The increasing prevalence of cancer as a global health issue is one of the main reasons for the continuous research and development of new treatment methods in the field of cancer therapy. With the positive developments in health technology, nuclear medicine is frequently utilized in the diagnosis and treatment of cancer today. One of the targeted therapy methods used in nuclear medicine, which plays an important role in the diagnosis and treatment of cancer, is lutetium therapy. During lutetium therapy, cancer cells that have spread to other parts of the body are marked so that lutetium can directly reach the cancer cells, aiming to kill tumor cells or reduce their spread. Lutetium therapy has been widely used in recent years for the treatment of prostate cancer and neuroendocrine cancers. Questions such as “What is lutetium, what are its benefits, how is it applied, and which patients are treated with it?” are addressed in the following sections of the article.
What is Lutetium?
Lutetium-177 (177Lu) has radioactive properties. Thanks to these properties, it is used in the treatment of various cancers, primarily prostate cancer and neuroendocrine tumors, in nuclear medicine.
During targeted radionuclide therapy (Theranostics), Lutetium-177 is combined with special radiopharmaceuticals to directly target cancer cells. This way, radiation is primarily directed at cancerous cells, minimizing damage to healthy tissues. Thanks to the contribution of Lutetium-177 in obtaining scintigraphic images, specialists can help predict the radiation dose that tumors and healthy cells will receive. This allows for a personalized treatment process for patients.
Recent studies have shown that Lutetium-177 yields positive results in the treatment of specific cancer types such as neuroendocrine tumors, prostate cancer, paraganglioma, medullary thyroid cancer, and lymphoma. This may indicate that Lutetium-177 is an effective element in cancer treatment.
Which Patients are Treated with Lutetium?
Lutetium-177 is a radionuclide isotope used in the treatment of various cancers, primarily neuroendocrine tumors, prostate cancer, paraganglioma, medullary thyroid cancer, and lymphoma. Before Lutetium-177 therapy, special antibodies or peptides labeled with Gallium-68 (Ga-68) are used to investigate whether cancer cells will retain these molecules. Patients who retain these molecules at sufficient levels form suitable patient groups for Lutetium-177 therapy. This ensures that treatment is given at the appropriate dose and time without making a blind decision before treatment. Thus, the risk of damage to healthy tissues, which is one of the most important complications of radiotherapy, is minimized, and patients are also prevented from wasting time unnecessarily. The main cancer types where lutetium therapy is currently used are as follows:
- Prostate Cancer: Prostate cancer is one of the most common types of cancer among men worldwide. In the treatment of prostate cancer, treatment methods such as drug therapy and chemotherapy can be utilized. However, traditional treatment methods may not always be sufficient to treat prostate cancer, as cancer can spread to other tissues and organs. Therefore, intensive scientific studies have been conducted in recent years to prevent the spread of prostate cancer to other tissues and organs and to make the treatment process more effective. Lutetium-177 is one of the most commonly used treatments for prostate cancer. Prostate cancer cells have a type of protein called PSMA, which is either absent or present at very low levels in normal prostate tissue. During targeted therapy, Lutetium-177 binds to the PSMA protein, allowing radiation to directly reach the cancer cells. This treatment option, known as Lutetium-177 PSMA therapy, can help kill cancer cells and/or prevent their spread.
- Neuroendocrine Tumors (NET): Neuroendocrine tumors, which are rare cancers, primarily originate from the gastrointestinal and respiratory systems. Neuroendocrine tumors contain a substance called somatostatin. Lutetium-177 has the ability to bind to somatostatin receptors. This helps control tumor growth and alleviate symptoms. Some scientific studies have shown that the use of Lutetium-177, especially in gastrointestinal and pancreatic cancers, can significantly increase the chances of treatment success.
- Medullary Thyroid Cancer: This is a type of cancer from the thyroid cancer family that is more aggressive than other thyroid cancers. In patients with recurrent or metastatic medullary thyroid cancer after surgery, Lutetium-177 targets cancer cells to maximize their exposure to radiation and kill them.
- Non-Hodgkin Lymphoma: Non-Hodgkin lymphoma is a type of cancer that affects the lymphatic system. The lymphatic system is a network found throughout the body. Non-Hodgkin lymphoma can progress slowly or aggressively spread throughout the lymphatic system. Targeted therapy is one of the main options for treating especially rapidly progressing Non-Hodgkin lymphoma. Lutetium-177 therapy can increase the chances of success in treatment-resistant cases.
The use of Lutetium-177 during cancer treatment aims to kill cancer cells, prevent disease progression, and minimize possible complications of the disease. You can also schedule an appointment with a specialist doctor to get detailed information about the treatment.
What are the Benefits of Lutetium Therapy?
