Isotopes for prostate cancer (radium therapy)

The Netherlands Cancer Institute’s Nuclear Medicine department offers patients with metastatic prostate cancer that has spread to the bones palliative treatment with radioactive Radium-223. Radium is mainly absorbed by the bone metastases, allowing the treatment to be delivered directly to the source. The treatment aims to destroy tumor cells which can shrink the metastases, slowing the progression of the illness.

When is radium therapy an option?

Patients with metastatic prostate cancer that has spread to the bones often experience pain when sitting, lying down, or when doing day to day activities. Radium therapy has proven to successfully extend the lifespan and quality of life of patients whose prostate cancer has progressed too far for hormone therapy, with less side effects than other, non-radioactive treatment types.

Radium therapy - how does it work?

Patients receiving radium therapy will be treated at the outpatient clinic of The Netherlands Cancer Institute’s Nuclear Medicine department. You will receive one dose of Radium-223 every 4 weeks for a period of 6 months. The radioactive material is delivered into your bloodstream intravenously into the arm, which will take several minutes. You will be able to go home directly after the treatment. Be mindful of the radium in your body and the radiation it gives off. This will stay inside of your body. You will not need to keep your distance from other people, children, or pregnant women. Radium is expelled by the body through bowel movements and urine. Be mindful of this and take additional hygiene and safety measures.

Your practicing physician and/or nuclear medicine professional will go over the safety measures with you. It shouldn’t be a problem to receive multiple radioactive radium treatments throughout your lifetime.

The treatment

This treatment does not require any preparations at home. You are allowed to eat and drink before your treatment and can take your medication as usual. You do need to be healthy enough to be able to physically withstand the treatment and can only start the therapy after six weeks without chemotherapy or intense radiation treatment on a large part of the body. Targeted radiation therapy on one or more painful bones will not interfere with the treatment. You will be scheduled for 6 radiation treatment sessions with a rest time of 4 weeks between the appointments.

Additional diagnostic tests

We will run several tests in preparation of the treatment. We will confirm bone metastases by making a bone scan (skeletal scintigraphy) prior to your treatment. Before your session, we will take some blood to ensure that your bone marrow functions as it should.

Side effects and complications

Radium therapy has very little side effects compared to other, non-radioactive treatments. Some people experience diarrhea, vomiting, a swelling of the legs, ankles, or feet, or general malaise. These side effects usually do not last long. The pain in your bones may increase for a brief time after treatment.

The treatment may lower your white blood cells, blood count, or hemoglobin. Most people do not notice these effects. Your practicing physician may need to take additional blood to predict the course of the treatment.