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. These may be given as a drink, capsules, or as an injection 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 hormonal therapy. It can help improve symptoms and may help you to live longer.

You have it as an injection through a small tube (cannula) which is put into a vein in your arm or hand. You usually have the injection every four weeks, up to six times. You will normally have the injection as an outpatient and be able to go home afterwards.

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.

Strontium-89 and Samarium-153

You may occasionally have strontium-89 to treat secondaries in the bone from prostate cancer and breast cancer. You have it 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 will 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 is safe for other people around you.

Learn more about iodine-131.


Side effects of radioisotope treatment

Radioisotopes such as radium-223 or strontium-89 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 are more prone to infection. If you develop an infection you will be given antibiotics.

Another side effect can be tumour flare which is 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 radiotherapy.

Back to Radiotherapy

What is radiotherapy?

Radiotherapy uses high-energy rays to destroy cancer cells. This treatment aims to treat cancer or relieve symptoms.

Who might I meet?

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