I understand how overwhelming it can be to learn that you or a loved one has prostate cancer. Especially when the cancer has spread (metastatic) to other parts of the body and is not responding well to standard treatments, the fear and anxiety are even greater. But don't worry. With the advancement of medical science, there are now specific, highly targeted treatments for these types of cases. Today we are going to talk about one of the newest and most important treatments. That is PSMA-Targeted Therapy.
What is this PSMA targeted therapy?
Simply put, this is a highly advanced treatment that targets and destroys only cancer cells.
Imagine that prostate cancer cells have a special 'antenna' on the outside that can recognize them. This antenna is what we call PSMA , or Prostate-specific membrane antigen, in medicine. This is a protein that is found in large quantities on the surface of prostate cancer cells.
In this treatment, we use something that works like a 'missile'. This 'missile' can find the PSMA antenna on the cancer cells and stick to it. This missile doesn't just go away, it takes a radioactive tracer with it. To be precise, it's a substance called Lutetium-177 . So when this missile sticks to the cancer cell, that radioactive substance targets and destroys only the cancer cell.
The biggest advantage of this treatment is that it goes directly to the cancer cells, so the damage to other healthy cells in the body is minimal.
In what cases is this treatment given?
PSMA therapy is typically used for advanced prostate cancer , specifically:
- When it does not respond to primary treatments such as surgery or radiation.
- When the cancer has spread to other parts of the body, for example, the bones (metastatic prostate cancer).
- Your doctor may recommend this treatment when other treatments, such as hormone therapy or chemotherapy, can no longer control the cancer.
Does PSMA treatment completely cure cancer?
This is something we all need to clearly understand. PSMA therapy is not a cure for cancer. The main goals are:
- Reducing the size of tumors.
- Controlling the rate of cancer growth.
- Reducing symptoms such as pain caused by cancer.
- Extending the patient's life span and improving the quality of life.
A 'cure' means that the cancer will never come back. However, after this treatment, the patient can be given a period of time when there are no symptoms and the cancer is not active, called a remission period .
What should I do before treatment?
Before starting this treatment, your doctor will examine you carefully. It is important to inform him about your complete medical history, previous treatments, and current medications. Also, this is a good time to ask any questions you may have.
In addition, the following tests need to be performed.
| Test | Simply put... |
|---|---|
| Blood Tests | To get an idea of the overall health of the body and the activity of the cancer. |
| CT Scan | Provides a three-dimensional (3D) picture of the soft tissues and bones inside the body. |
| MRI Scan | It uses magnets and radio waves to take very clear pictures of soft tissues. |
| PSMA PET Scan | This is very important. Here, a radioactive substance similar to the treatment is injected into the body and the exact location of the cancer cells is mapped. |
By combining all of these tests, doctors determine where the cancer cells are in your body and how suitable this treatment is for you.
How is the treatment done? How long does it take?
This is not a major surgery. Usually, a small cannula is placed in a vein in your arm, and the medicine is injected into your body through it. This takes a few minutes. You may also be given medication to prevent things like nausea.
After the treatment, you will be under medical supervision for a few hours and then you can go home the same day . This means you won't need to stay in the hospital.
Typically, 6 treatments are given at 6-week intervals. This means that the total treatment period is about 8 months. During each treatment period, blood tests are performed to assess your body's response to the treatment and any side effects.
What are the possible side effects?
As with any cancer treatment, there are some side effects that can occur. However, these are usually temporary. The most common side effects are:
- Dry mouth and eyes: This is somewhat common because the salivary glands also contain small amounts of the PSMA protein.
- Fatigue: Feeling tired in the body.
- Nausea and vomiting: Medication is given to control this.
- Loss of appetite
- Decreased blood cell count: The levels of hemoglobin and platelets in the blood, in particular, may temporarily decrease.
These side effects can vary from person to person, so it is important to inform your doctor about any discomfort you experience.
What can you do to get relief during treatment?
Cancer treatment can be a challenging time, both physically and mentally. There are a few things you can do to make this time a little easier.
Rest well.
Rest when your body feels tired. Try to get a good night's sleep. Avoid caffeine and alcohol before bed. Journaling or meditating can help you relax.
Do light exercise when you feel well.
If you are not tired, engaging in light exercise, such as walking, can be a good way to refresh your body and mind. However, you should always consult your doctor before starting any exercise program .
Eat a balanced diet.
Things like nausea and loss of appetite can reduce your appetite. But it's important to get the nutrition your body needs. Include lean proteins, vegetables, fruits, whole grains, and low-fat dairy in your diet. You can get advice from your doctor or a dietitian about this.
Get the psychological support you need.
You don't have to go through this journey alone. Talking about your feelings, fears, and anxieties with a trusted friend or family member can be a great relief.
Also, ask your doctor about counseling services or support groups for these types of patients. Talking to people who have had similar experiences can be a great source of strength.
Take-Home Message
- PSMA-targeted therapy is a specific treatment used for advanced prostate cancer that has spread to other parts of the body.
- Although this is not a treatment that completely cures cancer, it is very helpful in controlling the cancer, reducing symptoms, and improving the quality of life.
- This targets only cancer cells, so damage to healthy cells is minimal.
- Side effects such as dry mouth and fatigue may occur, but they can usually be controlled.
- It is very important to work closely with your doctor throughout the treatment period and inform him of any discomfort you experience.
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