What are the adverse effects of PSMA Therapy
Understanding the Impact of PSMA Therapy: Side Effects & Solutions by Dr. Ishita B Sen.
So what are the adverse effects of PSMA therapy whether it is with lutetium or with actinium which is the alpha emitter is generally very well tolerated and most patients do not have any significant adverse effects except for dry mouth now the salivary glands which are the glands in our mouth which make saliva they also physiologically express PSMA and that is why when we do the PSMA therapy the radioisotope is also accumulated by the salivary glands and because these are emitting radiation there is some degree of radiation damage which happens to the salivary gland Now this damage is very less with lutetium is much more with the alpha emitters and that is why dry mouth or xerostomia is one of the most prominent adverse effects of PSMA therapy if a patient has got extensive disease then all the radioisotope is actually absorbed by the disease and there is very little left for the salivary glands and so the dry mouth or the xerostomia happens much less in patients who've got a lot of disease But as the patient's disease starts responding and the volume of disease reduces there is more of the radioisotope available to the salivary glands and this may cause dryness of the mouth or xerostomia and one of the things which we do for this is as the patient starts to respond we start to reduce the dose so this is called de-escalation of the PSMA therapy and this enables us to give us give the patient an optimum dose to the tumor while reducing the xerostomia or the dry mouth Other than this there is practically no adverse effect to PSMA therapy