Radioisotope therapy for advanced prostate cancer
What is radioisotope therapy?
You may have a radioisotope if hormonal therapy (ADT) is no longer helping to control prostate cancer in the bones. It may be given after chemotherapy treatment.
This treatment uses a radioactive substance called a radioisotope which is injected into a vein.
Radioisotopes are more easily absorbed by cancer cells than normal cells. This means cancer cells get a higher dose of radiation while normal cells are protected. All areas of bone affected by cancer will be treated. Radioisotope therapy can be helpful when cancer affects many areas of bone.
How radioisotope therapy is given
The radioisotope used is called radium-223 (Xofigo®). You usually have it once every 4 weeks, for 6 treatments. You have radioisotope treatment as an outpatient in the nuclear medicine department of a hospital. You go home on the same day.
Before radioisotope therapy, you have a blood test to make sure your blood cells are at a normal level. This is because radioisotopes can reduce the number of blood cells.
The radiographer gives you the radioisotope as an injection into a vein in the arm. This only takes a few minutes. When they are finished, they cover the area with a small plaster.
After radioisotope therapy
After the injection, you will have some radioisotopes in your stools (poo), urine (pee) and blood. This means you need to do things to protect yourself and others from radiation. You only need to take precautions for 1 week.
When you go to the toilet, your cancer team will advise you to sit down to use the toilet rather than standing or using a urinal. You will be asked to flush the toilet twice with the lid down. You will also need to wear gloves if you need to clean up bodily fluids.
Your cancer team can also talk to you about having sex after treatment. They will advise you about any precautions to take.
It is also important to prevent making someone pregnant after radioisotope therapy and for at least 6 months after treatment finishes. Your cancer team will advise you about what types of contraception to use and for how long.
It is usually still safe for you to be in close contact with other people, including children. Your cancer team will explain more.
The cancer team will explain more about protecting others from radiation.
Related pages
Side effects of radioisotope therapy
The side effects of radioisotope therapy are usually mild. You may have some diarrhoea or feel slightly sick. Your doctor can give you drugs to control these effects if needed. It can also make you feel tired for a while. Sometimes it can cause a flare (worsening) in symptoms such as pain, but this usually improves quite quickly.
The treatment can sometimes reduce the number of blood cells for a short time. This is not usually a problem. But if you notice any unusual bruising or bleeding, contact the hospital straight away on the 24-hour number you have been given.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our prostate cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Prostate cancer: diagnosis and management. NICE guideline [NG131] Published: 09 May 2019 Last updated: 15 December 2021 (accessed October 2024) https://www.nice.org.uk/guidance/ng131
Parker, C. et al. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, Volume 31, Issue 9, 1119–1134 (accessed October 2024) https://www.annalsofoncology.org/article/S0923-7534(20)39898-7/fulltext#articleInformation
Reviewer
Consultant Medical Oncologist & Honorary Associate Professor
University College Hospitals, London
Date reviewed
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