Radioisotope therapy for secondary bone cancer

Radioisotope therapy is the use of radioactive substances to treat cancer. Radioisotopes can be given as a drink or capsule, or injected into a vein. Radioisotope treatment can be used if several bones are affected.

Cancer cells absorb radioisotopes more than normal cells. This means they get a higher dose of radiation and die.

There are different types of radioisotopes:

  • radium-223
  • strontium-89
  • samarium-153
  • iodine-131

Radioisotopes treatment may reduce the number of normal red blood cells. Having a low number of red blood cells is called anaemia, and this can make you feel tired and breathless. The treatment may also reduce your level of white blood cells. This means you are more likely to get an infection.

Another possible side effect is a swelling around the tumour area in the days following treatment. This is called tumour flare. It can cause you to temporarily feel more pain.

What is radioisotope therapy?

Radioisotopes are radioactive substances given by mouth as a drink or capsules, or injected into a vein. Cancer cells absorb radioisotopes more than normal cells and so get a higher dose of radiation. This causes the cancer cells to die.

The advantage of radioisotope treatment is that all the bones affected by cancer will be treated. So it can be a helpful treatment if several of your bones are affected.

There are different types of radioisotopes. The type you have will depend on the type of primary cancer you have.


Types of radioisotopes

Radium-223 (Xofigo®)

You may have radium-223 to treat secondaries in the bone from prostate cancer that is no longer responding to hormone therapy.

It is given as an injection through a small tube (cannula) which is put into a vein in your arm or hand. You will normally have the injection as an outpatient and be able to go home afterwards.

You will normally have an injection every 4 weeks up to 6 times.

Your pain may get worse for a few days after your treatment. Your doctor can prescribe extra painkillers if you need them. The pain usually improves over the following few weeks.

Your urine and blood will be very slightly radioactive for about seven days and you will be given advice to follow to reduce any risk to others.

Radium-223 is not available in all parts of the UK. If you live in England it is available through the Cancer Drugs Fund. If you live in Scotland, Wales or Northern Ireland you can find out from your specialist if it is available.

Strontium-89 and Samarium-153

You may have strontium-89 to treat secondaries in the bone. It is given as an injection through a small tube (cannula) which is put into a vein in your arm or hand. You will normally have the injection as an outpatient and be able to go home afterwards.

Samarium-153 may also be used to treat secondaries in the bone.

Your doctor or specialist nurse will give you more information about these treatments if they are suitable for you.

Iodine-131

You may have iodine-131 to treat secondaries in the bone from thyroid cancer. You will be given the radioactive iodine as a capsule or occasionally as a drink.

The radioactivity in iodine-131 breaks down slowly so you’ll need to stay in hospital in a single room for a few days. You can go home once the radioactivity reduces to a level that’s safe for other people around you.

We have more information about iodine-131.


Side effects of radioisotope treatment

Radioisotopes such as strontium-89 or radium-223 can temporarily reduce the number of normal red and white blood cells produced by the bone marrow.

If the number of your red blood cells is low (anaemia), you may feel tired and breathless. You may be given a blood transfusion if they are very low. When your number of white blood cells is low, you’re more prone to infection. If you develop an infection, you’ll be given antibiotics.

Another side effect can be tumour flare, which is a swelling around the tumour area in the days following treatment. This can cause a temporary increase in pain and tenderness, and you may need to take painkillers for a few days.

We have more information about the possible side effects of radiotherapy and how to cope with its side effects.

Back to Radiotherapy explained

Stereotactic ablative radiotherapy (SABR)

Stereotactic ablative radiotherapy (SABR) is a treatment that uses scans and specialist equipment to precisely target certain cancers. It is usually only suitable for smaller cancers.

Who might I meet?

You will meet many different specialists before, during and after radiotherapy treatment.

Possible side effects

There are things you can do to help manage the possible side effects of radiotherapy treatment.