What is Radionuclide Therapy?
This type of therapy is where a radioactive substance can be added to a carrier cell called DOTA Octreotate. There are two different types of radionuclides that can are usually used:
Once in your body, the Lu-177 DOTA-Octreotate or Y-90 DOTA-Octreotate attaches to specific receptors (called somatostatin-receptor) which are almost most frequently found on neuroendocrine tumours. The radioactive Lu-177 or Y-90 then destroys these cancerous cells. This treatment is known to be effective in gastroenteropancreatic (GEP) neuroendocrine tumours, such as:
- Intestinal carcinoids
- Tumours of the pancreas
This treatment can also be used for other slow growing tumours, such as:
- Bronchial Carcinoids
- Medullary thyroid cancer
- Thymic tumours
The team looking after you at The Wellington Hospital will consist of neuroendocrine doctors and nurse specialists, a nuclear medicine team.
How do I know that this therapy is suitable for me?
An Indium-octreotide scan (Octreoscan) or a special type of PET scan (Gallium-68 Octreotate PET) can be used to determine whether your type of tumour has these receptors or not. If the scan is positive at the sites of the tumour, then peptide receptor radionuclide therapy such as Lu-177 DOTA Octreotate or Y-90 DOTA Octreotate can be used to treat the tumour.
All patients who are considered for this type of treatment would have their case reviewed and discussed by the WELLNET multidisciplinary board who will determine if this is the most appropriate treatment. Our patient will be kept fully informed throughout this process and our nurse specialists are available to discuss any concerns you might have.
What is the difference between Lu-177 and Y-90?
The process for each therapy substance is similar. In general, 4 treatment with Lu-177 DOTA Octreotate iseach 8-12 weeks apart. For Y-90 the standard period of time is 3 treatments each 8-12 weeks apart. The type of therapy you receive is determined by your doctor in conjunction with your scans and medical history. Your doctor will discuss the process fully with you before any further action takes place and our clinical nurse specialists are available if you have any further queries or questions.
The therapy involves a radioactive substance, am I in danger?
There are very low levels of risk from the radioactive tracer. The amount of radiation varies but by utilising the latest technology we are able to keep your radiation exposure as low as possible. The radiation related risks are very small and the risk of missing a serious problem if you don’t have a scan could be much higher.
Once you have been considered suitable for this type of therapy, the WELLNET clinical nurse specialist will provide you with a detailed information book about the treatment process for Lu-177 or Y-90. Please don’t be afraid to ask questions, our nurses are very experienced and happy to help.
It is important that you have a CT or MRI scan within 2-3 months prior to this treatment and the WELLNET team will help arrange a suitable time for this to take place.