with almost no damage to normal tissue.

The essence of the procedure is that a radiopharmaceutical is injected intravenously into a person. It contains ligand molecules that target PSMA molecules and radionuclides. As a result, the ligands help deliver the radioactive substances to the cancer cells. The radioisotope accumulates only in the tumor tissue, exposes it to radiation for a few days, and is then excreted from the body. The person spends this time in the hospital.

Who may be a candidate for Actinium therapy?

Actinium therapy is not currently considered a standard treatment for cancer, so it is used as an experimental procedure. Lutetium-177 PSMA therapy remains the main option for radioligand treatment as a more researched method.

PSMA therapy is used for prostate cancer that has metastasized to the internal organs when the following treatments are no longer effective:

• Hormone therapy (castration-resistant cancer)
• Chemotherapy
• Targeted therapy

PSMA therapy may be used in cases where hormone therapy is not working, and other drug treatments are contraindicated due to poor health or the person refuses them due to poor tolerance to therapy.

In these cases, Lutetium targeted radionuclide therapy is prescribed. Actinium treatment is used as a second-line therapy. It may be used if:

• There is no response to Lutetium-177 therapy
• There was an initial response to Lutetium-177 therapy, but further treatment became ineffective and the cancer continued to progress
• Recurrent cancer progression in the long term after Lutetium-177 therapy

Actinium therapy is therefore used in the most severe cases when other treatments have been exhausted.

What is the process of treatment?

The patient is admitted to the hospital. He or she undergoes an examination to exclude contraindications. This includes clinical and biochemical blood tests, a urinalysis, and also PSMA-PET for tumor foci imaging.

The course of treatment includes a single intravenous injection of the radiopharmaceutical. Cooling of the salivary glands may be used to prevent the radionuclide from accumulating in them, as well as infusions of crystalloid solutions to protect the kidneys. The person then spends several days in isolation in a private ward.

The procedures are repeated every 6-8 weeks. After every second treatment, PSMA-PET is performed to measure tumor foci and to determine PSA levels. These procedures are required to assess objective (tumor shrinkage) and biochemical (reduction in PSA levels) response to therapy.

Treatment results

Actinium therapy results in the:

• Tumor shrinkage
• Increase in life expectancy of a person
• Reduction of the risk of cancer complications
• Symptom relief

Some patients achieve a complete response (disappearance of tumors) and a long relapse-free period that can last for several years.

At the same time, Actinium therapy is safe. It is much better tolerated than chemotherapy. The most common side effect is dry mouth. It is more common than with Lutetium therapy, but Actinium has less effect on the hematopoietic function of the bone marrow.

You are welcome to visit the Booking Health website if you are looking for a clinic that offers Actinium targeted radionuclide therapy. The website presents the world’s leading cancer centers with excellent results in the treatment of even terminal cancer. You can see prices, select a clinic, make an appointment for your preferred dates, and get travel arrangement services on the website.