Prostate Cancer Treatment with Lutetium-177 PSMA (program ID: 355871)
University Hospital of Ludwig Maximilian University of Munich
Peter BartensteinSpecialized in: nuclear medicine
Department of Nuclear Medicine
The program includes:
- Initial presentation in the clinic
- history taking
- general clinical examination
- laboratory tests:
- complete blood count
- biochemical analysis of blood
- TSH-basal, fT3, fT4
- PSA blood test
- tests for urogenital infections
- indicators of inflammation
- indicators of blood coagulation
- ultrasound scan of the urogenital system
- renal scintigraphy
- PSMA PET-CT (if indicated)
- PSMA treatment
- full body scintigraphy after 24 hours
- full body scintigraphy after 48 hours
- symptomatic treatment
- cost of essential medicines
- nursing services
- elaboration of further recommendations
- stay in the hospital with full board
- accommodation in a room with 2 beds
How program is carried out
During the first visit, the doctor will carry out a general physical examination and go through the results of your previous laboratory and instrumental tests. After that, you will undergo any necessary additional tests, such as an assessment of your liver and kidney function, a scintigraphy of your skeleton and salivary glands, a PSMA PET/CT. This will allow the doctor to assess how effective PSMA therapy with Lutetium-177 will be for you, and how well you will tolerate it. The doctor will also calculate your individual dosage of the radionuclide.
PSMA therapy with Lutetium-177 is carried out via intravenous administration of a solution containing the radioactive isotope, Lutetium-177. The solution is injected through a catheter. This is a short procedure, as the infusion usually takes no more than 20 minutes.
During the procedure, you will need to apply cooling bags to your salivary glands, as Lutetium-177 partially accumulates in the salivary glands, affecting their function and causing a dry mouth. You will also receive intravenous saline solutions to protect your kidneys.
After the infusion of Lutetium-177, you will stay in a specially equipped (radiation-shielded) ward for 48 hours. The drug is quickly excreted by the kidneys, and after 48 hours you will no longer be dangerous to others. During these 48 hours, you can read, use a mobile phone, tablet or computer – none of these devices will be a source of radiation in the future.
Follow-up examinations include either a whole-body scintigraphy or a computed tomography in 24 hours, and then again 48 hours after the procedure. Based on the results of this examination, the doctor will determine whether one procedure is enough for you, or whether you will need to visit the hospital again. As a rule, 1-2 procedures are required for achieving a stable, positive result. Procedures are carried out with an interval of 8 weeks.
- Medical records
- MRI/CT scan (not older than 3 months)
- Biopsy results (if available)
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About the department
The Department of Nuclear Medicine at the University Hospital of the Ludwig Maximilian University of Munich, offers a full range of diagnostic and therapeutic services in modern nuclear medicine, for both outpatients and inpatients. Their focus is on the detection and treatment of oncological, neurological, and cardiac diseases. The department is the largest institution of this kind in Germany. The international recognition is approved by ISO 9001: 2015 certification. The Chief Physician of the department is Prof. Dr. med. Peter Bartenstein.
The department specializes in diagnostic and therapeutic procedures in oncology (for example, the detection and treatment of malignant diseases, diagnostics of sentinel lymph nodes, pain therapy in bone metastases), neurology (for example, diagnostics and therapy of brain diseases, Parkinson’s disease, Alzheimer's disease), and cardiology (for example, the assessment of the state of cardiac vessels and heart attack diagnostics).
Since August 2013, the department has had a new center for the production of radiopharmaceuticals, which is equipped with a cyclotron and allows for the production of radioactive drugs in compliance with the GMP standard, according to the current requirements for radiation protection and drug prescription. Therefore, the department receives the necessary diagnostic markers and radiopharmaceuticals for the individualized treatment of patients in a shorter time. They are distinguished by higher quality and improved safety. Thus, the doctors provide patients with the best possible treatment.
The diagnostic options of the department include:
- Conventional radioisotope diagnostics (scintigraphy)
- Detection of the hemorrhage source
- Scintigraphy for the detection of inflammatory processes
- Brain scintigraphy
- Testicular scintigraphy
- Bone marrow scintigraphy
- Liver scintigraphy
- Positron emission tomography (PET)
- PET/CT within the oncological diagnostics
- PET in neurological / neuro-oncological diagnostics
- PET and PET/CT for other diagnostic issues (for example, in the field of cardiology, etc.)
- Other diagnostic options
Radiopharmaceuticals are successfully used for therapeutic purposes. Along with the treatment of benign and malignant thyroid diseases, the Department of Nuclear Medicine provides pain therapy in skeletal metastases, joint therapy (radiosynoviorthesis, for example, in rheumatic diseases), and neuroendocrine tumor treatment, in particular, SIRT in liver metastases. At the same time, these treatment programs are often developed in collaboration with doctors from other medical specialties (oncologists, endocrinologists, gynecologists, surgeons, orthopedists), for example, within the framework of the Comprehensive Cancer Center (CCC) or Breast Center.
The spectrum of radioisotope therapy:
- Treatment of benign and malignant thyroid diseases
- Radioiodine therapy
- Treatment of malignant prostate diseases
- Lu-177-PSMA-DKFZ-617 therapy
- Ra-223 therapy in bone metastases
- Treatment of neuroendocrine tumors
- Radiopeptide therapy
- MIBG therapy
- Selective internal radiation therapy (SIRT)
- Treatment of skeletal metastases
- Radiosynoviorthesis (RSO)
- Other treatment methods
Higher Education and Professional Career
- 1978 - 1984 Medical Studies, Universities of Bochum and Bonn.
- 1981 - 1984 Research work in the Department of Hematology and Oncology, University Hospital Bonn.
- 1984 - 1985 Clinical Internship in the Departments of Radiology, Internal Medicine and Surgery at the District Hospital Waldbröl.
- 1985 State Medical Examination, graded "very good".
- 1985 - 1986 Military Service as a Medical Officer in Andernach.
- 1985 Doctorate, University of Bonn, magna cum laude.
- 1986 - 1990 Assistant Physician in the Department of Nuclear Medicine, University Hospital Muenster.
- 1990 Board certification in Nuclear Medicine.
- 1990 - 1991 Research Fellowship, German Research Foundation), PET Group of the Medical Research Council, Hammersmith Hospital London.
- 1991 - 1994 Senior Physician in the Department of Nuclear Medicine, University of Muenster.
- 1994 Habilitation.
- 1994 - 1999 Senior Physician in the Department of Nuclear Medicine, University Hospital Rechts der Isar Munich, and Head of the Group on Neuroimaging.
- 1999 - 2006 Chairman of the Department of Nuclear Medicine, Johannes Gutenberg University Mainz.
- 2002 - 2006 Head of the University Neuroscience Center.
- Since 2006 Head Physician of the Department of Nuclear Medicine at the University Hospital of Ludwig Maximilian University of Munich.
Photo of the doctor: (c) LMU Klinikum
Accommodation in hospital
- Program [Description]
Prostate Cancer Treatment with Lutetium-177 PSMA
- Hospital: University Hospital of Ludwig Maximilian University of Munich
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