Molecules bound to the lutetium element are actively used in the treatment process of various cancers, especially prostate and neuroendocrine cancers. The benefits of lutetium therapy can be listed as follows:
- Possibility of targeted therapy: Various treatment methods in cancer treatment directly target cancer cells. Lutetium-177 therapy is also a treatment method that directly targets cancer cells. Lutetium-177 is a radioactive element. The radiation released from molecules specific to cancer cells bound to Lutetium-177 directly damages cancer cells. This way, while cancer cells are harmed, healthy cells can be protected from damage.
- May help prevent the spread of cancer: One of the main reasons for unsuccessful treatment outcomes in cancers such as prostate cancer is the rapid spread of cancer to other tissues and organs. Lutetium-177 therapy can prevent the spread of cancer by directly targeting cancer cells.
- Can reduce the risk of treatment-related complications: Traditional cancer treatments such as radiotherapy and chemotherapy can cause damage to healthy cells alongside cancer cells. As a result, symptoms such as fatigue and loss of appetite may occur. Targeting the cancer cell directly in Lutetium-177 therapy can help minimize the risk of complications.
- Can increase the chances of treatment success: Lutetium-177 therapy can be used alone or in combination with other treatment methods such as chemotherapy and hormone therapy to further increase the chances of treatment success.
In addition to the benefits listed above, symptoms such as fatigue, nausea, and dry mouth may also occur after lutetium therapy, as with other cancer treatments. Therefore, specialists carefully evaluate factors such as the patient’s overall health status and the stage of cancer before using lutetium therapy and plan a suitable treatment process for them. You can also schedule an appointment with a specialist doctor to get information about lutetium therapy, which has been actively used in cancer treatment in recent years.
How is Lutetium Therapy Applied?
Lutetium therapy is a radionuclide method that has been widely used in the treatment of certain types of cancer, especially neuroendocrine tumors and prostate cancer, in recent years. Patients who present to healthcare institutions with suspected cancer are first examined in detail by a specialized oncologist. After the examination by the specialist doctor, some tests may be requested. For example, in cases where prostate cancer is suspected, examining the PSA (a protein secreted by the prostate gland) levels in the blood can assist specialists in cancer diagnosis.
The treatment process begins after evaluating the patient’s overall health status and the stage of cancer. To prepare the treatment plan before therapy, molecules labeled with Ga-68 are injected into the patient’s body via intravenous route. These radioactive substances are transported to tumor areas through the bloodstream and are retained by cancer cells. Then, imaging devices are used to calculate the extent of tumors and the level of retention of the radioactive substance; following this, the correct dose planning for optimum treatment is carried out. On the treatment day, a drug containing Lutetium-177 bound molecules is injected into the patient via intravenous route, and the radiation targeting cancer cells destroys these cells. The patient’s condition is regularly monitored after treatment, and if necessary, a new treatment plan is prepared. Lutetium therapy can be used alone in cancer treatment or as a supportive treatment in other cancer therapies such as chemotherapy. Generally, hospitalization is not required after treatment, but for the evaluation of possible effects, our patients may be kept overnight.
Frequently Asked Questions About Lutetium
With the developments in health technology, innovative approaches to the diagnosis and treatment of cancer are coming to the forefront every day. Lutetium, which directly targets cancer cells, is one of the innovative approaches used in the diagnosis and treatment of cancer today. Some frequently asked questions about lutetium are addressed below.
In Which Department is Lutetium Therapy Performed?
Lutetium therapy is performed by specialized nuclear medicine physicians in the nuclear medicine department of healthcare institutions.
Does Lutetium Therapy Have Side Effects?
As with other cancer treatments, fatigue, nausea, dry mouth, dry eyes, anemia, and kidney failure are some rare symptoms and side effects that may occur during lutetium therapy.
Is Lutetium Risky?
Lutetium therapy is generally a treatment procedure with fewer side effects compared to other cancer treatments. However, during the treatment process, a slight decrease in patients’ blood values may be observed. This situation is usually temporary. Physicians planning the treatment dose individually can help reduce risks.
How Many Cycles of Lutetium Therapy are Applied?
The number of lutetium therapy cycles varies from patient to patient, but it is generally completed in 6 sessions.
How Long Does Lutetium Therapy Last?
The injection of the drug during lutetium therapy takes about 30 minutes. After the drug is administered, the patient is kept under observation for 1-2 hours, and then generally on the same day, sometimes for the evaluation of possible effects, our patients may be kept overnight.
Is Lutetium Therapy Used Only in Prostate Cancer Patients?
Lutetium therapy can be used not only for prostate cancer but also for various cancers that contain suitable molecules in high amounts, such as neuroendocrine tumors, medullary thyroid carcinoma, paraganglioma, Non-Hodgkin lymphoma, or breast cancer.
Cancer is one of the health issues that can be treated with early diagnosis today. Routine check-ups can often help detect and treat cancer in its early stages. Do not neglect to schedule an appointment with a specialized physician and have your regular check-ups.
