A new treatment for prostate cancer: PSMA-Targeted Therapy in a nutshell

It is difficult to put into words what it feels like to be diagnosed with prostate cancer. Also, the cancer cannot be controlled with standard treatments, and it is even more devastating to know that it has spread to other parts of the body. However, with the advancement of medical science, new and successful treatments have now emerged for such difficult cases. One of the newest treatments that brings such hope is PSMA targeted therapy. Let us talk about this very simply today.

What is PSMA-Targeted Therapy?

Simply put, this is a very advanced treatment that targets and destroys only cancer cells. The PSMA in this name stands for Prostate-Specific Membrane Antigen . Although this may sound a bit complicated in words, the way it works is very simple.

Think of prostate cancer cells as an army of enemies. Each of these enemy soldiers has a special insignia, a 'badge', on their uniform. That badge is PSMA. This protein, called PSMA, is present in very large quantities on the surface of prostate cancer cells.

So what you do in this treatment is inject a drug into the body that works like a 'smart missile'. This drug travels throughout the body, finds only cancer cells that have that special 'badge' called PSMA, and attaches itself to them. Then, a radioactive substance (`Lutetium-177`) in the drug destroys only that cancer cell. This is also called `Lu177-PSMA` therapy. Sometimes you will also hear the brand name `Pluvicto™`.

The biggest advantage of this is that it's not like just shooting at everyone, but rather identifying the exact enemy and targeting them, so the damage to healthy, good cells in our body is very minimal.

What is the prostate gland?

While we're at it, let's talk a little about the prostate gland. This is only found in men. This gland is located below the bladder, in front of the anus. It's usually about the size of a large walnut.

In what cases is this treatment used?

This is not a treatment for all prostate cancer patients. It is usually recommended for more advanced cases, meaning the cancer has spread far beyond the prostate gland (metastatic prostate cancer) . This means that the cancer has spread to other parts of the body, such as the bones or lymph nodes.

Also, doctors consider this treatment when the cancer is no longer controlled by conventional treatments such as surgery, radiation, and hormone therapy.

Can this treatment completely cure cancer?

This is a very important question. To be honest, no. PSMA-targeted therapy is not a cure for cancer.

So what happens with this? The main goals of this treatment are:

• Shrinking or making tumors smaller.
• Slowing the rate of further cancer growth.
• Reducing symptoms such as pain caused by cancer.
• Extending the patient's life span and improving the quality of life.

Simply put, it helps fight cancer and keep it under control. After this treatment, you may have a period of ``remission`` when you have no symptoms of cancer and the disease is not active. However, it is essential to continue to follow-up with your doctor.

What happens before treatment starts?

Usually, before undergoing this treatment, you may have already received other treatments, such as chemotherapy or hormone therapy. Your doctor will only discuss this option with you if these have not had the desired results.

Before starting treatment, your doctor will examine you thoroughly. You should discuss your complete medical history, previous treatments, and current medications with him or her. This is a good time to ask any questions you may have.

In addition, several blood tests and special scans are ordered. These scans are used to find out exactly where the cancer cells are in the body.

By combining all of these scans, doctors create a complete map of how the cancer has spread throughout your body.

What happens during treatment?

Giving this treatment is not as complicated as you might think.

• Usually, a small cannula is inserted into a vein in your arm, and the medicine is given into your body through it, like a saline solution.
• This injection contains the radioactive substance ``Lutetium-177'' that we talked about.
• The vaccination process only takes a few minutes.
• You may be given medication in advance to control things like nausea and vomiting.
• This is an outpatient procedure . This means you don't need to stay in the hospital. You will be monitored for a few hours after the treatment and then you can go home when your condition is stable.

How long does this treatment take?

This treatment is usually scheduled every six weeks . Six such treatment cycles must be completed. This means that the total treatment period is approximately 8 months (36 weeks).

After one treatment cycle and before the next, your doctor will do blood tests to see how your body is responding to the treatment and to monitor for side effects.

What are the benefits of this treatment?

The main advantage of this treatment is that it can control advanced prostate cancer that is unresponsive to other treatments, reduce symptoms, and slow the spread of the disease.

Are there any side effects? What are the risks?

As with any cancer treatment, there are some side effects that can occur. However, not everyone experiences them in the same way. Some people may experience them less frequently.

Don't worry about these side effects. Most of them can be controlled. It's important to talk to your doctor about any discomfort you feel.

Things you can do to make your treatment easier

Living with cancer and undergoing treatment is not easy. These things will help make this time a little easier for you.

Have a good rest.

When you find out you have cancer, the stress of thinking about treatment can make it difficult to sleep. But your body really needs rest. Not only can sleep deprivation affect your mood, it can also make it harder to cope with the stress of treatment.

• Avoid heavy meals, coffee, and alcohol before bed.
• Things like meditation and journaling can help you release your thoughts and relax your mind.
• Rest when your body tells you to, not when you can.

Shake your body a little when you can.

If you're feeling tired, it's a good idea to do some light exercise. Even something like walking can help keep your heart and lungs working properly, strengthen your muscles, help your immune system, and reduce fatigue and stress.

But remember, before starting any exercise, it is very important to consult your doctor.

Eat a balanced diet.

Nausea and loss of appetite may reduce your appetite, but it is very important to provide the body with the necessary nutrition during this time.

• Low-fat proteins (fish, chicken)
• Vegetables and fruits
• Whole grains
• Low-fat dairy foods

Add things like these to your diet. Talk to your doctor about this. He or she can refer you to an oncology-certified dietitian.

Get the support you need.

You are not alone in this journey. Talking about your fears, sadness, and worries with a family member or close friend can be a great source of comfort. You can also ask your doctor about support groups where others who have had similar experiences can go, or about a mental health counselor.

Is this treatment available in Sri Lanka?

PSMA-targeted therapy is a treatment method that has been approved and accepted by international institutions such as the FDA in the United States. In Sri Lanka, major hospitals that treat cancer also have the ability to receive such advanced treatment methods.

However, the best and only way to get the most accurate and clear information about whether this is right for you, where you can get this treatment in Sri Lanka, and how much it costs is to speak directly with your oncologist. He or she will study your condition thoroughly and guide you on the most appropriate treatment for you.