What is Lu PSMA (Lutetium-Prostate Specific Membrane Antigen) Therapy?

Lu177 PSMA Therapy is a treatment for patients with prostate cancer, especially those who have become refractory to conventional therapy. Lutetium PSMA therapy helps to slow down the growth of the cancer cells, reduce the size of the tumours and most importantly improve the quality of life of the patients by reducing the pain caused by the cancer.

Many prostate cancers, in particular those that have spread or become resistant to hormonal therapies, express a unique receptor on their cell surface called Prostate Specific Membrane Antigen (PSMA). When Prostate Cancer metastasizes i.e. spreads to other parts of the body, the PSMA receptor is expressed over the sites of metastases as well.

How does Lu PSMA Therapy Work?

Lutetium-177 is a radioactive substance that emits beta radiation, a destructive kind of radiation. Lutetium-177 is bound to a small peptide which attaches to the PSMA receptor expressed on the cancer cell surface. The Lutetium 177 – PSMA complex, thus attached to the prostate cancer cell, then emits killing radiation causing cell death of the cancer cell. Since the penetration of the emitted beta particle is very small, the surrounding normal cells are spared.

How is the Therapy Done?

Lu177 PSMA is administered intravenously. The patient is admitted to the hospital for 24 hours. A kidney function scan called a MAG3/EC scan is done prior to the administration of the Lu177 PSMA.

What are the Side Effects of Lu PSMA Therapy?

Lu177 PSMA is well tolerated. The most common side effects are a slightly dry mouth, fatigue and nausea. There may also be a slight fall in the white blood cells and platelets about 2 – 3 weeks after the Lu177 PSMA administration.

What is the Response Rate With Lu PSMA Therapy?

The response rates of Lu177 PSMA depend on the tumour biology of prostate cancer, the initial Gleason Score, the extent of disease and the responses to prior therapies. Typically, more than 70% of patients demonstrate a reduction in S. PSA and a shrinkage of tumours following Lu177 PSMA therapy.

When would the doctor consider using this Therapy?

Lu PSMA Therapy is a very specific therapy and is used for managing metastatic Prostate Cancer or when Prostate Cancer is no longer responsive to other types of treatment.

What are the Treatment Schedules with Lu PSMA Therapy?

Most patients undergo three-four treatment cycles at intervals of 8-12 weeks. The number of cycles and the interim duration may vary between individuals depending on the response and interim assessments.

Why should I choose the nuclear medicine therapy center at Fortis Memorial & Research Institute (FMRI), Gurugram (Haryana, India)?

The Nuclear Medicine Therapy Centre at FMRI was one of the first institutes to offer Radio-ligand Therapy with Lu PSMA, and today, the center receives patients from the country and from across the world.

My Experience Getting Lu177 PSMA Therapy In India at FMRI Gurugram

Summary (10 sec read)

A prostate cancer patient from the USA recounts his experience with Lu177 PSMA Therapy at Fortis Memorial Research Institute (FMRI) in Gurugram, India. He arrived on a weekend for a Monday morning treatment, aiming to avoid the usual patient rush. After a temperature check and receiving a hospital ID bracelet, he met Dr. Ishita B Sen, who explained the treatment plan and introduced him to her team. The patient changed into scrubs and underwent a PET scan after receiving an imaging injection of Gallium, with hydration provided throughout.
The Lu177 injection caused minimal discomfort, and the patient was kept hydrated with IV fluids. He relaxed for a couple of hours post-injection while his wife handled paperwork and interacted with the medical staff. After dosimetry scans, he stayed overnight in the hospital and was discharged the following morning.
The first dose of therapy cost approximately 5,500 USD, covering airfare, hotel, and other expenses. The total cost for the complete treatment, including three doses, is estimated to be between 28,000-38,000 USD, depending on travel and accommodation choices. The patient found the experience positive and encourages others seeking information to contact Mr. Manav Sadhwani at manav@nuclearmedicinetherapy.in for further details.

I am a Prostate Cancer patient from the USA (name withheld on request). I came to India, specifically to the Department of Nuclear Medicine & Molecular Imaging at Fortis Memorial Research Institute (FMRI) in Gurugram, India. I am writing this blog to share my experience of getting the Lu 177 PSMA (Prostate-Specific Membrane Antigen) Therapy.

I arrived in India on a weekend as the treatment was to start early on Monday morning. I was advised to come around 9 AM so that I could avoid the regular rush of patients that generally show up after 10 AM. When I reached the hospital, I was made to go through the mandatory temperature check and I was given a hospital identification bracelet to wear. I followed the signs to the Nuclear Medicine Department and asked for Dr. Ishita B Sen at the help desk. I met Dr. Sen who has a very pleasant appearance and welcoming. She spent some time with me to explain the treatment plan and then she introduced me to her staff of doctors and nurses. Her staff then took me to another room, where I changed into scrubs. They inserted a cannula to prep me for an imaging injection of Gallium for a PET Scan. They asked me to empty my bladder as they would be giving me a lot of fluids so as to keep me hydrated.

After the PET Scan, the team took me to a private room to await the injection of Lu177. I was served a vegetarian lunch which was good enough for my liking.

The next step was the injection of Lu177. I felt a slight stinging sensation

when they injected it, but it wasn’t that uncomfortable and I had no adverse sensations. All the time, I was being given IV fluids to keep me hydrated.

After the Lu177 injection, I was asked to relax for a couple of hours. My wife had accompanied me and while I was relaxing, she was busy interacting with Dr. Sen and her staff and of course, signing many necessary papers. After resting for some time, I was wheelchaired back to the Nuclear Medicine Department for Dosimetry scans. Post the scan, I spent the night in the hospital and was discharged the next morning. This ended my first dose of Lu177 PSMA Therapy for my Prostate Cancer.

I spent about 5,500 USD for my first dose of the therapy and I am told that there would be at least three rounds of therapy. This cost includes the cost of airfare, hotel, and other miscellaneous expenses. I am assuming that the entire treatment, including three doses, would cost somewhere between 28,000-38,000 USD depending on whether I choose to travel business class versus economy and select a hotel suite instead of a normal room.

Overall, the experience was good and I do not have anything to complain about. If anyone needs any additional information or wants to ask anything specific, please reach out to Dr. Sen’s colleague Mr. Manav Sadhwani – manav@nuclearmedicinetherapy.in.