When prostate cancer progresses to a metastatic stage despite standard treatments such as hormone therapy and chemotherapy, it is natural to look for options that offer hope, effectiveness, and quality of life. Radioligand therapy, such as Lutetium-177-PSMA, is one of these innovative options.
In this article, you will learn about:
- The essential role of PSMA PET imaging;
- How the treatment is administered;
- Possible side effects;
- Precautions to follow at home.
Medical review by uro-oncologist Dr. Nawar Hanna, December 2025
PSMA PET imaging to assess eligibility
Before considering radioligand therapy, your medical team must ensure that this treatment is appropriate for you. To do so, they use an advanced imaging tool called a PSMA PET scan (positron emission tomography using a tracer that targets the PSMA protein).
This technique allows physicians to precisely visualize cancer cells that express PSMA, a protein often found in high amounts on the surface of prostate cancer cells.
How does a PSMA PET scan work?
- Tracer injection: A healthcare professional injects a very low-dose radioactive tracer into a vein. The tracer circulates through the body and selectively binds to cells that express PSMA.
- Scanning: After a short waiting period, you undergo a PET scan, similar to a conventional PET scan.
- Results: The highly detailed images show where cancer cells are located and whether they express enough PSMA.
If sufficient PSMA expression is detected, you may be eligible for radioligand therapy.
If not, your care team will evaluate other treatment options suited to your situation.
A targeted therapy administered in a specialized center
If the PSMA PET scan confirms that you are a good candidate for radioligand therapy, you will be referred to a hospital with a nuclear medicine department. There, you will be cared for by a team specifically trained to administer this type of treatment.
What happens on treatment day?
Each session, from injection to observation, lasts approximately 1 to 2 hours.
- You are welcomed into a secure room designed for handling radioactive products;
- Lutetium-177 bound to a PSMA-targeting molecule is administered intravenously;
- Once injected, this “smart missile” delivers radiation directly to cancer cells — both visible lesions and more diffuse cancer cells — damaging them from within.
The usual protocol involves 4 to 6 cycles, with one treatment every 6 weeks.
Possible side effects
Most patients tolerate the treatment well, but some side effects may occur:
- Fatigue
- Anemia
- Nausea and loss of appetite
- Dry mouth
- Low white blood cell or platelet counts
- Diarrhea or constipation / vomiting
Close monitoring allows the medical team to adjust treatment if needed.
Important precautions at home
Because Lutetium-177 leaves a low level of radioactivity in the body for a few days, certain precautions help protect your loved ones:
- Limit prolonged close contact (especially with young children and pregnant women) for 3 to 7 days;
- Use a separate toilet if possible, flushing twice after each use;
- Wash your clothes separately, using hot water;
- Drink plenty of fluids to help eliminate the radioactive substance;
- Sleep alone if you live with a partner, according to the recommendations provided.
These measures may seem intimidating or concerning, but they are temporary and intended to ensure the safety of those around you.
A treatment that offers hope, but not a cure
Radioligand therapy does not cure prostate cancer, but it may:
- Slow disease progression;
- Reduce cancer-related symptoms;
- Improve quality of life;
- Extend survival in some patients when other options have failed.
Although this treatment is not yet widely available across Canada, scientific advances and advocacy efforts suggest a future where it will become more accessible.
At PROCURE, we believe that better understanding leads to better living with the disease. Our professionals are here to support you and answer your questions, seven days a week. Contact us at 1-855-899-2873 or visit our website procure.ca