The therapy is usually well-tolerated and induces relati-vely few side-effects. This type of therapy is performed in close consultation with a urologist and is usually repeated up to 3 times every 8 weeks to achieve op-timal effects.
Therapy of bone metastases:Bone metastases of prostate cancer can be targeted by means of bone-specific radionuclide therapies. This includes well-established Quadramet®-thera-py (Samarium-153-EDTMP), providing reduction of pain associated with bone metastases. Additionally, we also offer the recently introduced Xofigo® (Radi-um-223) therapy, which in addition to pain relief has been reported to increase survival. Xofigo®-therapy represents a valuable treatment option, particularly if chemotherapy is no longer successful/indicated or not well-tolerated.
Prostate CancerNovel options for
diagnosis and therapy
Information provided by the Department of Nuclear Medicine
(Director: Prof. Dr. Alexander Drzezga)
Consultation and Registration:All procedures are carried out in coordination with your urologist. To inform yourself about the new avai-lable procedures, we are also offering prostate-specific outpatient consultation in our clinic. Private insurance, Therapy with Lu-177-PSMA, Xofigo®, Quadramet® Prof. Dr. Alexander Drzezga (Director) Phone: +49 221 478-5024E-Mail: [email protected] General insurance Phone: +49 221 478-7570E-Mail: [email protected]: PSMA PET-CT, bone scan, etc.Phone: +49 221 478-4058E-Mail: [email protected]: http://nuklearmedizin.uk-koeln.de
Where to find us:Uniklinik Köln (University Hospital of Cologne), Gebäude 60, (Building 60), Klinik und Poliklinik für Nuklearmedizin, (Dept. of Nuclear Medicine), Kerpener Straße 62, 50937 Köln (Cologne), Germany
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Fig.4. [177Lu]Lutetium-PSMA Therapy Left side: ahead of therapy; Right side: following onset of therapy
Entwurf
Dear patients,
Today prostate cancer represents the most frequent malignant disorder in Males.
For successful therapy, early detection and precise localisation of the tumour, of its recurrence and of potential metastases are crucial. In this context, novel procedures in Nuclear Medicine have demonstrated very high potential.
In addition, new therapy options have recently been introduced in our field, combining high efficacy with little side effects. These innovative procedures repre-sent a major focus of our work and we would like to introduce them to you in this leaflet. Thank you very much for your interest.
Sincerely,
Prof. Dr. med. Alexander DrzezgaDirector, Department of Nuclear Medicine
DIAGNOSTICS
PSMA-PET/CT: PSMA PET/CT represents a novel, highly sensitive ima-ging procedure for the diagnosis of prostate cancer. Cells of the prostate carcinoma express a specific mo-lecule on their surface, the so-called prostate-specific membrane antigen (PSMA). This target can be detec-ted in smallest traces using sensitive PET/CT imaging (Positron Emission Tomography) in combination with newly developed radiotracers (slightly radioactive mar-ker compounds) such as [68Ga]PSMA or [18F]PSMA (see fig.’s 2-4). PSMA PET/CT has demonstrated very high potential, especially in detecting a recurrence, e.g. if PSA-values start rising again following surgery or radiation therapy. Even for PSA-values below 1 ng/ml, high sensitivity has been documented.
Further indications include biopsy planning or sta-ging in unclear cases. In our clinic, we have gained experience with these imaging techniques since 2013. The examination is carried out on a state-of-the-art PET/CT-scanner providing highest diagnostic quality at low radiation exposure, whilst ensuring high patient comfort (see fig. 1).
THERAPY
Lutetium-177-PSMA-therapyThe prostate-specific antigen can not only be used for diagnosis of prostate cancer (see PSMA PET/CT), but also for therapy of metastasized prostate cancer (as an individual therapy attempt). For this purpose, the PSMA-binding molecule is charged with a therapeuti-cally active radionuclide with low range (Lutetium-177) and injected via a peripheral vein. The labelled subs-tance finds its way specifically to prostate cancer cells and thus applies a therapeutically active dose to the tumour cells, whilst sparing healthy tissue (see fig. 4).
The [177Lu]PSMA-therapy is carried out as an in-pa-tient treatment, usually in 3-4 days. The procedure is particularly well-suited when other forms of thera-pies have already been exhausted and if metastases are present in other organs than the bone.
Fig. 3. Small lymph node metastases (left image); very small bone metastasis (right image)
Fig. 2. Local recurrence of prostate cancer
Fig. 1. State-of-the-art PET/CT–scanner
lymph nodes bone lesion
ventral dorsal
Entwurf